THE GENIUS BEHIND GUIDELINES

Abstract

Medical guidelines are documents containing recommendations which can be used in clinical practice. They are intended to help physicians make informed decisions on diagnostic or treatment dilemmas and help achieve the best outcomes for patients. Medical guidelines are not made overnight. Members of the guidelines development committee, composed of a multidisciplinary panel of experts from key groups, are carefully chosen to produce a high qualityscientificdocument. Thisisachievedthrough atransparent,evidence-baseddecision-makingprocess that is labor intensive and rigorous. This ensures that guidelines are sound, credible and at par with international standards. The process starts by defining the topic and scope for guideline development. Key issues and questions regarding the topic are drafted. Review of questions, literature search, evidence reviews, and committee discussions are done. Available medical evidence are summarized, and grading of evidence is made, until a draft recommendation is developed. Draft guidelines are then reviewed by stakeholders until a final guideline is produced and published. In this special issue, we bring you outputs from this guideline development process - four relevant documents on COVID-19, Pediatric Community Acquired Pneumonia (in collaboration with the Philippine Academy of Pediatric Pulmonologists), Leptospirosis, and Pediatric Immunization (prepared by the National Institutes of Health-Institute of Clinical Epidemiology and funded by the Department of Health ). The guideline development process is imperfect. Some shortcomings include paucity of evidence on certain questions, presence of potential conflicts of interest among members of the committee, limitations in funding, and even time. The major advantage is access to a summarized wealth of evidence on a specific topic to enhance physician expertise, improve healthcare quality, and reduce healthcare cost. Guidelines can also influence health policies so that underrecognized health concerns and services can be made available to the majority. Guidelines should be used with the best interest of the individual patient in mind. They help to improve patient care quality. The complex medical decision making process done by the physician however, should not be limited by simplistic algorithms suggested by guidelines.