Chest ACCP Education Calendar
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (12)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Guyatt, G.
Right arrow Articles by Schünemann, H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Guyatt, G.
Right arrow Articles by Schünemann, H.
(Chest. 2006;129:182-187.)
© 2006 American College of Chest Physicians

Addressing Resource Allocation Issues in Recommendations From Clinical Practice Guideline Panels*

Suggestions From an American College of Chest Physicians Task Force

Gordon Guyatt, MD, MSc, FCCP; Michael Baumann, MD, MSc, FCCP; Stephen Pauker, MD; Jonathan Halperin, MD; Janet Maurer, MD, MBA, FCCP; Douglas K. Owens, MD; Anna N.A. Tosteson, ScD; Brian Carlin, MD, FCCP; David Gutterman, MD, FCCP; Martin Prins, MD; Sandra Zelman Lewis, PhD and Holger Schünemann, MD, PhD, FCCP

* From the Department of Medicine (Dr. Guyatt), McMaster University, Hamilton, ON, Canada; the University of Mississippi Medical Center (Dr. Baumann), Jackson MS; Tufts-New England Medical Center (Dr. Pauker), Boston, MA; Mount Sinai Medical Center (Dr. Halperin), New York, NY; the Department of Veterans Affairs (Dr. Owens), Palo Alto Health Care System, Palo Alto, CA; the Departments of Medicine (Dr. Tosteson), Dartmouth Medical School, Hanover, NH; Drexel University School of Medicine (Dr. Carlin), Philadelphia, PA; the Department of Medicine (Dr. Gutterman), Medical College of Wisconsin, Milwaukee, WI; the Health and Science Policy Committee (Dr. Lewis), American College of Chest Physicians, Northbrook, IL; the Department of Clinical Epidemiology and Medical Technology Assessment (Dr. Prins), Academis Hospital Maas-tricht, University of Maastricht, Maastricht, the Netherlands; and the and Division of Clinical Research Development and Information Translation (Dr. Schünemann), the Department of Epidemiology, Italian National Cancer Institute Regina Elena, Rome, Italy.

Correspondence to: Gordon Guyatt, MD, MSc, FCCP, Department of Clinical Epidemiology and Biostatistics, HSC-2C12, McMaster University, 1200 Main St West, Hamilton, ON, Canada L8N 3Z5; e-mail: guyatt{at}mcmaster.ca

Abstract

Most panels that develop clinical practice guidelines are poorly equipped to address resource allocation or cost issues associated with management options. This risks neglect, arbitrariness, lack of transparency, and methodological flaws in consideration of resource allocation. We provide recommendations for guideline panels to promote greater transparency and rigor. We suggest focusing on resource allocation issues for only a limited number of recommendations and provide criteria for selecting those in which economic considerations are likely to influence the direction or strength of the recommendation. Panels should involve a health economist to assist with the systematic review and critical interpretation of relevant economic analyses. They should carefully define the intended audience and may consider issuing alternative recommendations when available resources vary widely across target clinical settings. Targeting a limited number of recommendations for the consideration of resource allocation issues, and ensuring methodologically high-quality review, will best serve guideline panels, and the health-care providers and patients they hope to assist.

Key Words: clinical practice guidelines • evidence-based recommendations • resource allocation




This article has been cited by other articles:


Home page
 ChestHome page
R. Milroy
New American College of Chest Physicians Lung Cancer Guidelines*: An Important Addition to the Lung Cancer Guidelines Armamentarium
Chest, September 1, 2007; 132(3): 744 - 746.
[Full Text] [PDF]

Home page
 ChestHome page
M. H. Baumann, S. Z. Lewis, and D. Gutterman
ACCP Evidence-Based Guideline Development: A Successful and Transparent Approach Addressing Conflict of Interest, Funding, and Patient-Centered Recommendations
Chest, September 1, 2007; 132(3): 1015 - 1024.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
R. Jaeschke and J. Brozek
Resource allocation issues and clinical practice guidelines.
Chest, August 1, 2006; 130(2): 623 - 623.
[Full Text] [PDF]

Home page
 ChestHome page
R. S. Irwin
The New "Face" of CHEST Heralds a New Era
Chest, January 1, 2006; 129(1): 1 - 3.
[Full Text] [PDF]

Home page
 ChestHome page
R. Kunz
"What's in the Black Box?"
Chest, January 1, 2006; 129(1): 7 - 10.
[Full Text] [PDF]

Home page
 ChestHome page
M. H. Baumann and D. D. Gutterman
American College of Chest Physicians Evidence-Based Guidelines-the Next Generation: Considering Resource Use and Evolution to a Single Grading System
Chest, January 1, 2006; 129(1): 10 - 12.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2006 by the American College of Chest Physicians.