Achieving health gain through clinical guidelines II: Ensuring guidelines change medical practice.

Clinical guidelines are proliferating on both sides of the Atlantic.” Nevertheless there is considerable uncertainty whether this will improve clinical practice. We therefore systematically reviewed published evaluations of clinical guidelines. We identified 59 rigorous evaluations covering a wide range of clinical activities all but four of which detected statistically significant improvements in the process of medical care and all but two of the 11 that also measured the outcome of care reported statistically significant improvements in outcome. We concluded that guidelines improve clinical practice and achieve health gains when introduced in the context of rigorous evaluations. (excerpt)