Clinical Practice Guidelines and Standards of Care
Clinical practice guidelines are statements developed by third-party organizations such as these:
While guidelines identify and describe generally recommended courses of intervention, they are not presented as a substitute for the advice of a physician or other knowledgeable healthcare professional or provider.
Guidelines are usually created by a panel of experts looking at all the evidence for or against a therapy. A systematic review is conducted using rigorous evidence-based methodology. The strength of evidence for each recommendation explicitly stated. Reviewers conduct an assessment of the benefits and harms of therapies and treatments.
Guidelines serve several purposes, including these:
SIO Recommendation Grades
The Society for Integrative Oncology grades therapies according to the evidence of benefit or harm, with a corresponding recommendation for or against use. This is a typical grading system, although the grade labels vary among publications:1
- Assist practitioners and patients in making decisions about appropriate health care for specific clinical circumstances
- Define for healthcare professionals the role of specific diagnostic and treatment modalities in the diagnosis and management of patients.
Standards of Care
A standard of care is “a diagnostic and treatment process that a clinician should follow for a certain type of patient, illness, or clinical circumstance.”3 Standards of care are often called on in malpractice or other legal actions wishing to show that a healthcare provider failed to provide care or performed harmful actions outside reasonable and customary established standards. A 2011 article provided this legal interpretation: “the standard of care is what a minimally competent physician in the same field would do in the same situation, with the same resources.”4
Healthcare providers, especially those in large hospital systems, are often held to the standards of care in their fields, dampening opportunities for innovative or unusual approaches, irrespective of their value.
Written by Nancy Hepp, MS. Updated January 28, 2020.
- Society for Integrative Oncology: Integrative Oncology Guidelines
- National Comprehensive Cancer Network: NCCN Guidelines®
- American Academy of Family Physicians: Clinical Practice Guideline Manual
- National Center for Complementary and Integrative Health: Clinical Practice Guidelines
- Raymond Chang, MD: Beyond the Magic Bullet: The Anti-Cancer Cocktail