Article
Are clinical guideline recommendations for primary care based on research conducted in, or generalisable to, a primary care setting?
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Authors
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T. Stokes
- National Institute for Health and Clinical Excellence (NICE), Manchester, UK
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N. Steel
- School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK
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A. Abdelhamid
- School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK
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H. Edwards
- School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK
| Published: | July 10, 2012 |
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Outline
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Background: The UK National Institute for Health and Clinical Excellence (NICE) clinical guidelines are developed from the best available evidence and apply to primary care (PC). Historically, however, much clinical research has been conducted on highly selected secondary care populations and so therelevance and applicability of this evidence to PC is limited. It is unclear what proportion of evidence used to develop NICE guideline recommendations that apply to primary care was conducted in a PC setting on an appropriate patient population.
Objectives: To determine what proportion of NICE guideline recommendations intended for use in PC are based on research conducted in, or relevant to, UK PC.
Methods: Recommendations specific or relevant to PC were identified from NICE guidelines published in 2010 and 2011. The evidence base underpinning these recommendations was identified, and then each identified research paper was assessed for relevance to PC using 3 criteria: population, setting and country.
Results: This study is ongoing. 24 NICE guidelines have been included. The evidence base for five guidelines has been analysed. Between 9% and 31% of the studies used to develop PC relevant recommendations were conducted in, or relevant to, UK PC. Final results will be presented.
Discussion: Preliminary results suggest a minority of the evidence used to develop PC recommendations is relevant to PC.
Implications for guideline developers/users: There needs to be greater clarity in attributing specific evidence to individual recommendations and more transparency in describing the relevance of included studies to the intended population and setting.
