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the acceptability of the amount of information contained in the guidelines, particularly compared with the amount of information contained in the professionals’ guidelines;
• the relevance of the guidelines to different groups of consumers; and
• the overall level of consumer satisfaction (or dissatisfaction) with the guidelines.
In all cases the evaluation needs to be carried out with extensive consumer input and direction.
Examination of the relationship between doctors and the pharmaceutical industry shows that clinicians who perform any research into, or evaluation of, a drug are more likely as a consequence to use that drug (Chren & Landefield 1994). Generalising from this experience, it would be expected that clinicians involved in evaluating guidelines are more likely to use those guidelines.
5.1.5 Economic evaluation
A number of cost factors relating to guidelines need to be known:
• process costs—the costs of development, dissemination and implementation;
• pre-implementation costs—the costs associated with existing practice patterns, including testing, pharmaceutical and surgical interventions; and
• post-implementation costs—the costs and cost savings resulting from observance of the guidelines. For example, the guidelines may result in the elimination of unnecessary tests or procedures, which may result in lower overall costs as well as better health outcomes.
Ideally, where a desired outcome is determined, a cost-effectiveness analysis should be done. Such analyses require an assessment of all costs incurred in providing the guidelines and the cost-related impact of the guidelines.
Such economic analyses can also assist by providing a comparison of guideline- dissemination and -implementation strategies. In this way it will be possible to assess which strategies are more cost-effective, in addition to improving clinical practice and health outcomes.
5.1.6 Reporting on the evaluation
The results of the evaluation, including any flaws found in the guidelines and their usefulness or otherwise for groups, should be included in a report on the evaluation. Wherever possible, indicators of avoidable outcomes should be provided. Among the avoidable outcomes might be the following:
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