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Commentary

How can Canadian guideline recommendations be tested?

Ananda Chatterjee, Onil Bhattacharyya and Navindra Persaud
CMAJ April 02, 2013 185 (6) 465-467; DOI: https://doi.org/10.1503/cmaj.121830
Ananda Chatterjee
From the Keenan Research Centre in the Li Ka Shing Knowledge Institute (Chatterjee, Bhattacharyya, Persaud), St. Michael’s Hospital, Toronto, Ont.; the Department of Family and Community Medicine (Bhattacharyya, Persaud), St. Michael’s Hospital; and the Department of Family and Community Medicine (Bhattacharyya, Persaud) University of Toronto, Ont.
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Onil Bhattacharyya
From the Keenan Research Centre in the Li Ka Shing Knowledge Institute (Chatterjee, Bhattacharyya, Persaud), St. Michael’s Hospital, Toronto, Ont.; the Department of Family and Community Medicine (Bhattacharyya, Persaud), St. Michael’s Hospital; and the Department of Family and Community Medicine (Bhattacharyya, Persaud) University of Toronto, Ont.
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Navindra Persaud
From the Keenan Research Centre in the Li Ka Shing Knowledge Institute (Chatterjee, Bhattacharyya, Persaud), St. Michael’s Hospital, Toronto, Ont.; the Department of Family and Community Medicine (Bhattacharyya, Persaud), St. Michael’s Hospital; and the Department of Family and Community Medicine (Bhattacharyya, Persaud) University of Toronto, Ont.
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Article Figures & Tables

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    Table 1:

    Strengths and limitations of 3 pragmatic methods for testing clinical practice guidelines

    MethodStrengthsLimitationsGuideline developers currently using this method
    Public consultations
    • Incorporates feedback from front-line clinicians

    • Increases acceptance from the medical community

    • Extends the length of time for guideline development

    • National Institute of Clinical Studies (Australia)

    • United States Preventive Services Task Force

    • Scottish Intercollegiate Guidelines Network

    • National Institute for Health and Clinical Excellence (UK)

    Clinical vignettes
    • Requires minimal resources

    • Provides rapid feedback

    • Allows different formats of recommendations to be tested

    • Requires a group of physicians as study participants

    • Must be carefully constructed and linked to explicit outcomes or evidence-based guidelines

    • May not reflect actual behaviours of clinicians

    • None

    Performance measures
    • Quality of medical care can be gauged

    • Feedback is available only after guidelines have been implemented

    • Performance measures do not always reflect the quality of care

    • Unmeasured aspects of care could worsen

    • Canadian Task Force on Preventive Health Care

    • Canadian Stroke Network

    • National Institute for Health and Clinical Excellence (UK)

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Canadian Medical Association Journal: 185 (6)
CMAJ
Vol. 185, Issue 6
2 Apr 2013
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How can Canadian guideline recommendations be tested?
Ananda Chatterjee, Onil Bhattacharyya, Navindra Persaud
CMAJ Apr 2013, 185 (6) 465-467; DOI: 10.1503/cmaj.121830

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How can Canadian guideline recommendations be tested?
Ananda Chatterjee, Onil Bhattacharyya, Navindra Persaud
CMAJ Apr 2013, 185 (6) 465-467; DOI: 10.1503/cmaj.121830
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