Clinical practice guidelines to inform evidence-based clinical practice.

Background: With the volume of medical research currently published, any one practitioner cannot independently review the literature to determine best evidence-based medical care. Additionally, non-specialists usually do not have the experience to know best practice for all of the frequent clinical circumstances for which there is no good evidence. Clinical practice guidelines (CPGs) help clinicians to address these problems because they are systematically created documents that summarize knowledge and provide guidance to assist in delivering high-quality medicine.

Staying at the cutting edge: a review and analysis of evidence reporting and grading; the recommendations of the American Urological Association.

The American Urological Association (AUA), as the premier urological organization in the USA, has been a pioneering force in the development of practice guidelines. Recently the AUA evaluated their guidelines development procedures and implemented several changes that resulted in more scientifically rigorous, transparent and efficient processes. These changes include narrowing the scope of the guideline, strengthening the systematic literature review, updating data-analysis capabilities, altering panel members' roles to exclude laborious data extraction, and identifying and specifying levels of evidence for guideline recommendations.

The value of nurse leaders on federal advisory panels: experience with the Agency for Healthcare Research and Quality.

This article focuses on interviews with six nationally known nurse leaders who have been, or currently are, members of National Advisory Committee for the Healthcare Research and Quality (NAC). The nurse leaders are either deans and/or professors of schools of nursing. They discuss how their participation on the NAC serves the Federal Government and what they view as the benefits they now offer the nursing profession from being on the NAC such as an increased focus on evidence-based research.

Expanded newborn screening for genetic and metabolic disorders: modeling costs and outcomes.

Newborn screening for genetic and metabolic disorders is a state-based public health program in the United States, for the elimination and/or reduction of associated mortality, morbidity, and disabilities. As new technologies for newborn screening and new interventions for treatment are realized, it will be increasingly important for health leaders and policymakers to have data to inform their decisions regarding expanding newborn testing. The entire costs of a screening program, including not only instrumentation but also labor and time costs; initial, repeat, and confirmatory testing; screening sensitivity and specificity; and short and long-term followup, should be considered in decisions regarding expansion of screening programs.

A primer on economic evaluations related to expansion of newborn screening for genetic and metabolic disorders.

Newborns in every state are screened for genetic/metabolic disorders, but there is no uniform national screening program. Recently, a federal panel concluded that the number of disorders screened should be increased from 9 to Twenty-nine. In order for state leaders, and for the clinicians who inform them, to make sound decisions about expanding newborn screening programs, they need to be aware of the costs and outcomes of the entire screening program.

The first national reports on United States healthcare quality and disparities.

In the Healthcare Research and Quality Act of 1999 (Public Law 106-129), Congress mandated that the Agency for Healthcare Research and Quality (AHRQ) produce annual reports on healthcare quality and disparities in the United States. The National Healthcare Quality Report and the National Healthcare Disparities Report were first released in 2003 by the AHRQ. These reports include broad sets of performance measures to portray the nation's progress toward improving the quality of care provided to all Americans.

Outcomes and effectiveness research: capacity building for nurse researchers at the Agency for Healthcare Research and Quality.

Several of AHRQ's priority areas including disease prevention, health promotion, primary care, quality of care, service delivery, and patient safety are particularly relevant to nurse researchers. With much national attention focused on nursing-related issues such as staff shortages, training, mandatory overtime, working conditions, and autonomy, it is mandatory that nursing research be conducted to inform healthcare delivery and policy. Nurses also need to contribute to the health services literature so that an even balance of discipline perspective is represented.