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. Below are listed several good repositories of clinical practice guidelines:

ECRI Guidelines Trust, created in 2018 to fill the unfortunate void left by the federal defunding of the National Guideline Clearinghouse, is a wonderful resource for locating clinical practice guidelines. Although access is free, one must first establish an account to search the guidelines.

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 of Systematic Reviews is a result. Although the abstracts and summaries resulting from a subject search are richly informative here, viewing the full text of some reviews requires payment through ReadCube.  However many of the Cochrane reviews are available free.

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. Approximately 1700 practice guidelines are available at this site.

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, although they make you jump through a few hoops to find them. For example, type "atrial fibrillation", on the search input line (so that PubMed will search for that exact phrase), and click the Search box. Then page down the sidebar at the left, and click on the Additional filters box. Scroll down to check Practice Guideline, and click on the Show box. Page up, and will see that Practice Guideline is added to the Article Types. Select it, and voila, a list of guidelines on the treatment of atrial fibrillation, many from prestigious organizations, is produced. 

May the above information lead you to clinical practice guidelines that support your important case!

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This Tips for Attorneys page was updated with links verified by MedMatters on September 12, 2021.

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