In correlation to health care quality and improvement the practice guidelines play a major role in the formulation of the standards of practice. The third article is peer-reviewed meta-analysis, which compared the quality measures in the clinical practices. In the evaluated 279 guidelines the mean (SD) number of standards satisfied (out of 25) was 10.77 (3.71), or 43.1%, with a range of 2 to 24 (Shaneyfelt, Mayo-Smith, & Rothwangl, 1999). These guidelines play a major role in health care organizations ability to adhere to quality improvement for methodological principles. This study concluded methodological principles are not being properly represented in the majority of clinical guidelines. In order to properly implement effective quality
