As health care technologies, evidence-based practice, and clinical guidelines
continue to evolve, so does understanding of their limitations.1- 3
The emphasis of the debate regarding evidence-based guidelines recently has
shifted from the what to the how.4 Formal evaluations of guideline quality
have called for improvements in their development.5
Guideline development represents an alloy of evidence, expert opinion, and
the views and opinions of other stakeholders.6
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