Updating clinical guidelines

CPG development and implementation have attracted the most international interest and activity, whilst CPG updating, adopting (with or without contextualization), adapting and impact evaluation are less well addressed.

High-quality, evidence-informed clinical practice guidelines (CPGs) offer a way of bridging the gap between policy, best practice, local contexts and patient choice.

primary, secondary), which should underpin the journey of care of patients with a particular diagnosis [8, 9].

Whilst broadly similar to CPGs, clinical pathways differ by being more explicit about the sequence, timing and provision of interventions.

It is presented in a way that can be updated as the field expands.They can include best-practice statements for any one or combination of concerns regarding screening, diagnosis, management or monitoring.The term ‘protocol’ is commonly used to prescribe behaviours at diplomatic and societal events.The most common approach to CPG development seems to come from the efforts of small teams of dedicated volunteers, often working with minimal funding and variable understanding of CPG development methods, to produce recommendations for practice in local settings, based on a range of evidence sources.These include peer-reviewed literature, grey literature, other CPGs and expert opinion.

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  1. A far less common example would be online infidelity that was so egregious that it caused emotional detriment to the innocent spouse that has impacted his or her ability to support himself—in other words, if an innocent spouse is so emotionally devastated that he or she is unable to work and needs therapy to recover.