Table 1:

Strengths and limitations of 3 pragmatic methods for testing clinical practice guidelines

Method	Strengths	Limitations	Guideline developers currently using this method
Public consultations	Incorporates feedback from front-line clinicians Increases acceptance from the medical community	Extends the length of time for guideline development	National Institute of Clinical Studies (Australia) United States Preventive Services Task Force Scottish Intercollegiate Guidelines Network National Institute for Health and Clinical Excellence (UK)
Clinical vignettes	Requires minimal resources Provides rapid feedback Allows different formats of recommendations to be tested	Requires a group of physicians as study participants Must be carefully constructed and linked to explicit outcomes or evidence-based guidelines May not reflect actual behaviours of clinicians	None
Performance measures	Quality of medical care can be gauged	Feedback is available only after guidelines have been implemented Performance measures do not always reflect the quality of care Unmeasured aspects of care could worsen	Canadian Task Force on Preventive Health Care Canadian Stroke Network National Institute for Health and Clinical Excellence (UK)