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The guideline process should also be subjected to an economic evaluation. A cost-effectiveness analysis would assess all costs incurred in providing the guidelines and their impact.
In addition, the various sets of guidelines that are produced (for general practitioners, consumers, and so on) should be evaluated for their relevance, ease of access, clarity, how much information they contain, and general user satisfaction.
A date should be set for revision of the guidelines. The National Health and Medical Research Council recommends that this occur every three to five years and more often where the subject matter or circumstances are prone to rapid change.
Legal considerations
Liability of practitioners
Many practitioners are concerned about their potential legal liability if a patient does not receive treatment as specified in clinical practice guidelines. It is certainly possible that guidelines could be produced as evidence of what constitutes reasonable conduct by a medical practitioner. The National Health and Medical Research Council’s Health Advisory Committee considers that practitioners who use guidelines will be afforded a measure of protection.
The case of Rogers v Whitaker (1992) 175 CLR 479 makes it clear that doctors should give information about the risks of any treatment, especially risks that may influence the patient’s decision. Patients should be provided with as much information as they seek, and in a form that is appropriate to their culture and level of education. They should be encouraged to make their own decisions.
Liability of guideline developers and bodies supporting guideline development
If guidelines purport to be a definitive statement of the correct procedure, there would be a greater risk of liability than if they were clearly stated to be a general guide subject to the practitioner’s expert judgment in each case.
Minimum legal requirements for guideline developers
The potential for guidelines to be used as evidence in court depends on the process used to develop them, the extent to which they are evidence-based, the degree of consensus about them, and whether they are up to date.
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