Developing clinical practice guidelines for heart failure: Creative process and practice implications

The rapid growth of medical knowledge has created many advances in therapeu tics related to chronic disease. Translation of these advances into everyda y care of patients with chronic disease has proven problematic. Guideline d evelopment offers a principal strategy to improve use of new and existing t herapeutic modalities of proven benefit. To be effective, practice guidelin es must not only deal with which therapies are efficacious but attempt to c onsider the many practical aspects necessary in the actual care of patients . In this way both the art and science of medicine can be employed to obtai n optimal patient outcomes in many chronic diseases that have been associat ed with severe mortality, morbidity, and poor quality of life. The logical process of guideline development and its use in one specific chronic diseas e, heart failure, is examined.