Policy on the Development and Use of Practice Guidelines
Disclosure of Potential Conflicts of Interest for Practice Guidelines Committee members
AASLD, recognizing the need to develop practice guidelines for liver diseases, has established a practice guidelines committee. AASLD guidelines represent the official opinion of the Association, as reflected in the evidence based reviews and recommendations of the individuals involved in developing the guidelines. (Members of the Practice Guidelines Committee serve a term of three years and have a wide range of expertise, from transplantation to pediatrics to clinical virology.)
AASLD guidelines deal with common problem areas for health care practitioners who care for patients with liver disease. These areas will include conditions (diseases, signs and symptoms) and technologies (diagnostic tests and therapeutic procedures). Guidelines are based on a formal review and analysis of relevant published data, carefully weighing the strength of the scientific evidence. However, there are situations in which such data are inconclusive or absent. Therefore, some recommendations will be based on expert opinion. The policy of the AASLD practice guidelines committee is to clearly identify the degree to which a guideline reflects facts or consensus opinion.
Practice guidelines can serve many useful purposes, including the development of logical aids to clinicians, hospitals, public health agencies, and managed care organizations in providing the highest standard of care for their patients, while taking into consideration the responsibilities for controlling medical costs. The primary purpose of an AASLD practice guideline, however, is physician education. The published guideline should assist the physician in patient care decisions and hopefully improve clinical outcomes.
Practice guidelines should not be viewed as “standards of care” to be followed to the letter, but should be designed to aid clinics and organizations in the care of patients with liver diseases, as well as be flexible enough to allow clinicians to use them to aid in the management of patients with specific liver diseases. Guidelines have been and will continue to be used to define adequate or appropriate medical care. It is important, therefore, that the recommendations are worded carefully, and the situations in which they do or do not apply, be made clear.
In addition to the development of practice guidelines supported by scientific data, the AASLD practice guidelines committee is empowered to develop, review and recommend the endorsement of position papers on topics in important areas of liver disease that present the state of the art of current clinical practice. In the absence of the availability of scientific data, the position papers may be based on expert opinion. A distinction will be made between guidelines and position papers.