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Competing Interests: Competing interests: Diane Kelsall was the interim editor-in-chief of CMAJ until October 2019, and is currently editor for CMAJ Open and consulting editor for CMAJ. Gillian Leng is an executive director of the National Institute for Health and Care Excellence, which also has a policy on declaring and managing conflicts of interest, and is the chair of the Guidelines International Network, which provides advice on managing potential conflicts of interest. Brett Thombs, Ainsley Moore and Navindra Persaud are, respectively, chair, vice-chair and a member of the Canadian Task Force on Preventive Healthcare, which develops clinical practice guidelines and also has a policy on declaring and managing conflicts of interests. Navindra Persaud reports receiving research funding from the Canadian Institutes of Health Research, the Ontario SPOR Support Unit, and the Canada Research Chairs program, outside of the submitted work. Holger Schünemann is a member of the GRADE working group and was the lead author on the Guidelines International Network principles for disclosure of interests, and is the corresponding author on the manuscript describing the PANELVIEW instrument. Rachel Rodin and Marcello Tonelli report receiving funding from the Canadian Institutes of Health Research to host the Best Brains Exchange referred to in the article. Elie Akl reports contributing to a number of studies on conflicts of interest. G. Michael Allan reports being an author of guidelines, who has received travel support, honoraria for speaking at conferences, and research support. The supports have been from nonprofit sources. Dr. Allan has received no funding from the pharmaceutical industry. Isabelle Ganache reports receiving personal fees from Institut national d’excellence santé et en services sociaux (INESSS), as director of the Bureau – Methodologies and Ethics (which is responsible for the institutional policy on declaring and managing conflicts of interest), during the conduct of the study. Quinn Grundy reports receiving grants from the Social Science and Humanities Research Council and a Connaught New Research Award from the University of Toronto, outside of the submitted work. No other competing interests were declared.

This article covers recent National Institute for Health and Care Excellence guidance relevant to public health. The article includes an overview of key public health aspects of the Community pharmacy: promoting health and wellbeing guideline, summarizing recommendations for commissioners and health promoting organizations and professionals around the potential to integrate community pharmacies into wider health and care pathways., (© The Author(s) 2018. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

This article covers recent NICE guidance relevant to public health and has a focus on healthy ageing. The article contextualizes NICE guidance on increasing personal capacity, creating supportive environments and developing longer term strategies to reduce chronic disease and disability through primary prevention., (© The Author(s) 2019. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

This article covers recent National Institute for Health and Care Excellence guidance and standards relevant to public health. The article also includes an overview of key public health aspects of the updated 'stop smoking interventions and service guideline', summarizing recommendations for commissioners and managers as well as individuals in contact with people who smoke.

Clinical guidelines and health technology assessments are valuable instruments to improve the quality of healthcare delivery and aim to integrate the best available evidence with real-world, expert context. The role of patient and public involvement in their development has grown in recent decades, and this article considers the international literature exploring aspects of this participation, including the integration of experiential and scientific knowledge, recruitment strategies, models of involvement, stages of involvement, and methods of evaluation. These developments have been underpinned by the parallel rise of public involvement and evidence-based medicine as important concepts in health policy. Improving the recruitment of guideline group chairs, widening evidence reviews to include patient preference studies, adapting guidance presentation to highlight patient preference points and providing clearer instructions on how patient organisations can submit their intelligence are emerging proposals that may further enhance patient and public involvement in their processes.

Background: In the UK, responsibility for many public health functions was transferred in 2013 from the National Health Service (NHS) to local government; a very different political context and one without the NHS history of policy and practice being informed by evidence-based guidelines. A problem this move presented was whether evidence-based guidelines would be seen as relevant, useful and implementable within local government. This study investigates three aspects of implementing national evidence-based recommendations for public health within a local government context: influences on implementation, how useful guidelines are perceived to be and whether the linear evidence-guidelines-practice model is considered relevant., Methods: Thirty-one councillors, public health directors and deputy directors and officers and other local government employees were interviewed about their experiences implementing evidence-based guidelines. Interviews were informed and analysed using a theoretical model of behaviour (COM-B; Capability, Opportunity, Motivation-Behaviour)., Results: Contextual issues such as budget, capacity and political influence were important influences on implementation. Guidelines were perceived to be of limited use, with concerns expressed about recommendations being presented in the abstract, lacking specificity and not addressing the complexity of situations or local variations. Local evidence was seen as the best starting point, rather than evidence-based guidance produced by the traditional linear 'evidence-guidelines-practice' model. Local evidence was used to not only provide context for recommendations but also replace recommendations when they conflicted with local evidence., Conclusions: Local government users do not necessarily consider national guidelines to be fit for purpose at local level, with the consequence that local evidence tends to trump evidence-based guidelines. There is thus a tension between the traditional model of guideline development and the needs of public health decision-makers and practitioners working in local government. This tension needs to be addressed to facilitate implementation. One way this might be achieved, and participants supported this approach, would be to reverse or re-engineer the traditional pipeline of guideline development by starting with local need and examples of effective local practice rather than starting with evidence of effectiveness synthesised from the international scientific literature. Alternatively, and perhaps in addition, training about the relevance of research evidence should become a routine for local government staff and councillors.

Background: Clinical guidelines are an important tool for improving service quality, the benefits of guidelines depend on their quality. In China, there has been a great increase in production of guidelines. However, little is known about their quality., Method: We identified Chinese guidelines published between 2006 and 2010 by searching three Chinese full-text databases, major Chinese guidelines websites and Google. Three appraisers independently evaluated each guideline by using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument. Subgroup analyses were performed according to source, title, version, aspect of care and developer of guidelines., Results: A total of 327 guidelines were eligible and 57 were excluded for their lacking of any account of the guideline development methodology. Of the 270 guidelines, 77 (28.5%) can be recommended, 6 (2.2%) were evidence-based guidelines. Sixteen (5.9%) guidelines described the methods used to search for evidence, 61 (22.6%) appraised the quality of evidence and 53 (19.6%) graded the strength of recommendations. Two guidelines declared the involvement of methodological experts and none reported considering patients' values. 29 (10.7%) guidelines received drug company sponsorship but only two declared the views of the funding bodies did not influence the recommendations, 259 (95.9%) didn't declare the interest conflicts of guideline developers. Guidelines downloaded from Internet and with updated versions yielded higher quality than the rest., Conclusions: Although numerous guidelines were produced in China, the quality was generally low. Focusing on improving the quality of Chinese guidelines, rather than continuing to produce them in great quantity, is urgently needed., (© 2012 John Wiley & Sons Ltd.)

Purpose: The purpose of this article is to give those in the psychology and psychotherapy fields an overview of the work the National Institute for Health and Clinical Excellence (NICE) is doing to encourage change in response to its guidance., Methods: A summary is provided of the work NICE undertakes to motivate others to use guidance and the practical support that is made available. Findings of selected studies are highlighted that demonstrate some of the successes and challenges relating to the uptake of NICE guidance., Results: Key aspects of NICE work include liaison with partners at a national level to ensure work programmes are aligned and provision of practical support, such as the commissioning guide on cognitive behavioural therapy (CBT). A range of studies show that there have been successes in increasing the provision of psychological therapies but there are still variations which present challenges., Conclusions: NICE provides a substantial programme of support for the implementation of guidance which impacts on psychologists and psychotherapists. Successes in the uptake of guidance can be demonstrated but it is acknowledged that this is challenging area. NICE is keen to provide the most effective support possible for implementation so continually evaluates and seeks feedback on its implementation programme.

Users of clinical practice guidelines and other recommendations need to know how much confidence they can place in the recommendations. Systematic and explicit methods of making judgments can reduce errors and improve communication. We have developed a system for grading the quality of evidence and the strength of recommendations that can be applied across a wide range of interventions and contexts. In this article we present a summary of our approach from the perspective of a guideline user. Judgments about the strength of a recommendation require consideration of the balance between benefits and harms, the quality of the evidence, translation of the evidence into specific circumstances, and the certainty of the baseline risk. It is also important to consider costs (resource utilisation) before making a recommendation. Inconsistencies among systems for grading the quality of evidence and the strength of recommendations reduce their potential to facilitate critical appraisal and improve communication of these judgments. Our system for guiding these complex judgments balances the need for simplicity with the need for full and transparent consideration of all important issues.