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VIII. How to Use Clinical Practice Guidelines B. What Are the Recommendations and Will They Help You in Caring for Your Patients?

Mark C. Wilson, MD, MPH; Robert S. A. Hayward, MD, MPH; Sean R. Tunis, MD, MSc; Eric B. Bass, MD, MPH; Gordon Guyatt, MD, MSc; Evidence-Based Medicine Working Group; Deborah Cook, MD, MSc; Brian Haynes, MD, MSc, PhD; Roman Jaeschke, MD, MSc; Andreas Laupacis, MD, MSc; Virginia Moyer, MD, MPH; David Naylor, MD, DPhil; John Philbrick, MD; Scott Richardson, MD; David Sackett, MD, MSc; Stephen Walter, PhD

JAMA. 1995;274(20):1630-1632.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

CLINICAL SCENARIO

At the conclusion of our first article on practice guidelines¹ in this series, we left you examining the full text of a practice guideline² that could help you marshal a convincing response to a colleague who disagrees with your approach to hormone replacement therapy (HRT) in postmenopausal women. Later that day, chatting with another colleague, you mention the disagreement. He shrugs, and avows, "It's entirely a matter of personal preference, the evidence doesn't support either of you." You return to the guideline, looking for how particular recommendations may be justified and adapted to your patient's circumstances.

WHAT ARE THE RECOMMENDATIONS?

Are Practical, Clinically Important, Recommendations Made?

To be useful, recommendations should give practical, unambiguous advice about a specific health problem. For guidelines about managing health conditions, you should determine if the intent is to prevent, screen for, diagnose, treat, or palliate the disorder. For guidelines about . . . [Full Text PDF of this Article]

Author Affiliations
From the Division of Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Md (Dr Bass); the Departments of Medicine (Drs Hayward and Guyatt) and Clinical Epidemiology and Biostatistics (Drs Hayward and Guyatt), McMaster University, Hamilton, Ontario; Health Program, Office of Technology Assessment, US Congress, Washington, DC (Dr Tunis); and the Department of Medicine, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC (Dr Wilson).

Footnotes
Reprint requests to Room 2C12, McMaster University Health Sciences Centre, 1200 Main St W, Hamilton, Ontario, Canada L8N 3Z5 (Dr Guyatt).

Users' Guides to the Medical Literature section editor: Drummond Rennie, MD, Deputy Editor (West), JAMA.

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