A long run for a short jump: understanding clinical guidelines.

Clinical guidelines for application of medical technologies are being advanced as consensus recommendations by consumer groups, professional societies, and health care managers. Although different groups' guidelines for use of a given technology may vary--or even conflict--depending on the methods by which they were formulated, their proponents' interests, and the subjective values attached to potential outcomes, they make it possible to quantify somewhat and predict, on a population basis, clinical gains relative to costs. Clinical guidelines can introduce into patient-physician decision making systematic consideration of a given technology's demonstrated efficacy and its likely advantages compared with its personal and its societal costs. Provided there is flexibility to allow for individual departures from consensus recommendations and for development of new technologies, applying clinical guidelines in health care can serve both individual patients and society and help to balance their respective needs for informed decision making and for resource allocation.