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Guidelines International Network: Toward International Standards for Clinical Practice Guidelines

The Issue

Because they are developed under a variety of approaches, clinical practice guidelines tend to vary in quality. Founded in 2002, the Guidelines International Network, which includes 93 organizations and 89 individual members from 46 countries, has issued recommendations for the development of clinical guidelines in hopes of promoting discussion and eventual consensus on international standards.

What the Study Found

The network proposes that developers of clinical practice guidelines should consider having the following:

  • a guideline development group with diverse and relevant stakeholders;
  • an open and established decision-making process;
  • disclosure of conflicts of interest by guideline group members, as well as disclosure of sponsoring organizations and financial support;
  • a specified scope of action;
  • clearly described methods;
  • a systematic evidence review process;
  • clearly stated recommendations based on evidence of benefits, harms, and, if possible, costs;
  • a rating system to communicate the quality and reliability of the evidence and recommendations;
  • peer review and stakeholder consultations prior to guideline publication; and
  • an expiration date for the guideline and any process for planned updating.


If carried out successfully, the steps identified by the Guidelines International Network can lead to guideline development processes that "are both rigorous and feasible even for modestly funded groups to implement," the authors write.

Publication Details



A. Qaseem, F. Forland, F. Macbeth et al., "Guidelines International Network: Toward International Standards for Clinical Practice Guidelines," Annals of Internal Medicine, April 3, 2012 156(7):525–31.