Prescription For Scolding Wives. Color etching. Anonymous, 1830. Courtesy of The National Library of Medicine.

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Clinical practice guidelines are for attorneys too!

Clinical practice guidelines for physicians and other healthcare professionals are carefully developed statements to assist in informed decision-making for quality patient care. Hundreds of these guidelines have been issued under the auspices of various distinguished medical organizations, and many are available in their entirety on the World Wide Web.

One cannot discuss clinical practice guidelines without mention of evidence-based medicine, as the two go hand in hand. For the past several decades, evidence-based medicine has been a popular concept in the medical community. In brief, evidence-based medicine is the practice of medicine according to the best evidence, that is, informed patient care decisions are based on systematic up-to-date reviews of the best scientific evidence available, as supported by clinically relevant research. Evidence-based medicine hence provides a foundation for the development of the best quality clinical practice guidelines.

Needless to say, clinical practice guidelines issued by prestigious medical organizations can provide valuable documentation of accepted medical practice and standards of care for the medical malpractice attorney. For the past several years, the best place to look for clinical practice guidelines was the National Guideline Clearinghouse, but unfortunately it was defunded by the federal government and forced to close down in July 2018. However there are other Websites and ways to look for clinical practice guidelines as listed below:

Cochrane Database of Systematic Reviews. Recognizing the woeful and widespread lack of attention to good scientific evidence in patient care decision-making, the late British epidemiologist, Archie Cochrane, got the evidence-based medicine ball rolling during the 1970s. The highly respected Cochrane Database is a result. Although the abstracts resulting from a subject search are richly informative here, viewing the full text of some reviews requires registration with the Wiley Online Library offering pay-per-view access. However many of the Cochrane reviews can be accessed free of charge.

CPG Infobase is a database of evidence-based Canadian clinical practice guidelines. Maintained by a subsidiary of the Canadian Medical Association, it includes approximately 1200 guidelines produced or endorsed by various distinguished medical and health organizations in Canada.

Trip Database, based in the United Kingdom, is a great search site for evidence-based medicine practices. And Trip Pro offers considerably more content for the very reasonable annual subscription fee of $55 U.S. dollars.

NICE - National Institute for Health and Care Excellence is a body of the Department of Health in the United Kingdom established in 1999 for the purpose of creating clinical practice guidelines. Well over 200 practice guidelines are available at this site.

ACP Clinical Guidelines and Recommendations, produced by the prestigious American College of Physicians for the use of internists, presents a number of clinical practice guidelines for health care based on the best available evidence. 

Besides searching at the above Websites, there are other good ways of locating clinical practice guidelines. One way is to use the ever popular Google search engine. Assume that you are looking for practice guidelines for the management of atrial fibrillation. Go to good old Enclosing phrases in quotes tells Google to look for that exact phrase. Therefore your search could be entered as follows: "atrial fibrillation" "practice guidelines" Other phrases and terms that might be effectively combined with "atrial fibrillation" are: "treatment guidelines" "clinical guidelines" "position statement" and "practice parameters".

Perhaps you are familiar with the name of a prestigious medical society that may have issued guidelines on the subject in which you are interested. Additional searches at Google entered in quotes, "American College of Cardiology" or "Infectious Diseases Society of America" lead one to the Websites of these organizations where indeed each provides links to full-text practice guidelines.

In addition, you can use The National Library of Medicine's PubMed search engine to locate clinical practice guidelines from the MEDLINEŽ database of authoritative medical literature. For example, type atrial fibrillation on the search input line, click the search button, then under Article types in the left hand column of the search page, click Customize, scroll down and select Practice Guideline, and click Show at the bottom. Practice Guideline will now show under Article types in the left hand column. Click it, and voila, a list of citations to sources of clinical practice guidelines on the subject of atrial fibrillation is produced.

May the above information lead you to the clinical practice guidelines that can help you win!

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This Tips for Attorneys page was updated with links verified by MedMatters on November 14, 2018.

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