Clinical Practice Guidelines in Surgery

Clinical practice guidelines (CPGs) are defined as “systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances.” A systematic approach for the development of CPGs ensures that the best available evidence is combined with clinical experience and patient preferences. CPGs are useful to surgeons because the published literature is synthesized into a useful recommendation. In developing CPGs, a systematic review of the literature should be performed, the quality of the evidence is assessed, and the recommendations are made based on the evidence as well as by consensus. All of this should be done in a reproducible and transparent fashion. Furthermore, the quality of the evidence directly influ-ences the strength of the recommendation. Finally, experience suggests that active strategies are required to implement CPGs in order to change physician behavior. This may, in fact, may be the most challenging part of CPG development.