Development of clinical practice guidelines: Surgical perspective

Clinical practice guidelines (CPGs) are systematically developed statements to assist practitioner and patient decisions about appropriate health case for specific clinical circumstances. The implications of this definition a re that: the methodologic perspective and operations for systematic develop ment must be specified, a strategy is needed to account for the patient's p erspective in the CPG development process and the clinical decision, and a mechanism is required to determine how appropriateness ought to be conceptu alized and defined. Addressing these issues, we review models of CPG develo pment, outline challenges to evidence-based approaches to CPG development, address unique factors relevant to the development of guidelines for the su rgical community, introduce an Ontario practice guidelines strategy that us es complementary methods of CPG development, and summarize the feedback pro vided by the surgical community regarding the practice guidelines produced in Ontario's cancer system.