AAOS Now

Published 11/1/2008
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David A. Halsey, MD; Fareeha Shuttari-Khan, MPH

Wanted: Clinical topics that make a difference

Submit your suggestions for clinical practice guidelines

Evidence-based medicine (EBM) is “the integration of individual clinical expertise with the best available external clinical evidence from systematic research,” as described by David Sackett, MD, one of the founders of the evidence-based medicine concept and movement.

EBM has the potential to improve the quality of care, reduce errors, and manage costs. Staying abreast of the best available evidence, however, can be an enormous challenge for the practicing orthopaedic surgeon. Research also suggests that proven evidence-based medical treatments are often undelivered. Disparities between what is known to be “best practice” and what is actually practiced underscore the urgent need to improve both clinical performance and quality of care while reducing medical errors.

To bridge that gap between knowledge and practice, the AAOS and other reputable sources are developing evidence-based clinical practice guidelines (CPGs). The CPGs summarize the clinical evidence and are written so they are easy to use and understand.

Your ideas count
So why should you consider making a request to the AAOS for development of a particular clinical practice guideline?

The AAOS Guidelines and Technology Oversight Committee has developed a rigorous process for developing CPGs that can dramatically simplify the implementation of EBM. However, the volume of potential musculoskeletal topics is overwhelming. The committee needs help in identifying the most clinically relevant subjects to consider. Your input will help the committee prioritize topics for development and promote guideline topic diversity.

In addition, getting involved early increases the chances that the guidelines will be implemented.

Issues to consider
As you think of topics to submit, consider the impact of the proposed guideline. For example, ask yourself the following questions:

  • Does the health problem in question carry a high individual or population burden of morbidity, mortality, or disability?
  • Does the health problem and/or its diagnosis and/or treatment carry a high unit or aggregate cost?
  • Are there substantial variations in the diagnosis and/or treatment of the health problem?
  • Is there a substantial public or political demand for this practice guideline?
  • Are there existing clinical practice guidelines on the proposed topic?

All AAOS members are welcome to nominate a topic for clinical practice guideline development. You’ll find a link to the procedures for nominating a guideline on the AAOS Web site, at www.aaos.org/guidelines

David A. Halsey, MD, is an ex-officio member of the Guidelines and Technology Oversight Committee. Fareeha Shuttari-Khan, MPH, serves as the staff liaison for the committee; for more information, e-mail shuttari@aaos.org