Intended for healthcare professionals

Letters Evidence base of guidelines

Guidelines are not perfect but provide safeguards for both patients and physicians

BMJ 2019; 366 doi: (Published 12 August 2019) Cite this as: BMJ 2019;366:l5052
  1. Peter A Andrews, consultant nephrologist
  1. South West Thames Renal and Transplantation Unit, St Helier Hospital, Carshalton SM5 1AA, UK
  1. peter.andrews4{at}

Elwenspoek and colleagues review the evidence base behind the current UK guidelines for monitoring diabetes and hypertension in primary care.1 They rightly conclude that most current guidelines are based on expert opinion and consensus rather than “hard” or published evidence.

The authors argue that unnecessary testing in primary care can lead to false positive and false negative results, increased workload, and higher …

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