Who monitors clinical guidelines?

There are innumerable organizations advising doctors with clinical guidelines.

But who ensures the standards behind the recommendations? It’s somewhat concerning to read the lack of evidence-based rigor behind many policy recommendations. For instance, the American Academy of Pediatrics admits that “academy standards did not require any systematic overview of the scientific literature before a policy was issued.”

Indeed, JAMA reported that “only about a third of clinical guidelines reviewed current medical evidence. Fewer than half followed any kind of standard format.”

Doctors are implored to follow evidence-based clinical guidelines to reduce practice variability. But with the rash of conflicting recommendations, do we need guidelines for the guidelines?

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