National Academies Press: OpenBook
« Previous: Use of Expert Judgment
Suggested Citation:"Independent Review." Institute of Medicine. 1990. Clinical Practice Guidelines: Directions for a New Program. Washington, DC: The National Academies Press. doi: 10.17226/1626.
×
Page 66

Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

ATTRIBUTES OF GOOD PRACTICE GUIDELINES 66 panel member is absent from active group discussion of the guidelines, that absence should be noted. A recent IOM workshop on group judgment noted that more research needs to be done regarding the validity and reliability of judgments reached using different group judgment techniques (IOM, 1990f; Lomas, 1990). Strength of Expert Consensus Expert groups will almost assuredly participate in the literature review and development of guidelines. The extent to which those experts agree on their findings and recommendations is important information. Thus, a set of guidelines should describe the strength and nature of the group consensus or agreement. In some cases, the experts may strongly agree that clear evidence supports precise statements in a set of guidelines about the appropriateness or inappropriateness of a particular clinical practice. This agreement is powerful support for the validity of those statements. In other situations, experts may strongly agree that no clear evidence exists on which to base precise statements about appropriateness. This, too, is important information. In still other cases, the experts may disagree about what the evidence indicates and what statements about appropriateness are warranted (Park et al., 1986). These three quite different situations have different implications for guidelines developers and users. The extent of agreement within an expert group should be reported in quantitative terms (for example, simple percentages describing levels of agreement or disagreement). When evidence or professional agreement is very strong, guidelines may be more confidently translated into criteria for evaluating practitioner performance. Independent Review In any endeavor involving expert panels and the subjective evaluation and interpretation of data, different groups may well arrive at different conclusions. Replication of guidelines development on the same clinical condition or technology is not likely to be feasible, affordable, or desirable (in terms of the opportunity costs involved). Therefore, at a minimum, some effort should be made to subject guidelines (including the relevant literature reviews) to review and criticism by professionals who are not involved in the original development process. These procedures should be described and the results summarized.

Next: RELIABILITY/REPRODUCIBILITY »
Clinical Practice Guidelines: Directions for a New Program Get This Book
×
Buy Paperback | $50.00
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF
  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  6. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  7. ×

    View our suggested citation for this chapter.

    « Back Next »
  8. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!