Clinical Practice Guidelines: Directions for a New Program (1990)

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IMPLEMENTATION AND EVALUATION 94 The committee's basic conclusion is that AHCPR and the Forum must incorporate planning for implementation—formatting, dissemination, application, and updating—and evaluation within their development strategy. For the overall process to be successful, in fact, it may be necessary for the Forum to devote some of its scarce resources now to these more future-oriented needs. REFERENCES American College of Physicians. Clinical Efficacy Assessment Project: Procedural Manual. Philadelphia: 1986. Audet, A., and Greenfield, S. A Survey of Current Activities in Practice Guideline Development. Paper prepared for an IOM Meeting on Medical Practice Guidelines: Looking Ahead, Washington, D.C., November 8, 1989. Avorn, J., and Somerai, S. Improving Drug-Therapy Decisions Through Educational Outreach: A Randomized Controlled Trial of Academically-Based "Detailing." New England Journal of Medicine 308:1457-1460, 1983. Field, M. Health Policy and Medical Practice Guidelines: The Case of Mammography Screening for Women Under 50. Paper prepared for an IOM Meeting on Medical Practice Guidelines: Looking Ahead, Washington, D.C., November 8, 1989. Greenes, R., and Shortliffe, E. Medical Informatics: An Emerging Academic Discipline and Institutional Priority. Journal of the American Medical Association 263:1114-1120, 1990. Institute of Medicine. Effects of Clinical Evaluation on the Diffusion of Medical Technology. Chapter 4 in Assessing Medical Technologies . Washington, D.C.: National Academy Press, 1985. Institute of Medicine. Controlling Costs and Changing Patient Care? The Role of Utilization Management, B. Gray and M. Field, eds. Washington, D.C.: National Academy Press, 1989. Institute of Medicine. Medicare: A Strategy for Quality Assurance, vols. 1 and 2, K. Lohr, ed. Washington, D.C.: National Academy Press, 1990. Jacoby, I., and Clarke, S. Direct Mailing as a Means of Disseminating NIH Consensus Statements. Journal of the American Medical Association 255:1328-1330, 1986. Kaluzny, A. Dissemination and Impact of Consensus Development Statements. Pp. 69-83 in Improving Consensus Development for Health Technology Assessment: An International Perspective. Washington, D.C.: National Academy Press, 1990. Kanouse, D.E., and Jacoby, I. When Does Information Change Practitioners' Behavior? International Journal of Technology Assessment in Health Care 4(1):27-33, 1988. Kosecoff, J., Kanouse, D., Rogers, W., et al., Effects of National Institutes of Health Consensus Development Program on Physician Practice. Journal of the American Medical Association 258:2708-2713, 1987. Lomas, J. Words Without Action? The Production, Dissemination, and Impact of Consensus Recommendations. In Annual Review of Public Health , vol. 12, G. Omenn, ed. Palo Alto, Calif.: forthcoming (draft dated May 1990). Lomas, J., Anderson, K., Dominick-Pierre, E., et al. Do Practice Guidelines Guide Practice? The Effects of a Consensus Statement on the Practice of Physicians. New England Journal of Medicine 321:1306-1311, 1989. Lundberg, G. Providing Reliable Medical Information to the Public--Caveat Lector. Journal of the American Medical Association 262:945-946, 1989. Moldover, S. NIH Scrambles to Get Out the FAX. Chevy Chase Gazette , May 3, 1990. Physician's Desk Reference, 44th ed. Oradell, N.J.: Edward Barnhart, 1990. Pressman, J., and Wildavsky, A. Implementation: How Great Expectations in Washington Are Dashed in Oakland. Berkeley, Calif.: University of California Press, 1973. 

IMPLEMENTATION AND EVALUATION 95 Rubenstein, E., and Federman, D., eds. Scientific American Medicine. New York: Scientific American, 1989. Shortliffe, E. Computer Programs to Support Clinical Decision Making. Journal of the American Medical Association 258:61-66, 1987. Somerai, S.B., and Avorn, J. Principles of Educational Outreach ("Academic Detailing") to Improve Clinical Decision Making. Journal of the American Medical Association 263:549-556, 1990. Steinbrook, R., and Lo, B. Informing Physicians about Promising New Treatments for Severe Illnesses. Journal of the American Medical Association 263:2078-2082, 1990. Suchman, E. Evaluative Research. New York: Russell Sage Foundation, 1967. Vickery, D., and Fries, J. Take Care of Yourself: The Consumer's Guide to Medical Care, 3rd ed. Reading, Mass.: Addison-Wesley Publishing Co., 1986. Williamson, J.W., German, P.S., Weiss, R., et al. Health Science Information Management and Continuing Education of Physicians. Annals of Internal Medicine 110:151-160, 1989. Word of Spinal-Injury Drug Not Getting Out, Group Says. Washington Post, April 11, 1990, p. A5.