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