AAFP Updates Videos on Clinical Practice Guideline Process

Academy Also Revises Conflict of Interest Policy

October 03, 2018 01:54 pm Chris Crawford

As just one of the many member services the Academy provides, the AAFP develops evidence-based clinical practice guidelines (CPGs) that are meant to serve as a framework for clinical decision-making and supporting best practices.

[physician's hand touching screen playing medical video]

A key aspect of patient-centered care, CPGs include practice recommendations informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options.

The Academy also reviews guidelines developed by other organizations, endorsing those that are relevant to family medicine and that meet stringent criteria for methodological rigor and transparency.

To inform members about these activities, the AAFP has updated a video series explaining the CPG development and assessment process.  

The four new videos go more in depth than their predecessors in describing the process the Academy uses to create and assess these guidelines, said Jennifer Frost, M.D., medical director for the Academy's Health of the Public and Science Division.

"The process followed for guideline development is complicated," Frost told AAFP News. "The goal of these videos is to help family physicians understand the more complex issues."

Interested in Helping the AAFP Develop CPGs?

You can be part of the AAFP's process for evaluating and developing clinical practice guidelines. Email clinicalpolicies@aafp.org to find out how.

The first video provides an overview of the AAFP's guideline process, she said, with the other three videos offering additional information on systematic reviews of evidence; evaluating the quality of evidence and making recommendations based on the evidence; and the Academy's endorsement process and what it looks for when evaluating other organizations' guidelines.

Additional Guideline Notes

The AAFP follows a rigorous process for CPG development and assessment that is not matched by most other medical specialty societies, Frost said.

The Academy bases its own CPGs on independent, high-quality systematic reviews, Frost said.

"This means that the literature is reviewed and evaluated by individuals with expertise in this process and without a stake in the outcome," she noted.

The AAFP then establishes a guideline panel, which includes members who have expertise in evidence-based guidance, relevant stakeholders and a patient or patient advocate. No one included on the panel can have relevant conflicts of interest.

"The panel then focuses its guidance on what the evidence tells us, with an explicit link between the quality of the evidence and the strength of recommendation," Frost said.

When the Academy reviews other organizations' guidelines for endorsement, it's not required that they follow the same process, but there are certain standards that must be met.

"We look for objective evaluation of the evidence, which includes considering all of the evidence, controlling for conflicts of interest and being transparent about the process followed," Frost said.

Additionally, the AAFP recently updated its policy on the purpose, development and use of CPGs, including those the Academy may work with other medical organizations to develop, which the Board of Directors approved in July.

Conflict of Interest Policy Updated

Conflict of interest (COI) is an important concern when developing trustworthy CPGs.

Historically, most of the focus has been on direct financial conflicts, but attention to indirect and intellectual conflicts also has grown more recently.

That's why the AAFP updated its COI policy and process in its CPG manual to reflect these changes.