An Annotated Algorithmic Approach to Clinical Guideline Development

Published In: JAMA, The Journal of the American Medical Association, v. 267, no. 24, June 24, 1992, p. 3311-3314

Posted on RAND.org on December 31, 1991

by David Hadorn, Kathleen McCormick, Ananias Diokno

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The Urinary Incontinence in Adults Guideline Panel facilitated the ready elucidation of its guideline's management recommendations through the use of an annotated algorithm approach. The algorithms created as part of this guideline differ from previous algorithms in two ways: (1) they employ systematic annotation to link explicitly the algorithms' recommendations to the literature, and (2) they contain patient counseling and decision nodes to depict the major preference-dependent decision or branch points in the algorithm. We believe that these two innovations can help ensure the clinical validity of guidelines' algorithms while preserving appropriate clinical flexibility and respecting patient preferences.

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