Guidelines and evidence-based medicine in Germany

Clinical Practice Guidelines (CPGs) are increasingly common in the German health care system. The German physicians' self-governmental body's position regarding CPGs as a tool of Evidence-based medicine (EBM) was described in a joint policy paper concerning quality in health care in late 1998. The German Medical Association (GMA) and the National Association for Statutory Health Insurance Physicians (NASHIP) stated that "the principles of EBM should be implemented into the German Health Care System" by the following means: to assess systematically and appraise critically the evidence in health care to develop evidence-based consensus CPGs for priority problems in health care to implement CPGs using graduate, post-graduate, and continuing medical education, as well as audits and CPG-based information management to evaluate quality in health care against the background of CPGs. The following paper will discuss the aims and scopes and the limits of this concept.