The Institute of Medicine (IOM) issued two new reports March 23 to give healthcare providers and organizations guidance on evaluating various healthcare options.
The first report, Clinical Practice Guidelines We Can Trust, recommends eight standards to ensure the "objective, transparent development" of trustworthy clinical practice guidelines. The Guidelines International Network database currently contains more than 3,700 clinical practice guidelines from 39 countries, but many of the guidelines used today suffer from "shortcomings in development," the IOM said.
In the report, the IOM calls for a new definition of clinical practice guidelines. Guidelines should be "statements that include recommendations intended to optimize patient care that are informed by a systematic review or evidence and an assessment of the benefits and harms of alternative care options," it said.
The eight standards call for objectives such as establishing transparency, managing conflict of interest, evaluating the composition of the guideline development group and articulating recommendations.
The second report, Finding What Works in Health Care: Standards for Systematic Reviews, recommends 21 standards to ensure "objective, transparent, and scientifically valid" reviews. Poor quality reviews can lead clinicians to the wrong conclusions and ultimately to inappropriate treatment decisions, noted the IOM.
"These standards are necessary given that there is little documentation to judge the quality and reliability of many of the existing clinical practice guidelines," said Sheldon Greenfield, MD, executive director of the Health Policy Research Institute, University of California, Irvine, and chair of the IOM committee on guidelines.
"Practice guidelines provide valuable data and guidance that not only inform individual decisions about care but ultimately could also improve overall health care quality and outcomes," he added.