[About protocols, regulations and guidelines in clinical practice. Spanish Society of Pediatric Neurology].

OBJECTIVE: In order to increase the awareness and perception of guidelines as a helpful tool in clinical practice, a description of its main features, foundations and social context is provided. DEVELOPMENT: Protocols, algorithms and guidelines are defined as instruments to improve patient care without interfering with the clinician's criteria regarding a particular patient. They are supported by the Evidence Based Medicine, and its development follows precise rules. Guidelines are the product of high quality research, made public through Medline, research that is previously evaluated in a specified manner. The level of evidence determines the strength of the recommendation. The effects of guidelines on the health status of patients are one of the subjects of the outcomes assessment methodology. They have some limitations but they contribute to avoid arbitrary practice and to reduce practice variability among professionals. Their contribution to the present health system management and to optimized resources utilization is decisive. CONCLUSIONS: At present, clinical, scientific and management practices are closely related. Guidelines have a role in the three aspects of the Health System.