Critical Analysis of Asthma Guidelines: Are They Really Evidence-Based? (original) (raw)

2008, Archivos de Bronconeumología ((English Edition))

Clinical guidelines are defined by "the systematic development of recommendations that have the aim of helping the practicing physician and the patient make decisions related to the specific circumstances of health care." 1 In the last decade, consensus statements or clinical guidelines have become increasingly important in clinical practice. Many of the daily decisions concerning patients or operative aspects of the management of health centers, and even decisions made by health managers, are therefore influenced by such documents. The marked increase in the number of guidelines published can largely be attributed to problems faced primarily in the health systems of countries of Europe, North America, Australia, and New Zealand, that is, the sharp increase in health costs along with increased demand, new and costly technologies, as well as the repercussions of the aging of the population, in combination with the desire of health professionals to offer (and the patients to receive) the best possible medical care. Thus, practicing physicians, health managers, and health policy makers see the guidelines as a means to providing more uniform and efficient health care, and to reducing the gap between what physicians actually do and what the scientific evidence indicates. 2,3 The main potential benefit of these guidelines or consensus statements is improved medical care for patients. Guidelines can make medical care more uniform and thus improve its quality. 4 Furthermore, they help ensure that patients are better informed about their therapeutic options,