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AHCPR News and Notes

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Internet "surfers" discover the ease of accessing AHCPR-supported guidelines

Tapping into the Internet is a fast and easy way to access the clinical practice guidelines released by the Agency for Health Care Policy and Research. Since the first AHCPR-supported guidelines were made available online via the Internet in June 1994, there have been about 373,000 instances of direct access to the text of the guidelines.

Use of the Internet to access AHCPR-supported guidelines has grown exponentially over the last year in June 1994 there were less than 1,000 accesses to the guidelines, compared with nearly 98,000 accesses in October 1995, about a 100-fold increase in monthly use over the 16-month period.

The National Library of Medicine (NLM), in collaboration with AHCPR, the National Institutes of Health (NIH), and the Public Health Service, launched HSTAT (Health Services/Technology Assessment Text) in April 1994. This free, electronic service provides computer access to the full text of clinical practice guideline products. More than 50 countries now link to the HSTAT site to browse AHCPR-supported guidelines, quick reference guides, and consumer guides in both English and Spanish, on 17 common clinical conditions.

Full-Text Retrieval System natural language searching, also developed by NLM, was recently added to HSTAT to offer users online word searching capabilities. HSTAT users include clinicians, health science librarians, and consumers.

AHCPR-supported clinical practice guidelines are in the public domain within the United States only—except for those copyrighted materials noted—and may be used and reproduced without special permission. Electronic user policies are provided on HSTAT for those who wish to download or reproduce the guidelines in whole or in part. (For more information, see Information about copyrighted sections in the Guidelines on HSTAT.)

The universal resource locator or URL is http://text.nlm.nih.gov to access HSTAT on the Internet using a Web browser. Other materials that can be accessed through HSTAT include NIH clinical research studies, conferences, and workshops; technical information on the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS); the Public Health Service's Guide to Clinical Preventive Services; and the Substance Abuse and Mental Health Services Administration/Center for Substance Abuse Treatment (SAMHSA/CSAT) treatment improvement protocol.

Disease prevention experts call for more counseling, better targeted screening

A task force of prominent preventive health specialists has recommended that doctors and nurses offer more frequent patient counseling on personal health and safety habits, significantly change the use of some screening tests, and add several new immunizations to their routine practice. The U.S. Preventive Services Task Force, an independent panel first convened in 1983, recently issued the first revision of its widely used 1989 guide to effective disease prevention and health promotion.

Many of the recommended changes in the 1995 Guide to Clinical Preventive Services, Second Edition, reflect new evidence about important health benefits of selected preventive services, while other changes reflect a more critical look at the balance of harms and benefits of screening tests now in wide use. The report also reaffirms the validity of many of the practices recommended in the 1989 report.

The 10-member task force emphasized the need to tailor the content and frequency of periodic health exams to the age, health risks, and preferences of each patient. The panel recognized the proven benefits of specific measures—such as periodic screening for high blood pressure and cervical cancer, scheduled vaccinations, and counseling about lifestyle issues, but found little evidence to support the importance of other routinely used tests, such as blood tests for diabetes, thyroid diseases, or anemia; chest x-rays, electrocardiograms, or urine tests.

The task force included specialists in family medicine, internal medicine, obstetrics, gynecology, pediatrics, and preventive medicine. They assessed more than 6,000 studies of 200 different interventions for 70 diseases and conditions.

With the publication of the second edition of the Guide to Clinical Preventive Services, the operations of the U.S. Preventive Services Task Force moved to the Agency for Health Care Policy and Research to join AHCPR's other guideline activities.

The Guide to Clinical Preventive Services, Second Edition, is available from the Superintendent of Documents (stock number 017-001-00525-8) at a cost of $35.00. Call (202) 512-1800 to order.

Internet access to the Guide will be available in early 1996 via the National Library of Medicine's HSTAT database at http://text.nlm.nih.gov and the Office of Disease Prevention and Health Promotion at http://odphp.osophs.dhhs.gov.

Questions about the scientific content of the Guide should be addressed to Carolyn DiGuiseppi, M.D., M.P.H., or David Atkins, M.D., M.P.H., at AHCPR's Office of the Forum, (301) 427-1608.

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