July 02, 2014
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AOA to revise clinical practice guidelines

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PHILADELPHIA – The American Optometric Association has assembled a guideline-development group to formulate evidence-based optometry guidelines to align with new standards from the Institute of Medicine, according to a poster here at Optometry’s Meeting.

Trennda Rittenbach, OD, and Bennett McAllister, OD, FAAO, said that the AOA developed consensus-based guidelines in the mid-1990s that have been periodically updated and were intended as a reference for clinicians, policymakers and the public.

“Recently, the Institute of Medicine (IOM) has been mandated by the U.S. Congress through the Medicare Improvements for Patients and Providers Act of 2008 to find the best methods for developing quality, trustworthy, evidence-based clinical practice guidelines,” the authors said.

Rittenbach and McAllister detailed in their poster the specific attributes of evidence-based guidelines according to the IOM and the Agency for HealthCare Research and Quality: The guidelines must be based on systematic reviews of current and existing evidence; developed by a knowledgeable multidisciplinary panel of experts; based on an explicit and transparent development process; graded for quality of evidence and strength of clinical recommendation; reviewed externally; and revisited every 2 to 5 years.

The AOA’s evidence-based optometry committee has developed a 14-step process to establish and maintain their guidelines from transparency to a search for evidence to draft writing and revising to posting to scheduling reviews.

“Health care practitioners have always endeavored to deliver the best care through the best available information,” Rittenbach and McAllister wrote in the poster. “That process has taken us from ancient potions and incantations through expert opinion and consensus to the highest level currently recognized, which are evidence-based clinical practice guidelines. The process will be ongoing as the literature is monitored for new and supporting evidence.” – by Nancy Hemphill, ELS