Applicability of textual clinical practice guidelines: impact of physician interpretation.
OBJECTIVE
1) Determine whether textual Clinical Practice Guidelines (CPGs) are interpreted accurately and unequivocally by targeted physicians. 2) Specify audience and perception of the CPGs.


METHODS
Comparative analysis of answers given by a panel of general practitioners to a series of questions and clinical case studies related to three textual CPGs produced and published by the French National Agency for Accreditation and Evaluation in Health (ANAES).


RESULTS
68 to 96% of physicians are aware of the existence of the CPGs studied. Less than 50% state having read them. On average, 38% of physician interpretations of CPGs are incorrect (i.e., not in agreement with expert interpretation). Furthermore, there is disagreement among physicians responses.


CONCLUSIONS
This study credits the argument of disparities in practice which derive from inaccurate and discordant CPGs' interpretations. The results should prompt those responsible for producing such decision-making support to design documents that are better structured, less ambiguous, and more precise. In a model which facilitates their computerisation the expression of CPGs provides a solution that should be included upstream in the publication process.
Dufour
Jean-Charles
JC
Laboratoire d'Enseignement et de Recherche sur le Traitement de l'Information Médicale, Faculté de Médecine, Université de la Méditerranée, Marseille, France.
Giorgi
Roch
R
Harlé
Jean-Robert
JR
Fieschi
Dominique
D
Volot
Françoise
F
Fieschi
Marius
M
D001364:Awareness; D058005:General Practitioners; D006801:Humans; D008962:Models, Theoretical; D017410:Practice Guidelines as Topic