Development and implementation of guidelines in neurosurgery.

Although it is intuitive that any neurosurgeon would seek to consistently apply the best available evidence to patient management, the application of evidence-based medicine (EBM) principles and clinical practice guidelines (CPGs) remains variable. This article reviews the origin and process of EBM, and the development, assessment, and applicability of EBM and CPGs in neurosurgical care, aiming to demonstrate that CPGs are one of the valid available options that exist to improve quality of care. CPGs are not intended to define the standard of care but to compile dynamic advisory statements, which need to be updated as new evidence emerges.