Report at a Glance
To promote adoption of the standards, the committee recommends that the U.S. Department of Health and Human Services (HHS) create a mechanism to identify trustworthy guidelines. Such identification will serve three purposes: promote wider adoption of the IOM standards by developers since there will be an advantage to clinical practice guidelines publicly identified as trustworthy, provide users of clinical practice guidelines with an easy guide to identify guidelines that are trustworthy, and promote adoption of trustworthy clinical practice guidelines.
To affect quality of care and patient outcomes, implementers should ensure that trustworthy guidelines are made available to clinicians and health systems. Therefore, the committee recommends that implementers employ effective, multi-faceted strategies targeting both individuals and healthcare systems to promote adherence to trustworthy clinical practice guidelines. Increased adoption of electronic health records and computer-aided clinical decision support (CDS) will open new opportunities to rapidly promote clinical practice guidelines to healthcare providers and patients. To advance this goal, guideline developers should structure the format, vocabulary, and content of clinical practice guidelines to help ease the implementation of computer-aided CDS by end-users.
Evaluating Trustworthy Guidelines
It is important that the committee’s standards are properly evaluated. The committee encourages AHRQ to direct a portion of its research funds to pilot-test the standards, to assess their reliability and validity, and to evaluate the effects of the standards on clinical practice guideline development and health care quality and outcomes. While AHRQ is not directly involved in clinical practice guideline development, it does play a vital role in disseminating guidelines through its NGC. The committee recommends that AHRQ require the NGC to discontinue the inclusion of guidelines whose development is not sufficiently documented, and to prominently identify guidelines that reflect the committee’s proposed standards for trustworthiness.
Patients rely on healthcare providers for quality care and expect that those providers have the knowledge and expertise to make health-related decisions. Clinical practice guidelines can aid clinicians and patients alike in determining the best treatment options for a particular disease or condition. While there always will be uncertainty in clinical practice, ensuring that clinicians have trustworthy guidelines will bring more evidence to bear on clinician and patient decision making. Trustworthy guidelines hold the promise of improving health care quality and outcomes.