Clinical guidelines: a must for rheumatology?

Clinical guidelines are sets of recommendations, backed by medical evidence , to aid physicians in patient-care decisions. There has been a proliferati on of practice guideline development in all fields of medicine, including r heumatology. This chapter will discuss the need for guidelines in rheumatol ogy, the methodology of guideline development, validation and implementatio n, the various guidelines published in rheumatology, and the role of the rh eumatologist in guideline development. Clinical guidelines can serve to inf orm practitioners of the latest medical evidence and minimize harmful pract ice variation. Guidelines must rely on good evidence to be credible to the medical community, yet there are still many barriers to guideline acceptanc e by practitioners. The theories behind guideline development and validatio n are well described, although not always practised. Guideline disseminatio n and implementation methods are still being explored. It remains unclear h ow best to implement guidelines and convince physicians to accept and incor porate evidence-based recommendations into their practice.