CPG and SR Work Group Members Information
The Introductory Packet for Clinical Practice Guidelines (CPG)/Systematic Review (SR) Work Group Members provides clinician work group members with an overview of the CPG/SR development process. This information is beneficial to clinicians who will be serving on a CPG/SR work group, as it reviews the work group structure, and the need to disclose potential conflicts of interest. Furthermore, the packet discusses what transpires during the work group introductory meeting, as well as the methodology used and parameters for the guideline literature review, how the final guideline recommendations and strength of recommendations are formulated, what transpires during the Peer Review and Public Comment timeframe, and how these reviews enhance the quality of the guideline, and lastly, the guideline approval process.
Quality Measures
Quality measures are "tools that help measure or quantify health care processes, outcomes, patient perceptions, and organizational structure and/or systems". The primary purpose of quality measures is to quantify aspects of healthcare (e.g. processes, outcomes, and patient experiences) to enable the collection of data that can be used for benchmarking, identification of strengths and weaknesses, and quality improvement.
Quality Payment Program
AAOS' Quality Payment Program (QPP) Information Center offers clinicians tools and resources to help to prepare for and navigate through either of the two QPP tracks - The Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Models (APMs).
The Agency for Healthcare Research and Quality
The Agency for Healthcare Research and Quality (AHRQ) conducts research and provides evidence that both increases the safety and improves the quality of health care. AHRQ offers curriculum tools for health care professionals to assist in patient safety and improve communication skills, as well as provides extensive online, searchable health care data to track and improve the performance and progress of the U.S. Health system.
Other External Resources
National Academies of Sciences Engineering Medicine
In March 2011, The Institute of Medicine (IOM) through the National Academies of Sciences Engineering Medicine published Finding What Works in Health Care - Standards for Systematic Reviews. These standards establish transparency, manage conflict of interest, shape the guideline development group composition, establish literature review standards, evidence foundations for rating strength of recommendations, the articulation of recommendations, as well as the need for an external review and guideline revisions plans.
Cochrane
Cochrane, named after Archie Cochrane, a British medical researcher who contributed to the development of epidemiology as a science, was founded in 1993 to organize and disseminate medical research and systematic reviews to enable evidence-based decisions faced by clinicians, healthcare professionals, patients, and policy makers. They organize their work around four goals: producing evidence, making that evidence accessible, advocating for evidence, and building an effective and sustainable organization. To generate authoritative and reliable information, working freely, unconstrained by commercial and financial interests, they do not accept any commercial or conflicted funding.
GRADE
In 2000 the Grading of Recommendations Assessment Development and Evaluation (GRADE) working group was established as an informal partnership of individuals who were interested in tackling the inconsistencies of grading guideline quality of evidence and strength of recommendations. As a result, the working group developed GRADE, a practical and transparent approach to this issue. The GRADE methodology and process is now considered the standard in guideline development, with more than 100 organizations around the world now using or endorsing the GRADE.
Appraisal of Guidelines For Research And Evaluation
The Appraisal of Guidelines for Research and Evaluation (AGREE) Instrument was developed in 2003 by a team of international guideline developers and researchers to address the variability in guideline quality. This tool assesses the quality, methodology and content in guidelines, and ensures that potential conflicts of interest and biases have been addressed, and the recommendations are internally and externally valid, and feasible for practice. The assessment includes judgments about the methods used for developing the guidelines, the components of the final recommendations, and the factors that are linked to their uptake.
*Other AAOS Resources
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1. Centers for Medicare & Medicaid Services. Quality measures. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityMeasures/index.html(www.cms.gov). Accessed February 7, 2018.
2. AGREE Collaboration. Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project. Qual Safe Health Care. 2003;12(1):18-23