Component 1: Introduction to Health Care and Public Health in the U.S. 1.9: Unit 9: The evolution and reform of healthcare in the US 1.9b:Clinical Practice Guidelines Component 1/Unit 9b Health IT Workforce Curriculum Version 1.0/Fall 2010 1

Clinical Practice Guidelines: Definition Systematically developed statements Assist practitioner and patient decision-making Intended for specific clinical circumstances Recommendations that are based on evidence obtained by conducting a systematic review Guidelines delineate the role of specific diagnostic and treatment modalities in diagnosis and management of a disease Component 1/Unit 9b Health IT Workforce Curriculum Version 1.0/Fall 2010 2

Clinical Practice Guidelines: Purpose To help clinicians and patients make appropriate decisions about health care How do guidelines achieve this? By specifying a set of generally accepted approaches By defining appropriate practices Example of clinical practice guidelines dissemination website: National guidelines clearinghouse http://www.guideline.gov/index.aspx Component 1/Unit 9b Health IT Workforce Curriculum Version 1.0/Fall 2010

U.S. Preventive Services Task Force (USPSTF) Independent panel of experts in prevention and evidence-based medicine Composed of primary care providers Conducts scientific evidence reviews of a broad range of clinical preventive health care services Develops recommendations Component 1/Unit 9b Health IT Workforce Curriculum Version 1.0/Fall 2010

Health IT Workforce Curriculum Version 1.0/Fall 2010 USPTF Grades A The USPSTF recommends the service High certainty of substantial net benefit Suggestions for practice: Offer or provide this service B The USPSTF recommends the service High certainty of moderate net benefit or moderate certainty of moderate to substantial net benefit Component 1/Unit 9b Health IT Workforce Curriculum Version 1.0/Fall 2010 5

USPSTF Grades (continued) C: Recommends against routinely providing the service. Tailor recommendations to individual patients At least moderate certainty that the net benefit is small Suggestions for practice: Offer or provide this service only if other considerations support the offering or providing the service in an individual patient D: Recommends against the service. Moderate or high certainty of no net benefit or that harms outweigh benefits Suggestions for practice: Discourage the use of this service Component 1/Unit 9b Health IT Workforce Curriculum Version 1.0/Fall 2010

USPSTF Grades (continued) I Statement: Current evidence is insufficient to assess the balance of benefits and harms of the service Suggestions for practice: Read the clinical considerations section of USPSTF Recommendation Statement. If the service is offered, patients should understand the uncertainty about the balance of benefits and harms Component 1/Unit 9b Health IT Workforce Curriculum Version 1.0/Fall 2010