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Restructuring of AHCPR's Clinical Practice Guideline Program
Statement Date: May 2, 1996
In April 30 testimony before the House Labor-HHS-Education
Subcommittee, AHCPR Administrator Clifton R. Gaus, Sc.D.,
announced a major
restructuring of the Agency's clinical practice guideline program
to meet the changing
needs of the health care system.
"The world of medical care in 1996 is far different from the one
that existed in 1989
when AHCPR was created," Dr. Gaus told the Subcommittee, noting
that AHCPR staff
has consulted extensively with public- and private-sector
guideline users. "Their
message is clear: they are seeking the scientific foundation from
which they can
develop their own high-quality, evidence-based guidelines."
In response AHCPR has decided not to develop clinical practice
guidelines in Fiscal
Year 1997. Instead the Agency will serve as a "science partner"
with private- and
public-sector organizations—provider societies, health
plans, purchasing groups, states,
and others—by producing the scientific foundation for them
to use in their efforts to
improve clinical practice.
Restructuring the guideline program in this way will allow AHCPR
to focus its
available resources on its well-recognized strengths—the
syntheses and meta-analyses
underlying the 18 guidelines that AHCPR has released. This new
focus will enable
AHCPR to address a broader number of conditions and health
problems for the same
This change will help decrease duplication, increase coordination
and uniformity in the
strong scientific underpinning of guidelines, and continue to
increase the science base
supporting improvements in clinical practice.
AHCPR's New Program
AHCPR's existing guideline development funds would be redirected
to support a three-pronged
- Centers for Evidence-based Practice. These
would respond to the growing demand for literature reviews,
decision analyses, meta-analyses, and other products on topics of
interest. Public and private sector organizations—provider
plans, purchasing groups, states, and others—would then use
this evidence base
to develop and implement their own clinical practice guidelines
and other quality
improvement measures and activities.
- National Guideline Database. AHCPR would work with
to develop a public-private sector consortium that would support
a national online database of
clinical practice guidelines. This would allow all clinicians,
provider groups, plans, and health
systems to obtain information about the major published
guidelines. The database could include
access information, summaries of the guidelines, full text when
available, and annotations
comparing the processes and recommendations of multiple
guidelines on the same topic.
- Research and Evaluation. AHCPR would continue its
program of research and
evaluation activities on the development and use of guidelines
and other tools to
improve clinical care. Research topics would range from
methodology to implementation strategies.
For additional information, contact AHCPR Public Affairs: Karen Migdail, (301) 427-1855 or Salina Prasad, (301) 427-1864.