IOM panel seeks program to evaluate research, guidelines

The report says creating one such reliable source could help physicians choose diagnostic and treatment options and keep pace with vast amounts of medical data.

By Susan J. Landers and Kevin B. O'Reilly , AMNews staff. Feb. 18, 2008.

Buried in clinical guidelines and buffeted by the latest published research findings, what's a physician to do when faced with a patient and a 15-minute treatment window? Begin to sort through the conflicting guidelines or analyze the latest research studies?

A Jan. 24 Institute of Medicine report suggests a way to bring order from the chaos that surrounds conflicting clinical guidelines and questions about how to choose the best available diagnostic, treatment or preventive service -- but Congress would have to create a federal program to make it happen.

Physicians and medical researchers who drafted the IOM report recommend that the program evaluate existing medical evidence in an unbiased way and set standards for clinical guidelines. Not only could such an initiative wipe out some uncertainty and disagreements over standards of care, it also could lower costs by eliminating ineffective care, the IOM panel said.

"If our recommendations are adopted and put into legislation, physicians will have better and more trustworthy information on what works in the practice of medicine," said panel vice chair Harold C. Sox, MD, who also is editor of the Annals of Internal Medicine.

With evidence-based medicine the goal, where to turn for reliable evidence looms large in health care. There are hundreds of clinical guidelines on some diseases and conditions, and often they conflict. There are 342 guidelines on cardiovascular diseases alone listed in the Agency for Healthcare Research and Quality's National Guideline Clearinghouse.