Reflections of the Guideline Methodologist

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A Socratic paradox of guideline development: those who have never done it think it’s simple; those who have looked into it a little find it bewildering. From the methodologist’s point of view, the truth lies somewhere in between.

This blog shares reflections from my work as a guideline methodology expert, drawing on experience across publicly available guideline projects and broader methodological work. Rather than presenting recommendations, it focuses on the philosophical considerations of how evidence is identified, assessed, and translated into guidance. It also considers how methodological choices shape recommendations and, ultimately, influence clinical practice. The posts are written for anyone interested in how guidance is created.

For details about scope, authorship, and use of examples, please read the full disclaimer.

I am a guideline methodology expert, not a subject-matter specialist in Infection Prevention and Control (IPC) or any other clinical topic. My involvement, primarily in IPC guideline development, arose through previous professional roles, where I contributed to the application of methodological standards in guideline development.

The reflections shared here draw on publicly available guideline projects on which I was an author, alongside broader experience in guideline development across disciplines. Posts focus on methodological lessons, evidence gaps, and the challenges of translating research into guidance — particularly where long-held expert beliefs may not be as well supported by published evidence as commonly assumed.

The views expressed are my own and are intended for reflective and educational purposes only. They do not restate or replace published guidelines, and readers should always consult the original guideline documents for official recommendations.

Copyright of published guidelines remains with the commissioning organisations and publishers.