1 Department of Otolaryngology-Head and Neck Surgery, University of Virginia, Charlottesville, Virginia, USA.
2 School of Law, University of Virginia, Charlottesville, Virginia, USA.
3 Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel.
Clinical practice guidelines aim to improve medical care by clarifying and making useful recommendations to providers. Although providers should account for patients' unique characteristics when determining a treatment plan, it is generally perceived as good practice to follow guidelines when applicable. This is of interest in malpractice litigation, where it is essential to establish a standard of care to evaluate the performances of providers. Although the opinions of expert witnesses are used to determine standards of care, guidelines are expected to play a leading role. Guidelines alone should not establish a legal standard but may help inform this discussion in the courtroom. Therefore, it is incumbent that excellent, practical, and timely guidelines are continually created and updated in a transparent way. These guidelines must be very clear and underscore the various strengths of recommendation based on the quality of available evidence.