This book examines methods for selecting topics and setting priorities for clinical practice guideline development and implementation. Clinical practice guidelines are "systematically defined statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances." In its assessment of processes for setting priorities, the committee considers the principles of consistency with the organization's mission, implementation feasibility, efficiency, utility of the results to the organization, and openness and defensibility--a principle that is especially important to public agencies. The volume also examines the implications of health care restructuring for priority setting and topic selection, including the link between national and local approaches to guidelines development.

Contents

• COMMITTEE ON METHODS FOR SETTING PRIORITIES FOR GUIDELINES DEVELOPMENT
• Acknowledgments
• Summary
• 1. Introduction
  • Background
  • Committee Approach
  • Priority Setting in Other Organizations
  • Overview of Report
• 2. Criteria for Topic Selection
  • Current Criteria for Guidelines Topics
  • Current Criteria for Technology Assessment
  • Differences in Criteria for Guidelines and Technology Assessment
  • Toward Common Criteria?
  • Additional Criteria
  • The Relative Importance of Individual Criteria
  • Procedures for Applying Criteria
  • Reassessment of Existing Guidelines
• 3. Procedures for Priority Setting
  • Forum and OHTA Priority-Setting Procedures
  • OHTA's Procedures for Priority Setting
  • Toward Common Procedures?
  • Process Modifications: Improving the Use of Expert Judgment
  • Development of a Procedure Manual
• 4. Future Directions for Priority Setting
  • Review of Findings and Recommendations on Priority Setting
  • Definition of Guidelines Topics
  • National and Local Guidelines
  • Future Roles for AHCPR
  • Conclusion
• References
• A Setting Priorities for Health Technology Assessment: A Model Process Executive Summary
• B Workshop on Setting Priorities for Practice Guidelines
• C Methods for Setting Priorities for Guidelines Development: Medical Malpractice
• D National Guidelines and Local Action: Priority-Setting for the Development of Research-Based Protocols at Intermountain Health Care
• E The Development of Clinical Guidelines for Primary Care Practice: A Systems Approach
• F Examples of Questionnaires for Use in Priority Setting
• G Committee Biographies

Support for this project was provided by the Agency for Health Care Policy and Research, U.S. Department of Health and Human Services, under Contract No. 282-94-2028. Printing of the report was made possible though support from the American College of Physicians, National Capital PPO, New England Medical Center, Permanente Medical Group, Inc., and Prudential Insurance Company of America. The views presented are those of the Institute of Medicine Committee on Methods for Setting Priorities for Guidelines Development and are not necessarily those of the funding organizations.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.