Methods underpinning national clinical guidelines for hypertension: describing the evidence shortfall.
BACKGROUND
To be useful, clinical practice guidelines need to be evidence based; otherwise they will not achieve the validity, reliability and credibility required for implementation.


METHODS
This paper compares the methods used in gathering, analysing and linking of evidence to guideline recommendations in ten current hypertension guidelines.


RESULTS
It found several guidelines had failed to implement methods of searching for the relevant literature, critical analysis and linking to recommendations that minimise the risk of bias in the interpretation of research evidence. The more rigorous guidelines showed discrepancies in recommendations and grading that reflected different approaches to the use of evidence in guideline development.


CONCLUSIONS
Clinical practice guidelines as a methodology are clearly still an evolving health care technology.
Campbell
Fiona
F
University of Newcastle upon Tyne, Centre for Health Services Research, Newcastle upon Tyne, NE2 4AA, UK. fiona.campbell@ncl.ac.uk
Dickinson
Heather O
HO
Cook
Julia V F
JV
Beyer
Fiona R
FR
Eccles
Martin
M
Mason
James M
JM
D000465:Algorithms; D000959:Antihypertensive Agents / Q000008:administration & dosage; D004039:Diet, Sodium-Restricted; D019317:Evidence-Based Medicine / Q000379:methods / Q000592:standards*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000178:diet therapy / Q000188:drug therapy / Q000517:prevention & control*; D038622:Internationality; D008019:Life Style; D015201:Meta-Analysis as Topic; D017410:Practice Guidelines as Topic / Q000592:standards*; D011788:Quality of Life; D012196:Review Literature as Topic
D000959:Antihypertensive Agents