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ATTRIBUTES OF GOOD PRACTICE GUIDELINES 52 3 Attributes of Good Practice Guidelines Remember the drunk who searched for his keys under the lamp post because that's where the light was? Science is a highly systematic process of creating lamps and then looking under them. David Warsh, Washington Post Developing practice guidelines that enlighten practitioners and patients is an exceptionally challenging task. It requires diverse skills ranging from the analysis of scientific evidence to the management of group decisionmaking to the presentation of complex information in useful forms. Although the need for these skills has not always been recognized in the past, the recent focus on guidelines is bringing not only a greater awareness of what is required for their development but also a higher level of expertise to the field. The Office of the Forum for Quality and Effectiveness in Health Care should make every effort to reinforce this trend as it works with contractors, expert panels, and others to develop and disseminate practice guidelines. This chapter describes eight attributes that the committee believes are essential if a set of guidelines are to serve their intended purposes of assisting practitioners and patients, providing a better foundation for the evaluation of services and practitioners, and improving health outcomes. These attributes are ideal characteristics to which real guidelines are unlikely to conform fully either now or in the future. However, in the committee's judgment, guidelines can approach these ideals to a greater extent than has generally been achieved to date.
