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Similarly, the government could measure how well physicians' prescribing behavior matches guidelines.
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In a system of private insurance plans the government could pay insurers an amount contingent on how well prescription use matched guidelines.
The highest number of matched guidelines was for one meta-analysis in non-small cell lung cancer, for which 16 matched guidelines were identified.
In addition, it was not always possible to match guidelines exactly.
Of the 29 meta-analyses with matched guidelines, 21 (72%) had been cited in at least one guideline (median 3, range 1-14 guidelines) and eight (28%) were not cited in any of the matched guidelines.
In order to implement patient-treatment matching in routine care, matching guidelines have been developed and evaluated in several countries.
The use of matching guidelines in the German SAT has also been the subject of discussion [ 17].
It should be recognized, however, that various complexities are involved in using matching guidelines and various factors affect how effective using them is.
Recently, our study group conducted two pilot studies on the feasibility of using matching guidelines for patients with alcohol dependence following their participation in an inpatient withdrawal program.
For each meta-analysis in the test sample, we recorded the total number and proportion of unique, matched guidelines that cited it.
Overall, based on this sample of 33 IPD meta-analyses and 177 matched guidelines, our results indicate that systematic reviews, based on IPD, are being under-utilised as a source of the best available evidence within clinical guidelines.
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