Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles.
Jackson and Feder have introduced a very useful set of criteria, perhaps because they are so oriented towards the needs of the endusers (patients and treating clinicians). Other guides on guidelines have perhaps been more complex because they have been intended for other users such as health service purchasers or commissioners. What is clear, then, is that guidance for guidelines will differ according to who will use them.
This represents a major problem for those who will develop National Service Frameworks, and the accompanying audits for the UK's new National Institute for Clinical Excellence - NICE (1). The use of the these Frameworks will be to provide the professions and representatives of users and carers with evidence-based guidance "for major care areas and disease groups"(1). But if these audiences have differeing information and presentation needs, then this will become an exacting task - not impossible, but very ambitious.
Information technology can help, and if the Government gets this right, by investing in the right skills and infrastrucutre, then the public health rewards will be many. However, if the information needs of the different parties to health care decisions are not understood and met in the frameworks, then the potential benefits of these national standards of care will be lost.
1. A First Class Service. Department of Health. London 1998.
Guidelines guidance and problems for NICE
Jackson and Feder have introduced a very useful set of criteria, perhaps because they are so oriented towards the needs of the endusers (patients and treating clinicians). Other guides on guidelines have perhaps been more complex because they have been intended for other users such as health service purchasers or commissioners. What is clear, then, is that guidance for guidelines will differ according to who will use them.
This represents a major problem for those who will develop National Service Frameworks, and the accompanying audits for the UK's new National Institute for Clinical Excellence - NICE (1). The use of the these Frameworks will be to provide the professions and representatives of users and carers with evidence-based guidance "for major care areas and disease groups"(1). But if these audiences have differeing information and presentation needs, then this will become an exacting task - not impossible, but very ambitious.
Information technology can help, and if the Government gets this right, by investing in the right skills and infrastrucutre, then the public health rewards will be many. However, if the information needs of the different parties to health care decisions are not understood and met in the frameworks, then the potential benefits of these national standards of care will be lost.
1. A First Class Service. Department of Health. London 1998.
Competing interests: No competing interests