[Possibilities and limitations of national guidelines based on the example of pediatric urology guidelines from the Pediatric Urology Working Group of the Austrian Society for Urology and Andrology (ÖGU)]. / Chancen und Grenzen nationaler Leitlinien am Beispiel der "Leitlinien Kinderurologie" des Arbeitskreises für Kinderurologie der österreichischen Gesellschaft für Urologie (ÖGU).

ABSTRACT

BACKGROUND: Medical guidelines are defined as practical orientation and decision-making aids; they are legally defined as noncommittal recommendations. International guidelines are written in very general terms, especially in the case of heterogeneous clinical pictures (e.g., vesicoureteral reflux). OBJECTIVE: Could national guidelines based on international recommendations become authoritative as specific treatment recommendations for the various specialist groups? MATERIALS AND METHODS: The value of international and national guidelines was assessed using the example case history of a child affected with vesicoureteral reflux. RESULTS: Due to the various therapeutic possibilities according to various guidelines, the child received unfavorable, incongruent, delayed, and repeated unsuccessful attempts with different treatment regimes CONCLUSION: Due to the nonbinding nature of general guidelines, there is a risk of suboptimal therapy. National guidelines aimed at individualized treatment recommendations should aim for higher medical and legal status.