Wie eine Leitlinie entsteht

Practitioners often doubt the sense of clinical practice guidelines. This may be caused by uncertainty about the methodological quality of guidelines and conflicts of interests of guideline authors and guideline publishers. However, the discrepancy between intentions of guideline developers and perceptions of (potential) guideline users may also be caused by different ideas about the features of a ??good?? guideline and the prospects and boundaries of their application in practice. To improve guideline acceptance and implementation, a systematic and methodically sound approach in guideline development is necessary. Key elements are stakeholder and patient involvement, systematic appraisal of the available evidence, and the application of formal consensus methods to agree on recommendations. In addition, the impact of guidelines depends on topic selection (i.e., the need for quality improvement), content validity, accessibility, applicability, and acceptance. Finally, to assess the sense of a specific guideline, its implications on processes and outcomes of care need to be monitored.