American College of Chest Physicians (ACCP) Health and Science Policy Committee Orientation Program Part #1 General Overview and Structure

Health and Science Policy Committee Leaders: David Gutterman, MD, FCCP, Chair Doreen Addrizzo-Harris, MD, FCCP, Vice-Chair Michael Baumann, MD, FCCP, Ex Officio

Health & Science Policy (HSP) Mission & Vision HSP Vision The American College of Chest Physicians is the leading resource in the development of evidence-based guidelines in the field of chest medicine. HSP Mission To optimize patient care by integrating evidence-based guidelines into clinical practice.

What is Evidence-Based Medicine (EBM)? Evidence-Based Medicine has been described as the "integration of best research evidence with clinical expertise and patient values." David Sackett, et al. Evidence-Based Medicine: How to Practice and Teach EBM (New York: Churchill Livingstone, 2000) Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. David L Sackett, William MC Rosenberg, JA Muir Gray, R Brian Haynes, W Scott Richardson Evidence-Based Medicine: What it is and what it isn't. [Based on an editorial from the British Medical Journal (BMJ 1996)]

What are Evidence-Based Clinical Practice Guidelines (CPG)? Evidence-based guidelines are founded upon the integration of the current best evidence, which is usually located in clinically relevant research that has been conducted using sound methodology. ACCP guideline development incorporates a systematic review of the clinical literature and provision of recommendations based upon the results of the review. "Clinical practice guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances." [Institute of Medicine, 1990]

Health & Science Policy (HSP) Goals 1.Identify conditions or interventions that potentially have high public health and global economic impact and in which management could be significantly improved by a change in clinical practice. 2. Identify clinical topics where treatment or diagnostic strategies are evolving. 3. Identify topics that have a sufficient established body of published evidence for development of a clinical practice guideline. 4. Identify topics that reflect the constituency of the American College of Chest Physicians and that may cross over to other disciplines. 5. Identify and develop tools that enable clinicians to quickly reference and utilize evidence-based guidelines in day-to-day practice. 6. Work collaboratively with the ACCP Continuing Education Committee and others as appropriate to incorporate evidence-based guidelines into educational venues. 7. Work with other organizations as appropriate to develop, sponsor, and/or disseminate evidence-based guidelines.

HSP Committee Composition The committee is comprised of thirteen voting members and one ex-officio. Of the thirteen voting members one serves as the committee chair and one as the committee vice-chair Roughly half are methodology experts and half are clinical experts preferably with some evidence-based medicine and guideline development experience

Subcommittees of the Health & Science Policy Committee Most HSP responsibilities fall under one of three categories, thus three sub- committees have been formed to equally distribute the responsibilities of the committee. The subcommittees meet once a month prior to the full HSP Committee conference call and present recommendations to HSPC on relevant issues. Guidelines Subcommittee: Reviews guideline topic applications, conducts yearly reviews of all guidelines and makes recommendations regarding the status of ACCP guidelines. This subcommittee also reviews draft ACCP guidelines. Policy & Procedures Subcommittee: Develops policy relevant to Health and Science Policy and reviews all issues related to conflict of interest. Implementation Subcommittee: Develops innovative methods for implementing ACCP guidelines and changing physician behavior.

HSP Member Role and Responsibilities The HSP Committee is essential to provide recommendations to the ACCP leadership on evidence- based medicine and policy development issues. Members must be available to review written drafts of clinical practice guidelines and provide recommendations for approval. Members may be asked to serve as an HSP liaison on guideline development panels convened by the ACCP to ensure that the documents are developed following the approved evidence-based methodology. From time to time, members may also be asked to serve as liaisons to guideline panels spearheaded by other organizations.