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Evidence-based medical guidelines are an inescapable element of
current medical practice, but how are they developed? This book
interrogates what causes these differences and similarities between
guidelines and uncovers the mechanisms behind the development of
medical practice guidelines. Four case studies, on lower back pain
and on type 2 diabetes in England and the Netherlands, are used to
provide a detailed empirical account of the development of medical
guidelines. Interviews with guideline developers are combined with
a detailed analysis of guideline documents. Theories from science
and technology studies, institutional literature, group
decision-making, and professional self-regulation are used to
demonstrate how the development of guidelines involves a series of
subjective choices driven by economic, cultural, institutional and
political frames. Medical evidence plays a more limited and nuanced
role in guideline construction than might be expected. Professional
Regulation and Medical Guidelines sheds light on the power of
experts and institutions to shape the governance of healthcare, and
argues for greater transparency of the processes by which experts
decide on the gold standard of care. The book will be of interest
to guideline developers, medical professionals, policy makers,
sociologists and lawyers who are interested in the interaction of
science and law. It provides rich empirical data into the often
opaque and little understood world of rule-making by experts.
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