How to use the government's new guidelines Web site
Q: Can you provide some information on the federally administered Internet site that catalogs practice guidelines?
A: The Agency for Health Care Policy and Research (AHCPR), in partnership with the AMA and the American Association of Health Plans (AAHP), operates a comprehensive database of evidence-based clinical practice guidelines and related documents called the National Guideline Clearinghouse (NGC). The NGC site is located at www.guidelines.gov.
The Web site's mission is to provide health care providers, health plans, integrated delivery systems, purchasers and others a way to access objective, detailed information on clinical practice guidelines. The site includes the following information:
- Structured abstracts about each guideline and its development.
- A tool to compare two or more guidelines side by side.
- Comparative syntheses of guidelines covering similar topics that highlight similarities and differences.
- Links to the full text of guidelines where available, and/or information on how to order print copies.
- An electronic forum where users can exchange information on how to develop, implement and use clinical practice guidelines.
- Annotated bibliographies on how to develop, implement and use guidelines.
Q: How can I find guidelines I'm looking for on the site, and how current is the information?
A: The NGC site is updated weekly with new and revised guidelines. You can browse the site's guidelines by disease, treatment or sponsoring organization. In addition, a "What's New" section contains all the recent listings.
NGC's creators hope that the site will make it easier for physicians and others to consult guidelines. Instead of having to search for guidelines in an unwieldy book, physicians can access guidelines through a few keystrokes.
Q: Are the practice guidelines listed on this site reliable?
A: The NGC database uses the Institute of Medicine (IOM) definition of clinical guidelines in deciding what to include on its site. The IOM defines practice guidelines as "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances."
To be posted on the site, guidelines must:
- be current;
- contain systematically developed statements to help practitioner and patient decision-making;
- have been produced by a medical or other relevant professional group, government agency, health care organization or plan, or other public or private organization; and
- have been developed based on peer-reviewed scientific evidence.
AHCPR verifies that each guideline meets the established minimum criteria for inclusion, but it does not verify or evaluate accuracy of the individual guideline content. The organization that wrote the guideline is solely responsible for its content.
While the guidelines identify and describe generally recommended courses of intervention, they are not meant as a substitute for the advice of a physician or other knowledgeable health care professional or provider. The guidelines are not entirely inclusive or exclusive of all methods of reasonable care that can produce the same results.
The site contains a disclaimer stating that AHCPR and its partners (AMA and AAHP) make no warranties concerning the content or clinical efficacy of the clinical practice guidelines and related materials; inclusion of any guideline does not constitute the endorsement of the organization that wrote it. Also, requirements for downloading and reproducing materials vary with each guideline. Read the disclaimer when using the NGC.
Q:What are the site's limitations?
A: First, not all conditions are currently represented on the NGC. The site currently contains 283 guidelines; its creators believe that it will rise to 3,500 within three years. Because of copyright issues, the full text of all the guidelines is not available on the site. Finally, users may have to pay to receive the full text of certain guidelines.
Brett Baker is a third-party payment specialist in the College's Washington Office. If you have questions on third-party payment or coding issues, call him at 202-261-4533, send a fax to 202-835-0441, or send an e-mail to bbaker@acponline.org.
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