Am Fam Physician. 2012;85(9):863
See related Implementing AHRQ Effective Health Care Reviews.
Author disclosure: No relevant financial affiliations to disclose.
How do you decide which treatments to recommend to your patients? Every day, family physicians must evaluate the benefits and harms of dozens of tests and treatments for which reliable practice guidelines are often lacking.1 In 2003, the Agency for Healthcare Research and Quality (AHRQ) established its Effective Health Care Program to provide patients, physicians, and policy makers with more information to compare the effectiveness of health care interventions.2 This program supports a national network of Evidence-Based Practice Centers that produce systematic reviews of the evidence for commonly used interventions ranging from drugs for type 2 diabetes mellitus3 to treatments for localized prostate cancer.4
To date, the track record of translating comparative effectiveness research findings into clinical practice has been mixed, at best. For example, several years after a landmark randomized controlled trial demonstrated the superiority of thiazide diuretics compared with other first-line medications for hypertension, prescribing of thiazide diuretics had increased only modestly.5 An evaluation of diabetes practice guidelines produced after the publication of an Effective Health Care review of oral treatments found numerous inconsistencies between guideline recommendations and evidence-based conclusions.6 Despite extensive evidence that initial coronary stenting provides no advantages over optimal medical therapy for stable coronary artery disease,7 more than one-half of patients who undergo stenting in the United States have not had a prior trial of medical therapy.8
To more effectively disseminate the results of comparative effectiveness research into practice, AHRQ's Effective Health Care Program produces concise summaries of its reviews for patients, policy makers, and physicians, which are available at http://www.effectivehealthcare.ahrq.gov. American Family Physician has partnered with AHRQ to introduce a new journal feature, “Implementing AHRQ Effective Health Care Reviews,” which includes key evidence-based conclusions from AHRQ's clinician guides, with practice pointers from an experienced physician whom we solicit to put the evidence into clinical perspective. In this issue, Corey D. Fogleman, MD, interprets the evidence from a recent Effective Health Care review of behavioral, medical, and educational interventions for children with autism spectrum disorders.9 We hope that this new feature will provide you with additional tools to make the best treatment decisions for your patients.
editor's note: Kenneth W. Lin, MD, is the associate deputy editor for AFP Online.