APPROPRIATE METHODOLOGY FOR THE DEVELOPMENT OF CLINICAL GUIDELINES: THE EXAMPLE OF ASTHMA

Key words: Guidelines, Asthma

Practice guidelines are quite widespread in many clinical areas, yet few of them are developed following a systematic method. This article describes the process needed to develop valid and reliable guidelines, so that they can effectively support health professionals and patients in the management of specific health conditions by providing them with reliable recommendations. Three aspects are highlighted: participation of all the relevant stakeholders (physicians and methodologists, nurses, administrators, patients’ representatives, etc) to the development process; systematic analysis of the available scientific evidence, through a reproducible process that prevents from selection biases; grading recommendations by considering the strength of supporting evidence. A specific paediatric example (asthma) is then provided to confirm that systematically developed guidelines are not easy to find. The “what for” issue is finally discussed, to assess when a new guideline is necessary and provides an “added value”.