In 1990, the Institute of Medicine recommended the development of clinical guidelines to reduce inappropriate variation in practice. This commenced an explosion of guidelines. For example, the National Guideline Clearinghouse now includes 471 guidelines for hypertension and 276 for stroke alone. For maximal variation reduction, the number of guidelines you need is one. Though it’s possible all of the hundreds of clinical guidelines on a subject say the same thing, that’s not the case.
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