BALTIMORE--"Clinical practice guidelines link science and the bedside, helping the doctor and patient to make the best possible decisions," said Mary L. Grady, a technical writer-editor with the Agency for Health Care Policy and Research (AHCPR).
Speaking at a panel at the American Medical Writers meeting, along with other staffers from AHCPR's Center for Health Information Dissemination, Ms. Grady said that her office has produced 17 clinical practice guidelines in the last 6 years and has another "three or four" in development.
So far, only one--"Management of Cancer Pain"--concerns oncology. Others are under consideration, but Congressional budget battles make future plans uncertain, she said. "We are open to nominations for topics, but AHCPR chooses subjects that affect many people and for which there are variations in treatment," she said. "Also, since $6 million of the agency's budget comes from Medicare, we look carefully at any topic that affects the Medicare population."
The development process takes 18 to 24 months. Once a topic is selected, a multidisciplinary panel is picked, an analytic framework developed, and literature reviewed.
"We try to put together a review panel of people who may have different views on treatment--like neurosurgeons and chiropractors," said Christine Williams, acting director of the Center. The review panel rates the strength of the evidence, thrashes out a final analysis, and offers its recommendations.
The approach, Ms. Grady said, "is explicitly scientific, based on a comprehensive literature search, and open to revision during the process. We also try to identify gaps in the knowledge for future research."
Added editor Randie Siegel, "We try to present consistent health messages. Every concept must be scientifically efensible."