From outdated to updated, keeping clinical guidelines valid

Evidence-based clinical guidelines use summaries of critically appraised, current evidence to provide readily available recommendations for clinical decision-making. When clinicians use evidence-based guidelines, patient outcomes improve, personnel have more positive attitudes, and organizations use resources more efficiently [1]. Because new evidence accumulates rapidly, guideline evaluators agree that guidelines need to be periodically updated [2–4]. The terms ‘valid’ and ‘up to date’ are used interchangeably to mean that a guideline includes all relevant, recent, valid evidence and reflects current clinician’s experience as well as patient values and preferences. Possible consequences of using out-of-date guidelines include a clinician’s use of diagnostic studies or treatments that do not provide the best-known outcomes. The scenario one seeks to avoid is harm or unnecessary suffering, hardship, or risk exposure experienced by patients. Although guideline evaluators agree that periodic revision is important, 9 of 18 guideline organizations reported that they lack formal procedures for keeping their guidelines up to date [5]. This observation suggests that effective programs for assuring guideline validity may be important but are challenging to achieve. To better understand the context, implications, and range of institutional experiences for keeping guidelines up to date, a systematic electronic search …