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AACE releases new guidelines for clinical practice guidelines
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American Association of Clinical Endocrinologists 19th Annual Meeting
BOSTON — The American Association of Clinical Endocrinologists released its Protocol for Standardized Production of Clinical Practice Guidelines — 2010 Update.
The new protocol is an update of the first AACE guidelines, which were published in 2004. In total, AACE has published 17 Clinical Practice Guidelines; nine have been published since 2004.
The goal of the protocol is to “try to bring some uniformity to the production of clinical practice guidelines,” Jeffrey I. Mechanick, MD, chair of the AACE Publications Committee and Task Force to Update Guidelines for Guidelines, said at a press conference here.
“There is a lot of imprecision in the way in which we rate evidence,” Mechanick said. “If we use certain words that say ‘good’ or ‘strong’ or ‘flawed,’ those words don’t necessarily mean the same thing from one guideline to another.”
The protocol was designed to ensure that all subsequent clinical practice guidelines meet evidence-based standards and incorporate subjective factors that can improve patient outcomes.
Guidelines that are currently under development will adhere to the new protocol. Such guidelines are being developed to address acromegaly, hypothyroidism and osteoporosis.
Mechanick said the most important item incorporated in the new methodology is “the differentiation between disease-oriented evidence and patient-oriented evidence that matters.”
The use of patient-oriented evidence that matters, also referred to as POEMs, allows future AACE clinical practice guidelines to address important humanistic factors in clinical medicine. Traditional evidence-based medicine standards are valuable and remain necessary, but may not be sufficient. One reason is because many large clinical trials require many years of study and are not generalizable to the fast pace of medical innovation.
The 2010 update also calls for a higher level of transparency and a more expeditious timeline so that future guidelines are thoroughly vetted by credentialed experts and are as up-to-date as possible.
The new guidelines for guidelines were an attempt to address the shortcomings of the 2004 guidelines.
“Three major goals are to: balance transparently the effect of rigid quantitative evidence-based medicine methods with subjective factors; create a less onerous, less time-consuming and less costly clinical practice guideline process; and introduce an electronic implementation component,” the guidelines state. – by Katie Kalvaitis
For more information:
- Mechanik JI. Presented at: American Association of Clinical Endocrinologists 19th Annual Meeting and Clinical Congress; April 21-25, 2010; Boston.
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