La valutazione della qualità delle linee guida: una nuova sfida per la medicina legale. Considerazioni medico legali sul metodo AGREE.

The guidelines are recommendations with the aim to improving the level of patient care through the systematic review of the best scientific available evidence and generally considered to be a preferred model of care. With the L. 8 November 2012, n. 189 is presumable to change significantly the mode of to approach to guidelines of legal medicine, providing for a higher and different profile of interest in a new area of responsibility by the practitioner. The research makes available to us instruments, as the Appraisal of Guidelines for Research and Evaluation (AGREE), useful in the evaluation of the quality of guidelines, effective and simple to use and, in the specific case of AGREE, also widely approved in literature. The authors realize an medico legal analysis of quality assessment of guidelines on osteoporosis operated by the National System Guidelines taking interesting ideas on the possible effects of the initiative of the legislator. The use of such instruments, formally characterized by a criteriology useful also in medico legal use, shows not encouraging limits of applicability of the guidelines and it draws attention on the burden of the evaluator practitioners about malpractice which will necessarily integrate their knowledge of research methodology in order to remedy the evaluation need that will be during the assessment.