In light of the thousands of practice guidelines available for doctors to follow, the American Medical Association decided it's time to stamp some with its seal of approval.
The AMA is launching a Clinical Practice Guideline Recognition Program, which will review guidelines to determine whether they are developed "in accordance with scientifically based criteria."
"It's like a scientist submitting a paper to a journal for review," says Yank Coble, M.D., a Jacksonville, Fla., endocrinologist who is a member of the AMA's board of trustees.
Coble says the AMA is responding to "growing concerns among physicians about the misapplication of clinical guidelines by some insurers, the proliferation of proprietary guidelines of questionable scientific integrity and the funding of guidelines by pharmaceutical firms that may preferentially suggest the use of their products."
Directory of Practice Guidelines, a resource book the AMA plans to publish by the end of 1998, is expected to list about 1,700 clinical practice guidelines.
Though the AMA will not officially endorse every guideline in the book, those it does approve will be clearly marked.
AMA guideline evaluators, including development experts and physicians, will base their research on criteria listed in a publication called Attributes to Guide the Development and Evaluation of Practice Parameters/Guidelines, the organization says. Attributes was developed by a partnership consisting of the AMA, national medical specialty societies, the Agency for Health Care Policy and Research, the American Hospital Association and the Joint Commission on Accreditation of Healthcare Organizations.
Suggested guidelines are being submitted by a variety of healthcare organizations, which pay $100 each for the first five items submitted, $75 each for the next five and $50 thereafter. Coble says the money does not ensure approval, it simply covers the AMA's cost for review.
The AMA program, Coble says, "will get these (approved) guidelines out to clinics faster because doctors will feel like they've been reviewed independently."