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Are guidelines a useful tool for improving outcomes in neurology?

A growing number of clinical practice guidelines are being developed for neurological diseases, and they have the potential to benefit patients, clinicians, policymakers and payers. However, the effectiveness of these guidelines has not been evaluated, so we do not yet know whether they improve patient outcomes in a real-world setting.

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  1. Grimshaw, J. M. et al. Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technol. Assess. 8, 6 (2004).

    Article  Google Scholar 

  2. Chan, A. H. Y. et al. Effect of electronic adherence monitoring on adherence and outcomes in chronic conditions: a systematic review and meta-analysis. PLoS One 17, e0265715 (2022).

    CAS  Article  Google Scholar 

  3. Kwan, J. & Sandercock, P. In-hospital care pathways for stroke. Cochrane Database Syst. Rev. 4, CD002924 (2004).

    Google Scholar 

  4. Trimarchi, L., Caruso, R., Magon, G., Odone, A. & Arrigoni, C. Clinical pathways and patient-related outcomes in hospital-based settings: a systematic review and meta-analysis of randomized controlled trials. Acta Biomed. 92, e2021093 (2021).

    PubMed  PubMed Central  Google Scholar 

  5. Setkowski, K., Boogert, K., Hoogendoorn, A. W., Gilissen, R. & van Balkom, A. J. L. M. Guidelines improve patient outcomes in specialised mental health care: a systematic review and meta-analysis. Acta Psychiatr. Scand. 144, 246–258 (2021).

    Article  Google Scholar 

  6. Donnellan, C., Sweetman, S. & Shelley, E. Health professionals’ adherence to stroke clinical guidelines: a review of the literature. Health Policy 111, 245–263 (2013).

    CAS  Article  Google Scholar 

  7. Osterberg, L. & Blaschke, T. Adherence to medication. N. Engl. J. Med. 353, 487–497 (2005).

    CAS  Article  Google Scholar 

  8. Pereira, V. C., Silva, S. N., Carvalho, V. K. S., Zanghelini, F. & Barreto, J. O. M. Strategies for the implementation of clinical practice guidelines in public health: an overview of systematic reviews. Health Res. Policy Syst. 20, 13 (2022).

    Article  Google Scholar 

  9. Guideline Production Group of the European Academy of Neurology et al. Guidelines should be guidelines: time to leave the terms “consensus” and “position” for other purposes. Eur. J. Neurol. 28, 2461–2466 (2021).

    Article  Google Scholar 

  10. El Baz, N. et al. Are the outcomes of clinical pathways evidence-based? A critical appraisal of clinical pathway evaluation research. J. Eval. Clin. Pract. 13, 920–929 (2007).

    PubMed  Google Scholar 

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Correspondence to Maurizio A. Leone.

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M.A.L. and J.C. are co-chairs of the Guideline Production Group of the European Academy of Neurology.

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Leone, M.A., Costa, J. Are guidelines a useful tool for improving outcomes in neurology?. Nat Rev Neurol 18, 447–448 (2022).

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