Clinical Practice Guideline Development

Even when evidence on values and preferences exists, panels must interpret it by considering risk of bias, consistency, directness to the decision, and applicability to the target population. Guideline panels frequently lack the time and resources to conduct large primary studies such as patient surveys. Unstructured discussion of patient values issues in guideline panels can be difficult, and panels may struggle to reach consensus. In practice, guideline panels may rely on small patient focus groups or discussions among clinical experts as feasible but limited alternatives to primary evidence.