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JAC Advance Access originally published online on April 14, 2003
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Journal of Antimicrobial Chemotherapy (2003) 51, 1103-1107
© 2003 The British Society for Antimicrobial Chemotherapy

Leading Article

From evidence-based guideline methodology to quality of care standards

Dilip Nathwani*

Infection Unit (Ward 42), Ninewells Hospital & Medical School, Dundee DD1 9SY, Scotland, UK

Keywords: evidence-based medicine, guidelines, quality of care

The first 150 words of the full text of this article appear below.


   Introduction
 
The culture of searching for evidence in medicine has revolved around three areas—the systemic–pathophysiological, the individual–clinical and the statistical–analytical approach.1 The origin of the first lies with Socrates (c. 400 BC) and Galen (c. AD 200), the second with the long evolution of the process we call ‘medical judgement’ and the last with the work of a number of pioneers such as James Lind, a Scottish naval surgeon (1716–1794), who validated his intuition about the best treatment for scurvy by undertaking a prospective randomized study on board a British naval ship.2 This and other work were the beginnings of systematic and analytical evaluation of evidence as a basis for clinical practice.


   Evidence-based guidelines
 
The last two decades have seen the emergence of evidence-based medicine (EBM), which regards rationale that is institutional, clinically unsystematic and pathophysiological as insufficient for clinical decision making, and stresses examining evidence from clinical research.3 . . . [Full Text of this Article]


   Recommended guideline development methodology
 

   Other approaches to guideline development
 

   Variability of quality of infection practice guidelines
 

   Guideline implementation
 

   Quality assurance and development of standards
 

   Development of clinical standards in Scotland
 

   Conclusion
 

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