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Suggested Citation:"DOCUMENTATION." Institute of Medicine. 1990. Clinical Practice Guidelines: Directions for a New Program. Washington, DC: The National Academies Press. doi: 10.17226/1626.
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Page 74

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ATTRIBUTES OF GOOD PRACTICE GUIDELINES 74 all of its guidelines to some kind of yearly examination to flag particular guidelines for either scheduled or unscheduled review. As described in the next chapter, the mechanisms for disseminating and administering guidelines need to provide for guidelines updating or withdrawal. TABLE 3-2 Provisional Documentation Checklist for Practice Guidelines Attribute Item Validity Projected health outcomes if guidelines are followed. Information required to evaluate outcomes. Projected costs if guidelines are followed. Information required to evaluate costs. Description of data, methods, and assumptions used to make projections. Explicit description of the relationship between the scientific evidence and the guidelines and explanations for any differences between the guidelines and the evidence. Explanations for any important differences between the guidelines in question and those developed by others. Thorough literature review describing scientific research including sponsors, settings, methodologies, findings, and qualifications. Description of methodology for evaluating the scientific literature and the results. Explicit assessment of the quality, consistency, clarity, and strength of the scientific evidence. Description of methodology for using expert or group judgment as a basis for evaluating scientific evidence or, in the absence of evidence, reaching a consensus based on expert opinion. Explicit description of the strength of expert consensus. Description of procedures, participants, and findings of review by experts and others not involved in the original development process. Description of methods, settings, and results of any pretests of the guidelines. Reliability/reproducibility Description of methods and results of testing (1) the reliability of the development method and (2) the reproducibility of the clinical decisions reached by users of the guidelines. DOCUMENTATION For the purposes of emphasis, the committee lists documentation as a separate attribute even though it has already been referred to repeatedly in the discussion of other attributes. As a practical matter, a documentation checklist, such as the preliminary version presented in Table 3-2, may be helpful for contractors and review panels.

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