“We need a better understanding of how to use guidelines — when they’re appropriate and when they’re not. I don’t recall ever being asked to unpick a guideline in my medical training despite using them almost daily. In a bid to resist the slow creep of guideline centred decision making, I’ve started to ask myself three questions:
Does the guideline apply to my patient?
Is the advice pragmatic?
Is it what my patient wants?
If the answer to any of those is no, I give myself the freedom to walk away from the guideline and to do what I think is right for the patient.”
Rammya Mathew: Three questions I ask before using a guideline. BMJ 2019: 364: I358