institute of medicine may 11, 2011 norman kahn md council of medical specialty societies

Institute of MedicineMay 11, 2011

Norman Kahn MDCouncil of Medical Specialty Societies

37 Member Specialty Societies 700,000 physicians in the US Strategic Priorities:

◦ Facilitate a Culture of Performance Improvement in Practice

◦ Model Professionalism Altruism (putting patients’ needs first) Self-regulation Transparency (to peers, patient, the public)

Adopted April 2010, revised March 2011 34 signers to date Independence and transparency CPG’s

◦ Professional responsibility of specialty societies to develop practice guidelines

◦ Evidence-based◦ Independent, transparent development process◦ No company financial support◦ Disclosure, management and resolution of relationships

resulting in perceived conflicts of interest◦ Chair and majority of panel free of relationships◦ Rigorous internal and external review

Conflict of Interest◦ Transparency

Disclosure of relevant relationships Resolution of conflicts of interest

◦ Chair plus majority of writing panel with no relationships (CMSS Code for Interactions with Companies, 2010, revised 2011)

Comprehensive systematic evidence reviews◦ Assessment of the strength of evidence

Recommendations should be actionable ◦ Clear, direct guidance

Recommendations should be practical ◦ Focus on high level evidence

Developer qualifications◦ Methodologist◦ Librarian◦ Multi-disciplinary panel◦ Panel training◦ External review◦ Patient preferences and feedback

Development process◦ Purpose/rationale/clinical question for the

guideline◦ Evidence-grading system disclosed◦ Reconciling low quality evidence◦ Timeline, maintenance and expiration◦ Performance metrics for implementation

Scope◦ Intended audience◦ Patient population◦ Distribution

Web National Guidelines Clearinghouse

Funding◦ No industry support for guideline development

(CMSS Code)◦ Derivative products

Internal CMSS review External review and feedback CMSS Council November 19, 2011