RT Journal
A1 Sanders, James O.
A1 Jevsevar, David S.
A1 Goldberg, Michael J.
A1 Weber, Kristy L.
T1 Quality Guidelines Need Evidence, Not OpinionCommentary on an article by Robert A. Pedowitz, MD, PhD, et al.: “American Academy of Orthopaedic Surgeons Clinical Practice Guideline on Optimizing the Management of Rotator Cuff Problems”
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2012
FD January 18
VO 94
IS 2
SP e14 1
OP 2
DO 10.2106/JBJS.K.01382
UL http://dx.doi.org/10.2106/JBJS.K.01382
AB 
The first issue is the selection of evidence for the AAOS CPGs. In the AAOS guidelines process, there is no restriction of evidence to Level-I studies. All AAOS clinical practice guidelines start with preliminary questions developed by a Work Group composed of clinical expert volunteers from the AAOS and from other medical and surgical professional societies so that all of the interests of the patient may be included. The experts develop the questions, and a complete systematic literature review is performed to address them. To prevent bias when members of the Work Group do not like the answers, questions cannot be changed once they are finalized. The CPG process is guided by the questions posed by the Work Group. Some guidelines have asked more clinically relevant and practice-relevant questions than others. The AAOS is developing a broader and more inclusive method to allow more members and other stakeholders to be involved in the formulation of questions for the guideline process.