Did You Know...? Thousands of Practice Guidelines Can Be Accessed Online

Dr. Zanni is a psychologist and healthsystems specialist based in Alexandria, Virginia.

The National Guideline Clearinghouse (NGC; www.guideline.gov) maintains a comprehensive database of evidence-based clinical practice guidelines. NGC?s mission is to provide clinicians an accessible mechanism to obtain objective, detailed clinical information and to promote guideline dissemination, implementation, and use. An initiative of the Agency for Healthcare Research and Quality (AHRQ), NGC was originally created by AHRQ in partnership with the American Medical Association and the American Association of Health Plans (now America?s Health Insurance Plans). NGC?s key components:

• Guideline summaries
• Links to full-text guidelines, where available, and/or ordering information for copies
• Palm-based personal digital assistant downloads of complete NGC summaries for all guidelines
• A guideline comparison utility that allows users to review guideline combinations side by side
• An annotated bibliography database to search for publications and resources about guidelines, including guideline development, methodology, evaluation, and implementation
• An index of recently added or updated guidelines
• Ability to search guidelines by disease/condition, treatment/intervention, or issuing organization

User-friendly Searches

NGC?s summary template facilitates guideline comparison by its standardized headings, including guideline scope (eg, disease/condition, clinical specialty), methodology, treatment recommendations, supporting evidence for recommendations, benefits/harm in implementing recommendations, contraindications, qualifying statements, and implementation strategies. This function is especially useful when multiple guidelines exist for a designated condition.

NGC also assigns indexing attributes to every guideline, permitting users to define guideline searches narrowly (eg, consensus panel guidelines for HIV treatment in 13- to 18-year-olds).

The NGC contains syntheses of 35 guidelines that cover similar topic areas. Key elements of each synthesis include the scope of the guidelines, the interventions and practices considered, the major recommendations, the strength of the evidence, and the areas of agreement and of disagreement. Examples of NGC?s guideline syntheses include acute otitis media, obesity and overweight in adults, chronic obstructive pulmonary disease, urinary incontinence, and lipid screening in coronary heart disease and atherosclerotic cardiovascular disease prevention.

A Focus on Patient Safety

NGC cites numerous patient safety and quality improvement guidelines, many being current health care priorities: medication safety, infection control, restraints, and surgical fire prevention. Additionally, NGC?s Web site links to numerous organizations, but those listed on its home page are pressing concerns for many clinicians and include pandemic/avian flu resource information, quality measures, and health care tools.

As evidenced-based treatment guidelines proliferate, so too will revisions with new research findings. Pharmacists are well served by making www.guideline.gov a favorite site.

Did You Know??

• Today, 2272 practice guidelines exist, and an additional 400 guidelines are under way
• More than 900 guidelines have "retired"
• NGC designates approximately 100 guidelines as ?most frequently requested guidelines?
• Users search for cancer, heart disease and stroke, diabetes, and mental health guidelines most often
• Medication monitoring guidelines exist for specific conditions, populations, and agents
• NGC lists 45 guidelines on pharmaceutical preparations, including 11 guidelines for OTC agents
• NGC summarizes disease-specific guidelines issued by more than 40 professional organizations and institutes

NGC = National Guideline Clearinghouse.

Adapted from www.guideline.gov.