Guidance, Guideline, Advice, Protocol

Please note: -In the UK, the term 'guidance' in the context of HTA refers to the reports produced by NICE. -In France, the term 'advice' in the context of HTA refers to whether health insurers are required to reimburse the cost of a health technology. See also Health technology appraisal

INAHTA Glossary

Clinical Practice Guideline: A systematically developed statement to assist practitioner and patient decisions about appropriate health care for one or more specific clinical circumstances. The development of clinical practice guidelines can be considered to be a particular type of HTA; or, it can be considered to be one of the types of policymaking that is informed or supported by HTA.

TU, Germany

These terms may be used as synonyms in many situations, specially by non-native English-speakers. In some languages, the translation for guideline, guidance and protocol may refer to the concept of Clinical Practice Guidelines and thus be completely interchangeable. However, the terms may have slightly different meanings specially concerning the degree of legal-binding. In some countries a guideline has to be followed, otherwise some kind of sanctions may be the consequence (i.e. not reimbursement of a procedure). Guidance can be interpreted as “orientation”, i.e.


The interconnection of the given terms:

Guidance is the concept involved when a HTA reports guides the new user through a certain field. We feel that this term is rather far from the core of HTA as HTA reports should either empower the user to make his own decision or to offer the user an option that the user can either adopt or modify. Guidance might refer to HTA reports as a science base but due to the other terms mentioned we assume that this is not meant here.


Guidance in the UK context is the generic term for advice given to health services. It may have the force of law or it may be more optional; it may be produced by NICE or by other national bodies, or it may be produced locally.

NICE guidance aims to ensure that the promotion of good health and patient care in local health communities is in line with the best available evidence of effectiveness and cost effectiveness. NICE produces guidance in 3 main areas:


Institute of Molecular Medicine, Portugal

Guidance is best translated to “Orientação” or “Guias”. The first one is the nearer to English version. Nevertheless, it is very similar lexically to the next word Guidelines which in Portuguese has been translated to “Normas de orientação” for some time now.

Guidelines has been translated to “Normas de orientação” and the term is well consolidated in our country.

Protocol has long been translated into “Protocolo” in our country.

Advice is best translated to “Aconselhamento” which literally means counselling in Portuguese, and is much nearer the English version than “Conselhos”.

FinOHTA, STAKES, Finland

What is a Guideline?

The purpose of a guideline is to assist practitioners and patients in making decisions about healthcare interventions in a specific situation (IOM 1990?)

Different types of guidelines

Guidelines are produced through different processes and their quality varies. Evidence based guidelines are based on a systematic analysis of existing literature and appraisal of the evidence. Guidelines can also be based on a consensus of clinical experts, stakeholders etc.