I have collaborated on some current guidelines (the German Program for Disease Management Guidelines on diabetic foot, diabetic nephropathy, etc). I have often asked myself why guidelines that are well intended in principle have a problem with their practical implementation. I regard the above article as a good example for the fact that a communication problem exists between those in charge of setting out guidelines and the doctor for whom they are intended. Might the lacking implementation of clinical guidelines be explained by the incomprehensible “sociolect” used in health services research or health economics, which is used in the general sphere of guideline business? On reading the article I notice how far the jargon in use (“indicator-guided analysis of patient data to determine physicians’ adherence to guidelines”) is removed from clinical practice. I think readers’ time is too limited to engage fully with an article that is written in such a complicated way. In my opinion the same holds true for many guidelines that provide no reading pleasure because the language and style they are written in is too removed from clinical practice.
Improvements could certainly be made in order to make guidelines more interesting for readers and to increase “the knowledge of guidelines as a valid surrogate parameter for the objective ‘guideline-conform clinical practice'.”
Prof. Dr. med. Gerhard Rümenapf
Krankenhaus, Speyer, Germany
Conflict of interest statement
Professor Rümenapf has received CME support from Jotext and honoraria from Mölnlycke.
|1.||Karbach U, Schubert I, Hagemeister J, Ernstmann N, Pfaff H, Höpp HW: Physicians’ knowledge of and compliance with guidelines: an exploratory study in cardiovascular diseases. Dtsch Arztebl Int 2011; 108(5): 61–9. VOLLTEXT|