Evidence-based guidelines.

The Advanced/Policy Track of the 2004 Kaiser Permanente Evidence-Based Medicine Symposium was an interactive session that focused on developing evidence-based clinical practice guidelines. The hypothetical scenario involved the imaginary drug "Memoryboost," a treatment for dementia. The participants were given materials describing the national Kaiser Permanente (KP) methodology for developing evidence-based guidelines and a summary of the highest-quality articles about the efficacy of this drug. The participants then formed small groups and used this information to develop a recommendation about its use for the treatment of dementia. In spite of having the same evidence, the groups developed three different recommendations. The entire group then explored some of the reasons for this variability. This article also addresses the reasons KP develops its own national guidelines, as well as who oversees the national guideline initiative and who develops guidelines.