The quality of most Australian clinical practice guidelines is disturbingly poor. The majority make recommendations that are not informed by evidence, do not appropriately identify and manage conflicts of interest and do not transparently report the process by which they were created. In many cases they are also out of date – potentially from the day they were published. As a result we should question whether or not clinical practice guidelines should be trusted to guide decision making by clinicians, policy makers, patients or their carers.
The Clinical Practice Guidelines Portal is a web site maintained by NHMRC that allows users to access Australian clinical practice guidelines. The database underpinning the portal now contains data on 1205 Australian guidelines published between 2005 and 2014, of which 117 are cancer guidelines. How do clinical practice guidelines in cancer stack up against other Australian guidelines? How confident are we that they can reliably guide clinical practice and what could be done to make them more trustworthy?