A third of recommendations in Scottish guidelines are based on poorest evidence, finds study

Expert groups that produce the longest clinical guidelines make the biggest proportion of recommendations that are based on poor evidence, a study has concluded.1

To investigate the levels of evidence used in guidelines, the researchers examined 42 guidelines of the Scottish Intercollegiate Guideline Network (SIGN). They chose these guidelines because they are internationally respected and they contribute to national policies, such as the Quality and Outcomes Framework (QOF), the incentive payment scheme for GPs in the United Kingdom.

SIGN guidelines have four grades of recommendation. A grade recommendations are the best and …