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Call for a European Guidelines Institute

Department of Psychiatry and Psychotherapy, Technische Universität München, Ismaningerstrasse 22, 81675 Munich, Germany.

M. Stiegler, C. Rummel, K. Wahlbeck and W. Kissling

Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany

Correspondence: E-mail: Stefan.Leucht{at}lrz.tum.de

EDITED BY KIRIAKOS XENITIDIS and COLIN CAMPBELL

The guideline assessment by Gaebel et al (2005) has been long overdue. Whereas there was originally quite a bit of scepticism about guidelines in psychiatry, there now appears to be a sort of ‘guidelines mania’, as each European national association tries to produce its own guidelines. We have recently completed an assessment of even more (n=61) guidelines, which was not limited to schizophrenia but focused on European psychiatric guidelines. Although our results were similar – the general quality of the guidelines was medium grade, although there were some of outstanding quality – we arrived at somewhat different conclusions.

By amending the AGREE instrument (AGREE Collaboration, 2003) with an additional item, we found that national particularities were very rarely considered by European psychiatric guidelines (18%), and then only very vaguely. This is not surprising, since the evidence available for guidelines is almost always of an international nature. There are hardly any treatment studies focusing specifically on national subgroups. Therefore the evidence underlying the guidelines must always be the same per se. Given the enormous expenditure of time and money that is necessary to develop a methodologically sound guideline, we strongly advocate the establishment of a European Guidelines Institute. It could then be the task of the national associations to adapt guidelines to the specific conditions of their own countries. Such a procedure could improve the quality of most national guidelines and foster the ongoing standardisation of European medical care.

REFERENCES

AGREE Collaboration (2003) Development and validation of an international guidelines appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project. Quality and Safety in Health Care, 12, 18 –23.[Abstract/Free Full Text]

Gaebel, W., Weinmann, S., Sartorius, N., et al (2005) Schizophrenia practice guidelines: international survey and comparison. British Journal of Psychiatry, 187, 248 –255.[Abstract/Free Full Text]

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