Giving support to disease guidelines

Abstract

The article by Weeramanthri et al (2002) provides an invaluable account of the processes, endeavours andbenefits derived from the development and use of disease guidelines for Indigenous populations. It highlights several important lessons from which others with a similar interest can benefit, including the following:? the importance of obtaining a consensus, and not just an evidence base, for guideline development? guidelines should be judged in relation to what already exists rather than in relation to a hypotheticalstandard of best practice? implementation is far more difficult than development.The term evidence, in this context, is often used to refer to proof of benefit derived from quasi-experimental design studies.However, one should not discount the use of other forms of evidence, particularly (in the absence of evidence from studies with an adequate experimental design) experiential-based evidence.I focus on two related matters in this commentary. The first concerns the extent to which the experiences ofthese two trials are similar to or contrasted by the experiences of the other Indigenous trials. The secondconcerns lessons learned from implementation and usage of disease guidelines as distinct from developmentissues which are the focus of the article by Weeramanthri and colleagues.