In reply: The fundamental purpose of clinical practice guidelines is to improve patient outcomes. Thus, as members of the CARI (Caring for Australians with Renal Insufficiency) Guidelines Steering Committee, we welcome Johnson's letter, which gives us reassurance and renewed enthusiasm to move forward with improving and refining the CARI clinical practice guideline process. The most gratifying revelation in Johnson's survey was the near-90% endorsement of the CARI guidelines as a document providing a useful evidence summary — clearly very reassuring in those areas in which that evidence relates to treatment interventions for patients with renal disease. Of additional interest was the range of responses to questions about matching the recommendations with available evidence. This seems to reflect both an awareness among renal medicine health workers of the importance of evidence-based medicine and a maturing understanding of the need for the evidence to be of high quality.
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