A 1990 report by the Scottish Executive's Clinical Resource and Audit Group highlighted the need for national, evidence-based clinical guide­ lines to be developed by 'the Royal Colleges, the specialist associations of the healthcare professionals and relevant educational bodies'.1 As a result of this, and the personal enthusiasm and determination of the late Professor James Petrie, the Scottish Intercollegiate Guidelines Network (SIGN) was established in 1993 by the Conference of Royal Colleges and their faculties in Scotland, to develop evidence-based clinical guidelines for the National Health Service in Scotland.2