INSTITUTE OF MEDICINE WORKSHOP


REVIEWING EVIDENCE TO IDENTIFY HIGHLY EFFECTIVE CLINICAL SERVICES


JANUARY 25, 2007


PANEL 1—USING SYSTEMATIC REVIEWS TO DEVELOP CLINICAL RECOMMENDATIONS


Moderator: Richard Marshall (Harvard Vanguard Medical Associates)

Panelists: Carolyn Clancy (AHRQ), Mary Barton (USPSTF), Steven Findlay (Consumers Union), and Ray Gibbons (American Heart Association)


The objective of this panel discussion is to learn about the experiences of well-regarded organizations that use systematic reviews or other syntheses of bodies of evidence to develop clinical recommendations. AHRQ serves multiple roles; generator of evidence (e.g., DEcIDE, CERTS), synthesizer of evidence (e.g., Evidence-based Practice Center Program), and developer of clinical recommendations (e.g., USPSTF). The USPSTF assesses and synthesizes the evidence on preventive services and issues clinical recommendations based on these bodies of evidence. Consumers Union’s Best Buy Drugs Program relies on evidence-based analyses of the safety and effectiveness of prescription drugs to help consumers choose the drug best suited to their medical needs. The American Heart Association (in collaboration with the American College of Cardiology) synthesizes bodies of evidence on selected topics and draws from other reviews to develop clinical practice guidelines for cardiovascular care.

Questions for the Panelists

  1. Who is the principal audience for your clinical recommendations? Have you assessed their use of the recommendations? Approximately how often does your audience follow your clinical recommendations:

    • In full, _____ percent

    • In part, _____ percent

  1. How do you identify and prioritize areas for which clinical recommendations are necessary?

  2. How do you identify sources of evidence on clinical effectiveness? Which criteria (if any) do you use to judge quality of evidence?

  3. How would you characterize the available evidence on the clinical



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