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Methods underpinning national clinical guidelines for hypertension: describing the evidence shortfall

Fiona Campbell1, Heather O Dickinson1, Julia VF Cook1, Fiona R Beyer1, Martin Eccles1 and James M Mason2*

Author Affiliations

1 University of Newcastle upon Tyne, Centre for Health Services Research, 21 Claremont Place, Newcastle upon Tyne, NE2 4AA, UK

2 University of Durham, School for Health, Wolfson Research Institute, Queen's Campus, University Boulevard, Stockton-on-Tees, TS17 6BH, UK

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BMC Health Services Research 2006, 6:47  doi:10.1186/1472-6963-6-47

Published: 5 April 2006



To be useful, clinical practice guidelines need to be evidence based; otherwise they will not achieve the validity, reliability and credibility required for implementation.


This paper compares the methods used in gathering, analysing and linking of evidence to guideline recommendations in ten current hypertension guidelines.


It found several guidelines had failed to implement methods of searching for the relevant literature, critical analysis and linking to recommendations that minimise the risk of bias in the interpretation of research evidence. The more rigorous guidelines showed discrepancies in recommendations and grading that reflected different approaches to the use of evidence in guideline development.


Clinical practice guidelines as a methodology are clearly still an evolving health care technology.