Are Guidelines Worth the Cost? Save

A thoughtful perspective on the purpose, focus and cost of guideline efforts in rheumatology has been published in the journal Rheumatology.

In the last 15 years, more than 120 guidelines have been published in the field.  One of the many problems inherent in such efforts is that the time and effort needed to establish a guideline is undermined by their being outdated in 3 years.

To assess the impact of guidelines, it would be ideal to assess their utility in daily patient care and assess if guidelines lead to improvements in the quality of patient care.  However, such evidence is usually lacking.

The process of guideline development consumes large amounts of resources. As such, the costs relate to the number of stakeholders, authors, the number of meetings, time expenditures up to and after publication, the cost of dispersal and education, and the involved efforts of target organizations and populations.

Guidelines need to be adapted to complicated clinical situations. Preventing clinicians from being overwhelmed by too many guidelines could be achieved by greater focus on those that are the most important to them, and those areas of greatest unmet need.  

Bottom line: planning and forethought are sorely needed in guideline development, so as to maximize value for money.