Guide to development of practice guidelines.

A commonly accepted definition of a clinical practice guideline is “a systematically developed statement to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances” [1]. Guidelines are written to improve the quality of care, to improve the appropriateness of care, to improve cost-effectiveness, and to serve as educational tools [2, 3]. The goal is not to create standards of care; however, other organizations may choose to adopt these guidelines or components thereof for such purposes. Practice guidelines, however, are never a substitute for clinical judgment. Clinical discretion is of the utmost importance in the application of a guideline to individual patients, because no guideline can ever be specific enough to be applied in all situations. To fulfill the objectives of guidelines adequately, standards must be established for the quality of guidelines so that their scientific validity and clarity of communication may be ensured (table 1) [4]. The challenge to guideline writers, therefore, is to adhere to these standards in the guideline development process while also making the document user-friendly. Because the majority of the guidelines of the Infectious Diseases Society of America (IDSA) will be published in the journal Clinical Infectious Diseases, it is essential that the turnaround time from concept to final draft be as short as possible, preferably !12 months. The IDSA Practice Guidelines Committee recommends that guideline developers carefully consider and incorporate the following standards.