Possibilities and limitations of national guidelines based on the example of pediatric urology guidelines from the Pediatric Urology Working Group of the Austrian Society for Urology and Andrology (ÖGU)

Abstract

Medical guidelines are defined as practical orientation and decision-making aids; they are legally defined as noncommittal recommendations. International guidelines are written in very general terms, especially in the case of heterogeneous clinical pictures (e.g., vesicoureteral reflux). Could national guidelines based on international recommendations become authoritative as specific treatment recommendations for the various specialist groups? The value of international and national guidelines was assessed using the example case history of achild affected with vesicoureteral reflux. Due to the various therapeutic possibilities according to various guidelines, the child received unfavorable, incongruent, delayed, and repeated unsuccessful attempts with different treatment regimes CONCLUSION: Due to the nonbinding nature of general guidelines, there is arisk of suboptimal therapy. National guidelines aimed at individualized treatment recommendations should aim for higher medical and legal status.