[Guidelines and scientific research: the basis should be both evidence and a variety of considerations].
In evidence-based medicine, decisions about patient care are based on the results of sound clinical research. Yet, even in evidence-based medicine, science does not directly dictate practice. Making decisions requires setting priorities and making trade-offs. The results of scientific research limit rather than prescribe the available options. When a treatment is known to be ineffective, it cannot be selected for its efficacy. When a treatment has been shown to produce a particular effect, opting for that particular treatment should be based on the desirability of the demonstrated effect and trade-offs between that effect and other effects. Guidelines for clinical practice should reflect the results of clinical research, as well as the priorities that have been set and the trade-offs that have been made.
Bossuyt
P M M
PM
Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Klinische Epidemiologie, Kamer J1b-212, Postbus 22.700, 1100 DE Amsterdam. p.m.bossuyt@amc.uva.nl
D019317:Evidence-Based Medicine; D006801:Humans; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic / Q000592:standards; D012106:Research / Q000592:standards*