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Vincenza Snow MD, FACP Director, Department of Clinical Programs and Quality of Care

Vincenza Snow MD, FACP Director, Department of Clinical Programs and Quality of Care. Who We Are and Who is our Audience. The US’s largest medical specialty organization 129,000 members Internists Sub-specialists in Internal Medicine Residents and fellows in training

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Vincenza Snow MD, FACP Director, Department of Clinical Programs and Quality of Care

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  1. Vincenza Snow MD, FACP Director, Department of Clinical Programs and Quality of Care

  2. Who We Are and Who is our Audience • The US’s largest medical specialty organization • 129,000 members • Internists • Sub-specialists in Internal Medicine • Residents and fellows in training • Medical students • Headquarters in Philadelphia and an office in Washington, D.C.

  3. Background: ACP Clinical Guidelines • Clinical Efficacy Assessment Subcommittee established in 1981 • Members are all internists/subspecialists, methodologists, full time practice, etc • Stable membership on CEAS (members up to 5 years and Chair up to 4 years • No external funding • Conflicts of Interest • No Consensus Statements

  4. Two Products • Clinical Guidelines • Involves a systematic review of available evidence and a guideline statement with recommendations • Clinical Guidance Statements • Involves review of available guidelines and summary recommendations

  5. How are the Guideline Topics Selected • Prevalence • Impact on mortality and morbidity • Effective health care available • Areas of uncertainty & evidence that current performance is deficient • Cost • Likelihood of availability of strong evidence • Relevance to IM

  6. Systematic Evidence Review for Clinical Guidelines • ACP sponsored (less and less) • Nomination of topics to the AHRQ’s Evidence-based Practice Centers for a systematic review and evidence report • Collaboration with other societies (after extensive negotiations regarding the evidence review and evidence levels)

  7. Review for Clinical Guidance Statements • Medline, NGC search, experts in the field • Use the AGREE instrument to “rate” guidelines • Summarize the guidelines and their recommendations • We make a summary recommendation based on the other guidelines

  8. Guideline Development Process • Formulate questions for the evidence review • Systematic Evidence review • Background evidence-review paper • Guideline paper (recommendations) • CEAS meetings and conference calls • CEAS Guideline Sub-Panel conference calls • Internal review • External review

  9. Guideline Development Process • Takes 18-24 months on average • Approved by the sub-panel, CEAS, Education Committee, Board of Regents • Guideline and background paper are then submitted to the journal (independent peer-review) • Shelf life of ACP Guidelines – 5 years

  10. ACP Guideline Recommendation Grading System * Adopted from the classification developed by the Grading of Recommendations, Assessment, Development,and Evaluation (GRADE) workgroup.

  11. Questions

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