Guideline evolution in family medicine

[摘要] This month’s issue of Canadian Family Physician features a commentary by Drs Leslie and James Rourkeand colleagues on the Rourke Baby Record (RBR),1which for almost 4 decades has been an indispensable aidto primary care providers who care for infants and children.Canadian Family Physician has been committed to publishing clinical practice guidelines (CPGs) developed byfamily physicians for family physicians since it began publishing the RBR in 1985.2 Why? Because there have been,and remain, many problems with CPGs developed by specialists for use in generalist clinical settings. These includetheir focus on single diseases (making them hard to applyin generalist settings); guideline panelists’ potential conflicts of interest3; most recommendations being basedon expert opinion rather than on the highest-quality evidence3; failure to consider how to support implementationby end-users; and insufficient representation of family physicians and patients—although in this area improvementshave occurred in some recent disease-specific CPGs.

[学科分类] 卫生学