Experiences with the development of guidelines. A literature review

Numerous expectations are associated with the development of guidelines. Re ferring to the experiences so far it can be stated that despite the large a mount of guidelines that have been developed, little attention has been giv en to dissemination, implementation and evaluation of guidelines. The devel oped guidelines often do not follow international accepted quality criteria , for example many are not based on scientific evidence or they lack the in volvement of all relevant parties. The main problems occur in the process f rom development to implementation of a guideline. Results from evaluation s tudies nevertheless show that guidelines can have positive effects on the p rocess and outcome of medical care. More scientifically sound evaluation st udies are needed to assess the effects of guidelines. Especially in Germany a lot more needs to be done to improve the quality of guidelines and the a mount of evaluation studies.