National guidance and allocation of resourcesBMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7334.427/b (Published 16 February 2002) Cite this as: BMJ 2002;324:427
Acting chairman of SIGN's response
- G C W Howard, acting chairman
- Scottish Intercollegiate Guidelines Network (SIGN), Royal College of Physicians, Edinburgh EH2 1JQ
- Medicines Monitoring, Department of Clinical Pharmacology, Ninewells Hospital, Dundee DD1 9SY
EDITOR—I think that Cookson et al in their criticisms of the Scottish Intercollegiate Guidelines Network (SIGN) show a lack of understanding of the role of this organisation and the methods it uses to develop its guidelines.1 Evidence based guidelines will not resolve all healthcare issues, just as randomised controlled trials are not appropriate to resolve all therapeutic controversies. There are, however, areas of healthcare delivery where there are variations in practice and outcome, and where there is also evidence to support one practice over another.
This is where SIGN concentrates its resources to produce guidelines. SIGN does not differentiate in its methodology between costly and non-costly treatments, and, contrary to the authors' supposition, the adherence to such guidelines will reduce variations in …