Following up from my question yesterday regarding Practice Guidelines. I
received fantastic responses, and have summarized below. I have split the
summary between the two parts of my question, and two miscellaneous items
of interest. THANK YOU to everyone who responded. Your replies were
extraordinarily useful. What was most interesting to me is that I was
expecting a "holy grail hub" to search for practice guidelines, and
expected that guideline selection was determined by a
departmental/institutional/regional/national criteria-- which certainly is
not the case. I'm glad to see that I seem to be on the same page as my
colleagues. Raquel

SEARCHING- general consensus? There is no one authoritative place to
search! Using a variety of resources will yield the best results.

- PubMed
        - using Practice Guidelines or Guidelines as limits
        - sometimes using Consensus Development Conferences
        - entering Guidelines into MeSH to retrieve other relevant options
- Searching other databases such as CINAHL, PsycInfo, depending on the type
of guideline needed
- National Guideline Clearinghouse
- US Preventive Services Taskforce (
- Healthcare Standards Online
- Any relevant societies/professional associations, and depending on the
guidelines needed, may check WHO, CDC, etc.
- Start with PubMed, without limits, then use limits if necessary. Will
often use NGC in addition, or if nothing is found via PubMed.
- A combination of PubMed,, and Google.

SELECTION- general consensus? There is no one authoritative selection
criteria to use!

- Leave the selection to the user, generally. If asked to choose, will
consider the source, date of the guideline and/or updates, and supporting
documentation, if available.
- Look for levels of evidence given in the content of the guideline. If
authors have provided evidence ratings, that guideline will be chosen over
another. Choose any guideline that has clearly been well-researched and
based on as much formal research evidence as possible.
- Tend to use nationally recognized associations/government guidelines, but
will look at others if they address to topic more specifically. Has found
their patrons (physicians, nurses, residents, etc.) prefer to have 2-3
guidelines from various organizations to meld into their own. Certain
specialties prefer guidelines from certain organizations (e.g. Pediatrics
prefers guidelines from AAP).
- Look for what is current & applicable to the USA.
- Calling the Academies directly to find out if there are any guideline
updates that may not have yet been made available, and when guidelines will
be updated again (essential if you find one more than 3-5 years old).
- Choose the best 10 or 12 by matching content with patron's question.
Provide these references to the expert (physician, nurse, etc.) and let
them choose.


- University of Toledo's LibGuide for practice guidelines:
- One responder did the following PubMed search to try to locate practice
guideline evaluation criteria:

("practice guidelines as topic"[MeSH Major Topic]) AND
evaluation[Title/Abstract]) AND standards[MeSH Subheading]
       Limited to English/last 10 years

She found two classification/grading tools:

    The GRADE system for classification of the level of evidence and grade
of recommendations in clinical guideline reports.
    PMID: 19944034 
    Making the AGREE tool more user-friendly: the feasibility of a user
guide based on Boolean operators.
    PMID: 20367706