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Clinical practice guidelines (CPG) make the core of a framework for clinical decision-making. When clinical practice guidelines are underpinned by strong scientific evidence, they help to reduce variation in practice by establishing standards of treatment. They are intended to optimise the healthcare and decrease the risk of preventable adverse events or harms [1]. The very first definition of clinical practice guidelines was published by the Institute of Medicine in 1990. They described them as “systematically developed statements to assist practitioner decision about appropriate health care for specific clinical circumstances” [2]. By 2011, the definition was updated to “statements that include recommendations intended to optimise patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options” [3]. In the new definition, the evaluation of both benefits and harms is highlighted. In addition, the importance of methodology is strongly emphasised. Despite the fact that guidelines are intended to optimise the standards of healthcare provision, applying them to a patient without considering their individual circumstances and healthcare system requirements, may potentially have harmful consequences. Firstly, the recommendations of the guideline panel may be wrong. The scientific evidence used to support the recommendations might be insufficient because high-quality evidence such as randomised controlled trials is often not available [4]. In addition, even the most well-designed randomised control trials might not be applicable to the populations or interventions addressed by the guidelines [5]. Secondly, there are concerns that the blanket recommendations ignore patient’s individual circumstances and medical history, as well as their values and preferences [6]. The balance between health costs and benefit to patients is challenging. When the recommendations are promoted to optimise the health costs, they might be harmful to individual patients. On the other hand, the guidelines may promote costly and unaffordable interventions, bringing potential losses to the healthcare system [6]. Finally, flawed clinical guidelines could harm healthcare professionals by encouraging ineffective, inconvenient and time-consuming interventions. This could be worsened by using conflicting guidelines from different professional bodies [6, 7].