Expert Commentaries: Promoting Transparent and Actionable Clinical Practice Guidelines: Viewpoint from the National Guideline Clearinghouse/National Quality Measures Clearinghouse (NGC/NQMC) Editorial Board

eg:

"..........The NGC/NQMC Editorial Board recommends avoiding vague or ambiguous recommendation statements (such as "Physicians may offer…" or "When possible…").

Recommendation statements containing vague or ambiguous language and expressions are not actionable, at least not consistently. This problem fosters subjective and potentially erroneous interpretation and thus can impede decision-making.

* Example:

  ..."Frequency of follow-up visits is based on the severity of disease presentation, etiology, and treatment.
A follow-up visit should include an interval history, measurement of visual acuity, and slit-lamp biomicroscopy." (9)

Although this statement recommends the activities to be performed during a follow-up visit, it does not provide recommendations for the frequency of follow-up, nor does it define the conditions that would be determinants of that frequency. We recognize that there may be sound reasons for crafting recommendation statements that are not actionable. For example, evidence to support a more specific recommendation statement may be absent or experts may disagree. If this is the case, then the guideline should explicitly state why a recommendation cannot be made.....cont'd