Intended for healthcare professionals

Rapid response to:

Learning In Practice

Randomised controlled trial of clinical decision support tools to improve learning of evidence based medicine in medical students

BMJ 2003; 327 doi: (Published 06 November 2003) Cite this as: BMJ 2003;327:1090

Rapid Response:

Towards collaborative research in evidence based medicine : the international network for evidence based guidelines G-I-N.


We fully agree with Leung et al (BMJ 2003;327:1090) that collaborative,
multicentred efforts in educational research in evidence based medicine is
more necessary than ever. One of the major barriers against this kind of
research has been the lack of institutionalised international
collaboration in all fields of evidence based health care. For example -
despite several multinational activities dealing with the use of evidence
based guidelines (EBG) (1-3), there was no established forum for
communication between those involved in developing, appraising and
implementing clinical guidelines. As a result, in different countries
aiming at similar goals and using similar strategies, efforts are
unnecessarily reduplicated.

In order to promote sustainable partnerships in the field of EBG and to
support development and research activities in evidence based health care,
a network of non-for-profit organisations dealing with development,
implementation and evaluation of EBGs was founded in November 2002,
called Guidelines International Network (G-I-N). G-I-N was recognised as
Scottish Charity, and has grown to a network of 46 organisations from 24
countries (by October 2003), representing expertise from America, Asia,
Oceania, and Europe including WHO.

During the last months G-I-N has been developing the INTERNATIONAL
GUIDELINE LIBRARY with information on more than 1300 guidelines and
evidence reports - available on the Internet since 3 November (www.g-i-

One of the Network’s major tasks for the next few years will be the
promotion of international research on the evaluation of knowledge
transfer by the use evidence based guidelines – in partnership with other
established networks (f.e. the Cochrane Collaboration).
In that way G-I-N’s work might contribute to the realisation of Leung et
al’s vision.


1) Burgers JS, Grol R, Klazinga NS, Mäkelä M, Zaat J, for the AGREE
Collaboration. Towards evidence-based clinical practice: an international
survey of 18 clinical guideline programs. Int J Qual Health Care 2003; 15:

2) Council of Europe. Developing a methodology for drawing up guidelines
on best medical practice. Recommendation Rec(2001)13 and explanatory
memorandum. Strasbourg, Council of Europe Publishing 2002. Internet: www.g

3 )The AGREE Collaboration. Development and validation of an international
appraisal instrument for assessing the quality of clinical practice
guidelines: the AGREE project. Qual Saf Health Care 2003;12:18–23.


Prof. Guenter Ollenschlaeger FRCP Edin – German Agency for Quality in
Medicine AQuMed (D)

Catherine Marshall, New Zealand Guideline Group NZGG, Wellington (NZ)

Dr. Safia Quershi, Scottish Guideline Intercollegiate Network SIGN,
Edinburgh (UK)

Dr. Kitty Rosenbrand and Dr. Teus van Barneveld, Dutch Institute for
Healthcare Improvement CBO (NL)
for the Guidelines International Network Board of Trustees

Competing interests:
None declared

Competing interests: No competing interests

07 November 2003
Guenter Ollenschlaeger
Chairman, Guidelines International Network
Catherine Marshall, Safia Qureshi, Kitty Rosenbrand, Teus van Barneveld
German Agency for Quality in Medicine, Aachener Str. 233-237, D-50931 Koeln, Germany