Are Guidelines Following Guidelines?

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Abstract
Clinical practice guidelines are commonly defined as "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances."1 Over the past decade there has been a surge of interest in the use of clinical practice guidelines fueled by the discovery of large, unexplained variation in physician practice,2-6 documentation of significant rates of inappropriate care,7 and an interest in managing health care costs.8 It is believed that practice guidelines can improve the quality, appropriateness, and cost-effectiveness of health care,1 and can also serve as valuable educational tools.9