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Whose Guideline Is It, Anyway?
Barry G. Saver, MD, MPH
Arch Fam Med. 1996;5(9):532-534.
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IF, AS Tip O'Neill said, "All politics are local politics," must all guidelines be local guidelines? This is one of the key questions raised by Fang and colleagues1 in their article in this issue of the ARCHIVES, in which 87% of responding provider groups affiliated with a large California health maintenance organization stated that they were planning, developing, or had completed work on at least 1 clinical guideline. The costs to develop a guideline incurred by the few organizations providing estimates were quite modest, $100 to $5000. Given that the evidence-based guidelines produced by the Agency for Health Care Policy and Research (AHCPR) each cost hundreds of thousands of dollars to produce, is the private sector being vastly more efficient than the public sector, or are these organizations doing something else? Local expert opinion, the medical and scientific literature, and externally developed guidelines were rated as the 3 most
. . . [Full Text PDF of this Article]
Author Affiliations
University of Washington School of Medicine Seattle
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