Improving clinical practice through the use of clinical practice guidelines

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Clinical practice guidelines are a valued resource for clinicians looking for expert recommendations to direct clinical decision‐making. However, the reliability and trustworthiness of many clinical practice guidelines were subpar as many guidelines were fraught with expert opinion, conflicts of interest and bias. The Institute of Medicine thus created a set of standards for the development of clinical practice guidelines. These standards emphasize transparency, avoidance of conflicts of interest and a foundation in high‐quality peer‐reviewed evidence. The AABB adhered to the IOM standards in generating guidelines on red blood cell transfusion in 2012. A varied, multidisciplinary panel was convened to perform a rigorous evaluation of all available research. Clear rationale was given to every recommendation, including a discussion on the lack of available evidence when the panel was unable to make a strong recommendation. Both the quality of evidence used to make recommendations and the strength of the recommendations themselves were rated. The end result was a set of recommendations expounding a restrictive blood transfusion strategy that clinicians should feel comfortable relying on to influence their practice. Overall, all future guidelines should strive to follow in the footsteps of the AABB guidelines by meeting the IOM standards.