This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Hoelzer, S. Articles by Dudeck, J. Search for Related Content PubMed PubMed Citation Articles by Hoelzer, S. Articles by Dudeck, J. Pubmed/NCBI databases Medline Plus Health Information Cancer Social Bookmarking                         What's this?

Evaluating the Implications of Clinical Practice Guidelines for Patient Care

Institute of Medical Informatics, Justus-Liebig-University of Giessen, Giessen, Germany, simon.hoelzeiainformatik.med.uni-giessen.de

Amy M. Fremgen, PhD

Commission on Cancer, American College of Surgeons, Chicago, Ill

Andrew Stewart

Commission on Cancer, American College of Surgeons, Chicago, Ill

Christoph Reiners

Clinic and Policlinic for Nuclear Medicine of the University of Wurzburg, Wurzburg, Germany

Joachim Dudeck, MD

Institute of Medical Informatics, Justus-Liebig-University of Giessen, Giessen, Germany

Patient care evaluation studies have been developed by the Commission on Cancer of the American College of Surgeons. The studies were primarily designed to monitor trends in diagnosis, therapy, and outcome of specific oncologic diseases in hospitals and cancer centers. As they reflect the current standards of patient care, patient care evaluation studies have become valid tools of quality management in medicine. In an international pilot project that began in 1996, this approach was redefined to evaluate the impact of current clinical practice guidelines in oncology. Close cooperation between medical societies in the United States and Germany under the coordination of the Commission on Cancer and the Institute of Medical Informatics at the Justus-Liebig-University of Giessen was established. This infrastructure for data collection, data management, analysis, and interpretation of results allows for the recognition of international differences in patient care. Our results indicate discrepancies between current state-of-the-art patient care represented by clinical practice guidelines and the diagnostic and therapeutic procedures in the clinical routine. Patient care evaluation studies are designed as exploratory, not confirmatory, trials. In contrast with confirmatory trials, their aims may not always lead to predefined hypotheses. They reflect routine practice and are not the basis of the formal proof of efficacy, although they may contribute to the total body of relevant evidence. Without this comprehensive approach to evaluation, the potential of clinical practice guidelines to improve patient care remains unknown.

Key Words: Clinical practice guidelines • exploratory trials • patient care evaluation • quality assurance • thyroid cancer

American Journal of Medical Quality, Vol. 16, No. 1, 9-16 (2001)
DOI: 10.1177/106286060101600103


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?