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European Heart Journal Advance Access originally published online on May 3, 2005
European Heart Journal 2005 26(12):1155-1158; doi:10.1093/eurheartj/ehi262
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oupjournals.org

Evidence-based vs. ‘impressionist’ medicine: how best to implement guidelines

Jean-Pierre Bassand1,*, Silvia Priori2 and Michal Tendera3

1University Hospital Jean Minjoz, Boulevard Fleming, 25030 Besançon, France
2Molecular Cardiology, Maugeri Foundation, Pavia, Italy
3Silesian School of Medicine, Katowice, Poland

Received 14 October 2004; revised 1 February 2005; accepted 3 February 2005; online publish-ahead-of-print 3 May 2005.

* Corresponding author. Tel: +33 381 668 539; fax: +33 381 668 582. E-mail address: jean-pierre.bassand{at}ufc-chu.univ-fcomte.fr

Abstract

Implementing clinical practice guidelines improves outcomes. This has been shown by several large scale registries. However, in spite of this, guidelines are poorly implemented in clinical practice for a wide variety of reasons. We examine the reasons behind the low uptake of guidelines into routine medical practice. Many physicians are simply not aware that guidelines exist; or they do not believe in them; or they simply do not care to implement them. Economic and social factors may also influence uptake of guidelines. It is the role of professional societies to disseminate best scientific knowledge, and ensure optimum implementation of guidelines. This can be achieved through educational activities and CME credit. Close collaboration between the profession, health authorities, and maybe even the industry could improve uptake of clinical practice guidelines, and thereby improve patient outcome.

Key Words: Guidelines • Implementation • Evidence-based medicine


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