Titre :
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Are guidelines following guidelines ? The methodological quality of clinical practice guidelines in the peer-reviewed medical literature. (1999)
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Auteurs :
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T.M. SHANEYFELT ;
M.F. MAYO-SMITH ;
J. ROTHWANGL ;
Ambulatory Care Service. Veterans Affairs Medical Center. Manchester. NH. USA ;
Division of General Internal Medicine. Department of Medicine. Beth Israel Deaconess Medical Center. And Department of Medicine. Harvard Medical School. Boston. MA. USA
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Type de document :
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Article
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Dans :
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JAMA - Journal of the american medical association (vol. 281, n° 20, 1999)
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Pagination :
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1900-1905
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Langues:
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Anglais
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Mots-clés :
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Etats Unis
;
Amérique
;
Système santé
;
Profession santé
;
Médecin
;
Recommandation
;
Validité
;
Amérique du Nord
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Résumé :
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[BDSP. Notice produite par INIST YXjsXR0x. Diffusion soumise à autorisation]. Context Practice guidelines play an important role in medicine. Methodological principles have been formulated to guide their development. Objective To determine whether practice guidelines in peer-reviewed medical literature adhered to established methodological standards for practice guidelines. Design Structured review of guidelines published from 1985 through June 1997 identified by a MEDLINE search. Main Outcome Measures Mean number of standards met based on a 25-item instrument and frequency of adherence. Results We evaluated 279 guidelines, published from 1985 through June 1997, produced by 69 different developers. Mean overall adherence to standards by each guideline was 43.1% (10.77/25). Mean (SD) adherence to methodological standards on guideline development and format was 51.1% (25.3%) ; on identification and of evidence, 33.6% (29.9%) ; and on the formulation of recommendations, 46% (45%). Mean adherence to standards by each guideline improved from 36.9% (9.2/25) in 1985 to 50.4% (12.6/25) in 1997 (P<. however there was little improvement over time in adherence to standards on identification and summary of evidence from prior after no difference the mean number satisfied by guidelines produced subspecialty medical societies general or government agencies guideline length positively correlated with methodological>
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