Medical Outcomes Trust Conference presents dramatic advances in patient-based outcomes assessment and potential applications in accreditation.

Background: At its fourth annual State-of-the-Art Health Outcomes Conference, November 2, 1998, the Medical Outcomes Trust (Boston) convened experts to review advances in outcomes assessment technology and potential applications in clinical trials, clinical practice, and accreditation.

Keynote Address: "Future Directions in Health Status Assessment" identified what needs to happen next in order to put patient-defined outcomes into the databases used in medical decision making. Advances include a major recalibration of the SF-36 and SF-12 instruments from the Medical Outcomes Study (MOS) offering new norm-based scoring and the new methodology known as Dynamic Health Assessment (DynHA), which uses a computerized interactive process to select questions to produce a briefer but more precise assessment.

AMA Clinical Quality Improvement Forum ties it all together: from guidelines to measurement to analysis and back to guidelines.

Background: In Chicago October 15, 1998, the American Medical Association (AMA) Department of Clinical Quality Improvement introduced a broadened scope for its Practice Parameters Forum, now retitled the Clinical Quality Improvement Forum. The Forum will now focus on integrating all the components of what the AMA has identified as the quality continuum-clinical practice guidelines, performance measurement, and process and outcomes analysis.

Keynote Address: The address "The Quality Continuum" heralded the ushering in of a third stage known as "clinical integration," which will become medicine's "industrial revolution.

Health services researchers zero in on quality, policy, and practice in a changing health care system: report of the 15th annual meeting of the Association for Health Services Research.

Background: The Association for Health Services Research (AHSR) drew a record attendance of more than 2,100 to its 15th annual meeting, "Health Services Research: Implications for Policy, Delivery, and Practice," in Washington, DC, June 21-23, 1998. The conference offered 113 sessions, identifying policy roundtables and research report and panel sessions according to ten themes, with the "quality" theme on top and the effects of managed care a key concern. Selected presentations are reported.