Article type
Year
Abstract
Introduction/Objective: To present the history and future of evidence-based practice initiatives at the U.S. Agency for Health Care Policy and Research.
Methods: Historical review and update.
Results: AHCPR, created in 1989, began publishing evidence-based clinical practice guidelines in 1992. It issued 19 guidelines, using a similar methodology but a different private-sector expert panel for each one. The guidelines - on topics ranging from prevention of pressure ulcers to low back pain to unstable angina - were widely circulated and cited, frequently implemented and adapted for local use, and often controversial. The program ended in 1996, to be replaced by a three-part Evidence-based Practice Initiative. The three components of the initiative are: (1) Evidence-based Practice Centers (EPCs) to produce systematic reviews of clinical topics and evidence-based assessments of medical technologies; (2) a National Guideline Clearinghouse (NGC), which will provide an on-line source of information, abstracts, and comparisons of clinical guidelines; and (3) a research initiative on implementing evidence-based recommendations into different practice settings.
Discussion: AHCPR has concluded that, given the dramatic changes in U.S. health care, it can best apply its limited resources to provide the evidence for others to create guidelines and other quality improvement activities, as well as supporting the efficient distribution of guidelines and research on their implementation.
Methods: Historical review and update.
Results: AHCPR, created in 1989, began publishing evidence-based clinical practice guidelines in 1992. It issued 19 guidelines, using a similar methodology but a different private-sector expert panel for each one. The guidelines - on topics ranging from prevention of pressure ulcers to low back pain to unstable angina - were widely circulated and cited, frequently implemented and adapted for local use, and often controversial. The program ended in 1996, to be replaced by a three-part Evidence-based Practice Initiative. The three components of the initiative are: (1) Evidence-based Practice Centers (EPCs) to produce systematic reviews of clinical topics and evidence-based assessments of medical technologies; (2) a National Guideline Clearinghouse (NGC), which will provide an on-line source of information, abstracts, and comparisons of clinical guidelines; and (3) a research initiative on implementing evidence-based recommendations into different practice settings.
Discussion: AHCPR has concluded that, given the dramatic changes in U.S. health care, it can best apply its limited resources to provide the evidence for others to create guidelines and other quality improvement activities, as well as supporting the efficient distribution of guidelines and research on their implementation.