UK guidelines: methodology and standards of care

Dilip Nathwani

    Research output: Chapter in Book/Report/Conference proceedingChapter

    1 Citation (Scopus)


    The culture of searching for evidence in medicine has revolved around three areas-the systemic-pathophysiological, the individual-clinical, and statistico-analytic approach (Trohler, 2001). The origin of the first lies with Socrates (c. 400 BC) and Galen (c. 200 AD), the second with the long evolution of the process we call "medical judgement" and the last with the work of a number of pioneers such as James Lind, a Scottish Naval Surgeon (1716-94) who validated his intuition about the best treatment for scurvy by undertaking a prospective randomised study on board a British Naval Ship (Trohler, 1981). This and other works, were the beginnings of systematic and analytic evaluation of evidence as a basis for clinical practice. The analytic and evidencebased culture has been prevalent and ascendant in UK practice of the last decade and forms the basis of the clinical effectiveness cycle (Figure 1). This process underpins the core components of ensuring good quality clinical practice. This chapter is based on a paper published in the Journal of Antimicrobial Chemotherapy (Nathwani, 2003). It aims to synthesise issues related to clinical effectiveness by addressing the development of evidence-based guidelines and the standards used to evaluate the quality of care, with emphasis on antimicrobial prescribing in hospitals. Although some aspects of this chapter may overlap with other chapters, they are in general complementary and provide the readers with a distinctly UK and Scottish perspective on the subject. (figure presented)
    Original languageEnglish
    Title of host publicationAntibiotic Policies
    Subtitle of host publicationTheory and Practice
    EditorsIan M. Gould, Jos W. M. van der Meer
    Number of pages13
    ISBN (Electronic)9780387228525
    ISBN (Print)9780306485008
    Publication statusPublished - 2005


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