The real difficulty in improving concordance of clinical practice with guidelines

Nengliang Yao, Abram Recht


The degree to which patient care is concordant with guidelines is widely used to assess the quality of health care. Compliance with guidelines is very high for certain cancers and procedures but not for others. For example, patients with stage I-III colon cancer routinely undergo bowel resection, with very little variation in rates between regions or institutions (1).