1. CP1282124-1 Clinical Practice Guidelines MayoClinic.com Content Martha Grogan, MD Martha Grogan, MD Consultant Cardiovascular Diseases Medical Editor, MayoClinic.com Institute of Medicine Next Steps: Implementation Workshop on Standards for Systematic Reviews and Clinical Practice Guidelines May 10-11, 2011

2. MayoClinic.comMayoClinic.com Launched 1995 Launched 1995 Health information for general public Health information for general public Independent of the clinical practice Independent of the clinical practice Practice site: MayoClinic.org Practice site: MayoClinic.org Goal: Help users Goal: Help users Assess symptoms Assess symptoms Understand diagnosis Understand diagnosis Manage their health Manage their health Launched 1995 Launched 1995 Health information for general public Health information for general public Independent of the clinical practice Independent of the clinical practice Practice site: MayoClinic.org Practice site: MayoClinic.org Goal: Help users Goal: Help users Assess symptoms Assess symptoms Understand diagnosis Understand diagnosis Manage their health Manage their health

3. MayoClinic.com Top 5 Reasons Users Visit 1. Specific info: recent diagnosis 2. Look up a symptom 3. Specific info: chronic condition 4. Wellness Information 5. Browse general health info 1. Specific info: recent diagnosis 2. Look up a symptom 3. Specific info: chronic condition 4. Wellness Information 5. Browse general health info

4. MayoClinic.com April 2011 Statistics Unique Visitors: 17,019,517 Unique Visitors: 17,019,517 Total Visits: 22,470,932 Total Visits: 22,470,932 Page Views: 79,882,497 Page Views: 79,882,497 Unique Visitors: 17,019,517 Unique Visitors: 17,019,517 Total Visits: 22,470,932 Total Visits: 22,470,932 Page Views: 79,882,497 Page Views: 79,882,497 61% of adults look online for health information

5. Country of Residence United States Other country

6. AgeAge 18-24 25-34 35-44 45-54 55-64 65-74 75-84 85 and older

7. Female Male GenderGender

8. Less than a high school diploma Completed high school Some college/trade school/Associate’s degree Bachelor’s degree Some graduate work or graduate degree DK/DA Education

9. MayoClinic.comMayoClinic.com Professional Writers, Managing Editors Professional Writers, Managing Editors Research Staff and Librarians Research Staff and Librarians Physician Editors Physician Editors Three for new content General Internists provide perspective General Internists provide perspective Sources Documented Sources Documented Scheduled update every two years Scheduled update every two years Interim update if needed Professional Writers, Managing Editors Professional Writers, Managing Editors Research Staff and Librarians Research Staff and Librarians Physician Editors Physician Editors Three for new content General Internists provide perspective General Internists provide perspective Sources Documented Sources Documented Scheduled update every two years Scheduled update every two years Interim update if needed

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11. MayoClinic.com Practice Guidelines Struggled with methodology Struggled with methodology Recognition of conflict of interest Recognition of conflict of interest Tiered approach Tiered approach ICSI ICSI USPSTF, Natl Guideline Clearinghouse USPSTF, Natl Guideline Clearinghouse Major Medical Associations, Societies Major Medical Associations, Societies Acknowledge controversy – discuss with care provider Acknowledge controversy – discuss with care provider Struggled with methodology Struggled with methodology Recognition of conflict of interest Recognition of conflict of interest Tiered approach Tiered approach ICSI ICSI USPSTF, Natl Guideline Clearinghouse USPSTF, Natl Guideline Clearinghouse Major Medical Associations, Societies Major Medical Associations, Societies Acknowledge controversy – discuss with care provider Acknowledge controversy – discuss with care provider