Developing clinical guidelines: a challenge to current methods

Abstract
Clinical guidelines are rarely based solely on research evidence. In most cases they also incorporate the consensus views of experts. Despite recognition of the need for rigour in developing a consensus, current approaches often lack sufficient transparency, fail to make clear what influence the level of resources in the health system has, lack sufficient reliability, and will never achieve comprehensive and timely coverage of the whole range of health care. We propose a new approach that we believe will be more cost effective and that could meet these challenges.