Criteria for evaluating treatment guidelines.

Abstract

This document presents a set of criteria to be used in evaluating treatment guidelines that have been promulgated by health care organizations, government agencies, professional associations, or other entities. 1 Although originally developed for mental health interventions, the criteria presented are equally applicable in other health service areas.Two factors prompted this effort by the American Psychological Association (APA) to create a policy basis for evaluating guidelines. First, guidelines of varying quality, from both public and private sources, have been proliferating. Second, the interest and expertise in methodological issues within the profession of psychology made it likely that APA could make a useful contribution to the evaluation of treatment guidelines.Generally, health care guidelines are pronouncements, statements, or declarations that suggest or recommend specific professional behavior, endeavor, or conduct in the delivery of health care services. Guidelines are promulgated to encourage high quality care. Ideally, they are not promulgated as a means of establishing the identity of a particular professional group or specialty, nor are they used to exclude certain persons from practicing in a particular area.There are two different types of health care guidelines: practice guidelines and treatment guidelines. Practice guidelines, which are not addressed in this document, consist of recommendations to professionals concerning their conduct and the issues to be considered in particular areas of clinical practice rather than on patient outcomes or recommendations for specific treatments or specific clinical procedures at the patient level. Treatment guidelines, which are the focus of this document, provide specific recommendations about treatments to be offered to patients. That is, treatment guidelines are patient directed or patient focused as opposed to practitioner focused, and they tend to be condition or treatment specific (e.g., pediatric immunizations, mammography, depression).The purpose of treatment guidelines is to educate health care professionals 2 and health care systems about the most effective treatments available. When there is sufficient information and the guidelines are done well, they can be a powerful way to help translate the current body of knowledge into actual clinical practice.Many treatment guidelines are disorder based. The most common classification system is the International Classification of Diseases (ICD-10; World Health Organization, 1992) and, for mental disorders, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994). The disorder-based approach has limitations: Patients 3 commonly present issues This document was approved as policy of the APA in August 2000. This document replaces as policy and is in part a revision of an earlier document, the Template for Developing Guidelines: Interventions for Mental Disorders and Psychosocial Aspects of Physical Disorders (APA, 1995), approved by the APA Council of Repr...

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A translational model of research-practice integration.

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