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The Placental Pathology Practice Guideline Development Task Force, a multidisciplinary group, has prepared this guideline to assist those involved with placental examination. It provides recommendations related to indications and methods for placental examination as well as sample worksheets. An algorithm for the handling of placentas summarizes the recommendations of the guideline. A summary of specific findings of placental examination together with their pathogenesis and clinical associations is also provided. Recommendations related to reporting with sample reporting formats are included. The guideline is intended as an educational tool, and its use should be guided by the individual circumstances and care setting of specific cases.
(Arch Pathol Lab Med. 1997;121:449-476)
The American Medical Association is working cooperatively with national medical specialty societies, including the College of American Pathologists (CAP), to guide the development and implementation of practice guidelines. In an attempt to improve the quality and consistency of practice guidelines, attributes have been established to guide their development 1:
1. Practice guidelines should be developed by or in conjunction with physician organizations.
2. Reliable methodologies that integrate relevant research findings and appropriate clinical expertise should be used to develop practice guidelines.
3. Practice guidelines should be as comprehensive and specific as possible.
4. Practice guidelines should be based on current information.
5. Practice guidelines should be widely disseminated. Several definitions are important to the development, understanding, and use of practice guidelines.
Parameters.-Practice parameters are strategies for patient management developed to assist physicians in clinical decision making. Practice parameters include standards, guidelines, and other patient management strategies.
Standards.-Standards are accepted principles for patient management. Practice variation owing to patient- or physician-specific factors is not expected.
Guidelines.-Guidelines are recommendations for patient management that identify a particular management strategy or a range of management strategies. Practice variation is reasonable to the extent that definitions of management strategies or applicable clinical categories allow incorporation of patient- or physician-specific information.
Options.-Practice variation is expected because implementation of options requires incorporation of substantial patient- or physician-specific information.
Guideline development has become a high priority of organized medicine and the government. It attempts to provide a setting in which the effects of medical intervention on health outcomes can be evaluated, in terms of both human benefit and cost-effectiveness. It seeks to aid in...