GUIDELINE EVIDENCE BASE - Ignore guidelines at your peril

摘要

Elwenspoekand colleagues conclude that most UK guidelines are based on expert opinion and consensus rather than "hard" or published evidence (Uncertainties, 22 June). As chair of the standards committee of the British Transplantation Society, I agree. The authors say that most guidelines should not be adopted uncritically but should inform discussion with patients. This is logical but impractical. Primary care providers are chronically overworked and lack the resources to devote to mass education programmes, and most patients are not sufficiently informed or motivated to engage in such decisions.