Development of the AHCPR-sponsored Heart Failure Guideline

Methodologic and Procedural Issues

Published In: The Joint Commission Journal On Quality Improvement, v. 20, 1994, p. 539-546

Posted on RAND.org on January 01, 1994

by David Hadorn, David William Baker

In its capacity as a contractor for AHCPR, RAND presided over a 16-member panel charged with developing a guideline for the management of patients with heart failure. Panel discussions about practice recommendations were held until consensus was reached. This article summarizes methodologic and procedural issues involved in this process. The first step was to determine the focus of the guideline. The key tool for panel discussion in this regard was a draft algorithm that dealt with how to begin the literature review, rate the strength of evidence underlying practice recommendations, and determine the relationship of strength of evidence and strength of recommendations. The panel solicited opinions of national experts early and often during the guideline development, and it is believed that this process helped the panelists agree on conclusions concerning controversial issues.

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