Clinical practice guidelines
- Concept
A clinical practice guideline gathers recommendations based on systematic reviews to help decide; how far to trust it depends on how it was made.
What it is
Clinical practice guidelines (CPGs) are recommendations developed systematically from the evidence and the balance of benefits and harms, to help professionals and patients decide and to reduce unjustified variation in care. A trustworthy guideline has a multidisciplinary panel that includes patients, manages conflicts of interest, rests on systematic reviews, rates the evidence (for example with GRADE), is open about how it moves from evidence to recommendation, is externally reviewed and is updated. In Colombia, the Ministry of Health publishes guidelines on its CPG portal and IETS develops guidelines and health technology assessments.
Worked example
- Data (made up): two appraisers rate the AGREE II domain «scope and purpose», with 3 items, on a scale of 1 to 7.
- Maximum possible: 7 × 3 items × 2 appraisers = 42.
- Minimum possible: 1 × 3 items × 2 appraisers = 6.
- Score obtained: the sum of the 6 ratings = 30.
- Domain score: (30 − 6) / (42 − 6) = 24 / 36 = 0.667, that is, ≈ 67 %.
- Reading: the domain reaches two thirds of the maximum; the calculation is repeated for all 6 domains before recommending the guideline.
Signs of a trustworthy versus an untrustworthy guideline
| Feature | Trustworthy | Untrustworthy |
|---|---|---|
| Panel | Multidisciplinary, with patients | A few experts from one specialty |
| Conflicts of interest | Declared and managed | Not declared |
| Evidence | Systematic reviews and GRADE | Articles picked at will |
| Recommendations | Explicit strength and certainty | Ungraded |
| Currency | Date and update plan | Undated, out of date |
Markers
- CPG
- GRADE
- AGREE II
- IETS
- MinSalud
In practice
- In Colombia, the Ministry of Health's Clinical Practice Guidelines portal gathers the national guidelines; IETS also develops clinical practice guidelines.
- A guideline does not replace clinical judgement: a conditional recommendation leaves room for the patient's values and the setting.
Common pitfalls
- Trusting a guideline because of who signed it, without checking its methods or conflicts of interest.
- Using an outdated guideline when the evidence has already changed.
- Reading a conditional recommendation as if it were mandatory.
Test yourself
Think of the answer, then tap the question to see it.
What makes a clinical practice guideline trustworthy?
A multidisciplinary panel with patients, managed conflicts of interest, systematic reviews, rated evidence, graded recommendations, external review and updating.
Which instrument assesses the methodological quality of a guideline?
AGREE II, with 23 items grouped in 6 domains.
Where are Colombia's national clinical practice guidelines published?
On the Clinical Practice Guidelines portal of the Ministry of Health and Social Protection; IETS also develops guidelines.
Connections
Educational content on epidemiological and statistical methods; the examples use made-up numbers to teach the calculation. Not a clinical or legal guide: current Colombian rules are in the official sources.
Sources: WHO handbook for guideline development, 2nd Edition (World Health Organization, 2014); Guías de Práctica Clínica GPC (Ministerio de Salud y Protección Social, 2026); Guía de Práctica Clínica - IETS (Instituto de Evaluación Tecnológica en Salud, 2026).
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Representative model, for educational purposes only.