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The twenty-first century will be the era of the market economy, a
century char acterized by the penetration of market forces into
every social field, even into government activities, education, and
medical care. Guidelines for the provision of clinical care have
been developed in recent years chiefly in American health-care
services, which are the most thoroughly exposed to the market
economy. The problem of escalating medical costs in the United
States led the government and consumer groups to introduce clinical
practice guidelines. Guidelines were introduced to control medical
costs and quality. Initially, guidelines were developed mainly on
the consumer side, but professionals, too, soon recognized the
importance of clinical practice guidelines. The involvement of
diverse groups in the development of guidelines has inten sified
the need to create and improve scientific methods for drawing up
those guidelines. Owing to the development of systematic and
structured abstraction methods, evidence-based guidelines have been
proposed. Principally, guidelines are a sum mary of published
treatments created by statistical analysis of clinical outcomes."
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