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NDT Advance Access originally published online on March 6, 2006
Nephrology Dialysis Transplantation 2006 21(5):1145-1153; doi:10.1093/ndt/gfl084
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Editorial Comment

Clinical Practice Guidelines in nephrology—for worse or for better

Katrin Uhlig, Ethan M. Balk, Joseph Lau and Andrew S. Levey

National Kidney Foundation Center for Clinical Practice Guideline Development and Implementation, Tufts-New England Medical Center, Boston, USA

Correspondence and offprint request to: Katrin Uhlig, Email: kuhlig@tufts-nemc.org

Keywords: clinical practice guidelines; systematic review; evidence grading; chronic kidney disease

The first 150 words of the full text of this article appear below.



   Introduction
 
Clinical practice guidelines (CPGs)* (throughout the text, terms marked with an asterisk are defined in Table 1 in alphabetical order) [1] have become important tools in shaping the care of individuals with chronic kidney disease (CKD). CPGs inform patient care, scientific debate, research agendas and policies. At the same time, CPGs have been criticized for restricting the care provided by physicians to patients. This article is intended as a review of selected topics related to guideline development and its application in nephrology, which ultimately aim at informing decision making and improving the quality of care.


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  		Table 1. Glossary of terms

 


   What guidelines are and are not
 
The primary purpose of CPGs is to improve patient care. As defined in the Institute of Medicine's 1990 report, guidelines are ‘systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances’[1,2]. CPGs are evidence-based when they are derived from . . . [Full Text of this Article]



   Methodological challenges for guideline development
 
Evidence grading
Quality of evidence in nephrology


   Guideline development in nephrology
 
Guideline implementation
Challenges in international guideline development


   Conclusions
 

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