1. Impact of Two Studies on Future of NGC AHRQ Annual Conf Sept 19, 2011 1:30 – 3:00pm

2. What is the NGC?  Online database of structured summaries of evidence-based clinical practice guidelines (CPGs), describing more than 40 attributes of CPGs, including underlying methodology used to develop each guideline  Freely available since 1999; Redesigned site launched July 2010  Currently has summaries for 2600 guidelines from over 200 different guideline developers

3. Future of NGC Moderator: Mary Nix, AHRQ Moderator: Mary Nix, AHRQ Speakers: Speakers: – Michelle Tregear, AFYA Inc – Rick Shiffman, Yale School of Medicine AHRQ Response: Mary Nix AHRQ Response: Mary Nix Discussants: Panel + You Discussants: Panel + You

4. Evaluation of NGC program impact Evaluation of NGC program impact – Has NGC had an impact? If so, how? – Not focused on Web site; focused on program IOM study on developing trustworthy guidelines (sister study on systematic review) IOM study on developing trustworthy guidelines (sister study on systematic review) 2 AHRQ-commissioned studies

5. Michelle Tregear, PhD Rick Shiffman, MD

6. AHRQ Response IOM Standards for Developing Trustworthy Guidelines IOM Standards for Developing Trustworthy Guidelines – Recommendation: NGC provide clear indication of the extent to which CPGs adhere to standards for trustworthiness Right now: Right now: – Over 2600 guidelines summaries from 203 developers – How many would meet all the IOM standards for trustworthiness? – Zero!

7. Response to IOM It is not practical or possible for NGC to implement the IOM Committee’s recommendation immediately and across the board. It is not practical or possible for NGC to implement the IOM Committee’s recommendation immediately and across the board.

8. Response to IOM NGC will be providing the indication NGC will be providing the indication 1. Working with experts to prioritize 2. Assessing methods, web options 3. Determining when

9. Response to IOM: specifics NGC Team: NGC Team: – Plan to phase in documenting adherence, starting with 3 to 5 that seem feasible and most critical to ensure trustworthiness. Inputs from experts Inputs from experts – Conduct a small pilot using recent guidelines to determine which IOM standards they meet and where they fall short. – Make recommendations to AHRQ regarding how to proceed with implementation.

10. Key Response to IOM

11. AHRQ Response Evaluation Study – AHRQ Opportunities Evaluation Study – AHRQ Opportunities – Increase physician awareness of NGC – Revisit NGC’s inclusion criteria – Revisit NGC’s age criterion – Increase knowledge among guideline developers about how to create and report trustworthy guidelines – Identify additional efforts to enhance the dissemination of guidelines – Invest in major enhancements that will increase the value of NGC

12. Evaluation Study Response AHRQ will work with the NGC team on: AHRQ will work with the NGC team on: – Major enhancements (over next 2 years) Customized site, email (my NGC, my NQMC) Customized site, email (my NGC, my NQMC) Indicate trustworthiness Indicate trustworthiness – Adopting IOM definition – Exploring changing inclusion criteria Systematic review Systematic review Aging Aging

13. Evaluation Study Response AHRQ will consider in context of extremely tight budget AHRQ will consider in context of extremely tight budget – Best ways to raise awareness among physicians – Additional mechanisms for dissemination – Its and NGC’s role in helping guideline developers create and report trustworthy guidelines

14. QUESTIONS?? Mary.Nix@ahrq.hhs.gov