In 1995, the National Health and Medical Research Council (NHMRC) announced its commitment to developing evidence-based clinical practice guidelines "to promote best practice linked to outcomes and effective cost management". To date, resources for dissemination and implementation have been identified for only two guidelines developed by the NHMRC as part of that commitment. Clinical practice guidelines for the management of men with lower urinary tract symptoms (LUTS) were launched in 1997. We were members of the working party that developed these guidelines, and here we give our personal account, offering insights into the tensions and contradictions impeding the translation of political commitment to evidence-based medicine into policy and practice.
Correspondence:
- 1.
- Clinical practice guidelines for the management of uncomplicatedlower urinary tract symptoms in men. Canberra: National Health andMedical Research Council, 1997.
- 2.
- Ward JE, Sladden M. Urinary symptoms in older men, theirinvestigation and management: is there an epidemic of undetectedmorbidity in the waiting room? Family Practice 1994; 11:251-259.
- 3.
- Pinnock CB, Marshall VR. Troublesome lower urinary tract symptomsin the community: a prevalence study. Med J Aust 1997; 167:72-75.
- 4.
- Ward JE, Hughes A-M, Hirst GHL, Winchester L. Men's estimate ofprostate cancer risk and self-reported rates of screening. Med JAust 1997; 167: 250-253.
- 5.
- Benign prostatic hyperplasia: diagnosis and treatment. Clinicalpractice guideline no. 8. Agency for Health Care Policy and Research,US Department of Health and Human Services, 1994 (AHCPR PublicationNo. 94-0582).
- 6.
- Guidelines for the development and implementation of clinicalpractice guidelines. Canberra: National Health and MedicalResearch Council, 1995.
- 7.
- McDonald J. Evidence-based health care from the consumerperspective. Aust Health Consumer 2000; 1 (Summer): 8-10.
- 8.
- A guide to the development, implementation and evaluation ofclinical practice guidelines. Canberra: National Health andMedical Research Council, 1999.
- 9.
- Davidoff F. Evangelists and snails redux: the case of cholesterolscreening. Ann Int Med 1996; 124: 513-514.
- 10.
- Butler J. Economic aspects of lower urinary tract symptoms in menand their management. Working paper 37. Canberra: National Centrefor Epidemiology and Population Health, Australian NationalUniversity, 1996.
- 11.
- AHTAC. Prostate cancer screening. Canberra: AGPS, 1996.
- 12.
- Young J, Muscatello D, Ward J. Are men with lower urinary tractsymptoms at increased risk of prostate cancer? A systematic reviewand critique of the available evidence. Br J Urol Internat2000. In press.
- 13.
- "Is it my prostate Doc?": a guide for general practitioners.Canberra: National Health and Medical Research Council, 1997.
- 14.
- To pee . . . or not to pee . . . A guide for men about their urinarysymptoms. Canberra: National Health and Medical Research Council,1997.
- 15.
- Pinnock C, O'Brien B, Marshall V. Older men's concerns about theirurological health: a qualitative study. Aust N Z J PublicHealth 1998; 22: 368-373.
- 16.
- How to present the evidence for consumers: preparation ofconsumer guidelines. Canberra: National Health and MedicalResearch Council, 2000.
- 17.
- Hirst G. Clinical practice guidelines: to what end? Med JAust 1997; 167: 288.
- 18.
- Clinical practice guidelines: the management of early breastcancer. Canberra: National Health and Medical Research Council,1995.
- 19.
- Young J, Ward J. General practitioners' use of evidencedatabases. Med J Aust 1999; 170: 56-58.
- 20.
- Hirst G. Men and their urinary symptoms: guidelines support aconservative approach to the management of many men. NHMRCNews. 1999; 1(2): 3-5.
- 21.
- Pinnock C. Report from the first national meeting of theAustralian Prostate Cancer Collaboration Education Group.Cancer Forum 1999; 23: 165-167.
- 22.
- Hirst G, Wilde S. Your prostate, your choices: the news may be morereassuring than you think. Sydney: Bantam Books, 1999.
- 23.
- Health and Medical Research Review Strategic Review. Thevirtuous cycle: working together for health and medical research.Canberra: AGPS, 1998.
- 24.
- Australian Department of Health and Aged Care. The 1999-2000Health Budget in detail. Major boost to medical research takesAustralia into the century of healing. Budget media release, 11 May,1999. <http://www.health.gov.au/pubs/budget99/media/mrmw991.htm> (accessed 15 February, 2000).
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