IOM Guidelines Focus on Clinical Practice, Review of Effective Health Care
On Wednesday, the Institute of Medicine released two reports that recommend eight clinical practice guidelines and 21 standards for systematic comparative effectiveness reviews, CQ HealthBeat reports (Norman, CQ HealthBeat, 3/23).
Congress requested the two reports -- which were sponsored by HHS -- through the Medicare Improvements for Patients and Providers Act of 2008 (Zigmond, Modern Healthcare, 3/23).
'Clinical Practice Guidelines We Can Trust'
The first report, titled "Clinical Practice Guidelines We Can Trust," aims to help health care providers determine the best treatment options for a condition or disease, CQ HealthBeat reports (CQ HealthBeat, 3/23).
The eight guidelines outlined in the report include recommendations for establishing transparency in a clinical practice, conducting external reviews, developing group composition and managing conflicts of interest (Commins, HealthLeaders Media, 3/24).
IOM also recommends that HHS' Agency for Healthcare Research and Quality test the standards to analyze their validity. "If guideline users had a mechanism to immediately identify high quality, trustworthy clinical practice guidelines, their health-related decision making would be improved," according to IOM.
'Finding What Works in Health Care: Standards for Systematic Reviews'
IOM says systematic reviews assess and synthesize separate but similar studies, but notes that the quality of systematic reviews varies (Modern Healthcare, 3/23).
To reconcile the disparities, the second report, titled "Finding What Works in Health Care: Standards for Systematic Reviews," offers 21 guidelines to ensure transparent, objective and scientifically valid reviews of competing guidelines (HealthLeaders Media, 3/24).
The recommendations include:
- Managing bias and conflict of interest;
- Ensuring stakeholder input;
- Assembling a team with appropriate expertise;
- Using a third party for peer-review; and
- Ensuring free public access to the published report.
According to Alfred Berg -- professor of family medicine at the University of Washington School of Medicine in Seattle and chair of the committee that wrote the systematic reviews report -- the recommendations present "the 'gold standard' to which those who conduct systematic reviews should aspire to achieve the most reliable and useful products" (Modern Healthcare, 3/23).
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