THE RELATION BETWEEN SYSTEMATIC REVIEWS AND PRACTICE GUIDELINES

Clinical practice guidelines have been developed to improve the proces s and outcomes of health care and to optimize resource utilization. By addressing such issues as prevention, diagnosis, and treatment, they can aid in health care decision making at many levels. Several other d ecision aids are cast in the guideline lexicon, regardless of their fo cus, formulation, or format; this can foster misunderstanding of the t erm ''guideline.'' Whether created or adapted locally or nationally, m ost guidelines are an amalgam of clinical experience, expert opinion, and research evidence. Approaches to practice guideline development va ry widely. Given the resources required to identify all relevant prima ry studies, many guidelines rely on systematic reviews that were eithe r previously published or created de novo by guideline developers. Sys tematic reviews can aid in guideline development because they involve searching for, selecting, critically appraising, and summarizing the r esults of primary research. The more rigorous the review methods used and the higher the quality of the primary research that is synthesized , the more evidence-based the practice guideline is likely to be. Summ aries of relevant research incorporated into guideline documents can h elp to keep practitioners up to date with the literature. Systematic r eviews have also been published on the dissemination and implementatio n strategies most likely to change clinician behavior and improve pati ent outcomes. These can be useful in more effectively translating rese arch evidence into practice.