Practice guidelines and clinical governance: do the means match with the ends? A quality appraisal of local practice guidelines Available to Purchase

The quality of 39 guidelines developed locally was assessed, using a standardised instrument addressing five quality domains (scope and purpose, stakeholders involvement, rigour of development, applicability and clarity). For each of them a domain‐specific quality score (ranging from 0 to 100) was estimated. Overall, local guidelines scored particularly low on rigour (mean: 5.1; sd: 12.1) and applicability (mean: 16.9; sd: 12.9). Scores for other domains were only slightly better. This study suggests that local guidelines do not assure neither scientific validity of the recommendations nor attention to their adoption in clinical practice. Without substantial changes in their local use, practice guidelines will not be of any benefit in supporting the implementation of clinical governance.