American College of Physicians Uses AHRQ Research to Improve Clinical Practice Guidelines
The American College of Physicians (ACP) uses AHRQ research in creating clinical practice guidelines for its members. ACP relies primarily on two AHRQ programs—the Evidence-based Practice Center Program (EPC), which produces evidence reports, and the Effective Health Care Program, which produces comparative effectiveness guides. ACP issues guidelines on screening, diagnosis, and treatment for a primary care audience.
Douglas K. Owens, MD, MS, Chair of ACP's Clinical Efficacy Assessment Subcommittee, is also Senior Investigator, VA Palo Alto Healthcare System, and Professor of Medicine at Stanford University. He is also the Director of the Stanford UCSF Evidence-based Practice Center. Owens reports that nearly a dozen EPC reports have been used to create ACP guidelines. ACP also used AHRQ's Effective Health Care guide on depression medications.
"AHRQ's EPC program has enabled the ACP to base our guidelines on very rigorous evidence. AHRQ research has made our guidelines better," Owens says.
Since January 2007, ACP guidelines have had an estimated reach of 340 million people. The individual guidelines have been downloaded tens, even hundreds of thousands of times.
According to Amir Qaseem, MD, PhD, MHA, FACP, Senior Medical Associate at the American College of Physicians, who is responsible for the ACP's clinical practice guidelines program, these guidelines have reached wide audiences via print, television, and the internet. He shares specific examples, as follows:
|ACP Guideline||No. of Print/Internet Stories||No. of TV Stories||No. of Downloads||Total Audience, 2007-08|
|Diagnosis & Management of Chronic Obstructive Pulmonary Disease||165||102||4,500||7,480,387|
|Screening for Osteoporosis||155||35,300||24,865,850|
|Treatment of Depression||114||89||14,000||21,608,408|
|Treatment of Osteoporosis||54||34,400||7,936,165|
|Treatment of Dementia||54||55,400||7,870,523|
|Palliative Care at the End of Life||140||42,000||7,028,522|
Beginning its guideline program 28 years ago, the ACP has one of the oldest guideline programs in existence, Owens notes. "The EPC reports are now our primary source for developing ACP guidelines," he says.
In the four years since Owens became Chair of ACP's guidelines committee, ACP's use of EPC reports in creating guidelines has increased fourfold. "In 2005, few of our guidelines were based on EPC reports; now, most are," he says.
"We look for very rigorous evidence-based reviews," explains Owens. "AHRQ has been a leader in producing these high quality reviews."
Qaseem says, "AHRQ does a really comprehensive and wonderful job with their evidence reviews, and EPC reviews are the gold standard of systematic reviews."
The ACP also used AHRQ's Effective Health Care summary on antidepressants, Comparative Effectiveness of Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Depression, in developing a treatment guideline for depression in adults.
ACP is the largest medical specialty organization and second largest physician group in the United States. Its membership of 126,000 includes internists, internal medicine subspecialists, medical students, residents, and fellows.
AHRQ EPC reports are available by visiting http://www.ahrq.gov/research/findings/evidence-based-reports/index.html.
AHRQ Effective Health Care Reports are available at http://www.effectivehealthcare.ahrq.gov.
Comparative Effectiveness of Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Depression, January 2007. Comparative Effectiveness Review No. 7. Agency for Healthcare Research and Quality, Rockville, MD.