National Guideline Clearinghouse (NGC) Inclusion Criteria
Effective June 1, 2014, NGC used the 2011 definition of clinical practice guideline developed by the
Institute of Medicine (IO).1
Clinical practice guidelines are statements that include recommendations intended to optimize patient
care that are informed by a systematic review of evidence and an assessment of the benefits and harms
of alternative care options.
2013 (Revised) Criteria for Inclusion of Clinical Practice Guidelines in NGC
Effective June 1, 2014: In order for NGC to accept a submitted clinical practice guideline, the guideline
had to meet all the criteria below. In addition to the guideline, developers needed to provide NGC with
documentation of the underlying systematic review*.
1. The clinical practice guideline contains systematically developed statements including recommendations
intended to optimize patient care and assist physicians and/or other health care practitioners and patients
to make decisions about appropriate health care for specific clinical circumstances.
2. The clinical practice guideline was produced under the auspices of a medical specialty association;
relevant professional society; public or private organization; government agency at the Federal, State, or
local level; or health care organization or plan. A clinical practice guideline developed and issued by an
individual(s) not officially sponsored or supported by one of the above types of organizations does not
meet the inclusion criteria for NGC.
3. The clinical practice guideline is based on a systematic review of evidence as demonstrated by
documentation of each of the following features in the clinical practice guideline or its supporting
documents.
a. An explicit statement that the clinical practice guideline was based on a systematic review†.
b. A description of the search strategy that includes a listing of database(s) searched, a summary of search
terms used, and the specific time period covered by the literature search including the beginning date
(month/year) and end date (month/year)‡.
c.
A description of study selection that includes the number of studies identified, the number of studies
included, and a summary of inclusion and exclusion criteria.
d. A synthesis of evidence from the selected studies, e.g., a detailed description or evidence tables.
e. A summary of the evidence synthesis (see 3d above) included in the guideline that relates the evidence
to the recommendations, e.g., a descriptive summary or summary tables.
NB: A guideline is not excluded from NGC if a systematic review was conducted that identifies specific
gaps in the evidence base for some of the guideline's recommendations.
4. The clinical practice guideline or its supporting documents contain an assessment of the benefits and
harms of recommended care and alternative care options.
5. The full text guideline is available in English to the public upon request (for free or for a fee). Upon
submission of the guideline to NGC, it also must be noted whether the systematic review or other
supporting documents are available in English to the public upon request (for free or for a fee).
6. The guideline is the most recent version published. The guideline must have been developed, reviewed,
or revised within the past five years, as evidenced by appropriate documentation (e.g., the systematic
review or detailed description of methodology).
1997 Criteria for Inclusion of Clinical Practice Guidelines in NGC (in effect
through May 31, 2014)
NGC used the definition of clinical practice guideline developed by the IOM in 1990. 3
Clinical practice guidelines are systematically developed statements to assist practitioner and patient
decisions about appropriate health care for specific clinical circumstances.
All of the criteria below were met for a clinical practice guideline to be included in NGC.
1. The clinical practice guideline contains systematically developed statements that include
recommendations, strategies, or information that assists physicians and/or other health care practitioners
and patients to make decisions about appropriate health care for specific clinical circumstances.
2. The clinical practice guideline was produced under the auspices of medical specialty associations;
relevant professional societies, public or private organizations, government agencies at the Federal,
State, or local level; or health care organizations or plans. A clinical practice guideline developed and
issued by an individual not officially sponsored or supported by one of the above types of organizations
does not meet the inclusion criteria for NGC.
3. Corroborating documentation can be produced and verified that a systematic literature search and review
of existing scientific evidence published in peer reviewed journals was performed during the guideline
development. A guideline is not excluded from NGC if corroborating documentation can be produced and
verified detailing specific gaps in scientific evidence for some of the guideline's recommendations.
4. The full text guideline is available upon request in print or electronic format (for free or for a fee), in the
English language. The guideline is current and the most recent version produced. Documented evidence
can be produced or verified that the guideline was developed, reviewed, or revised within the last five
years.
References
1. Institute of Medicine. Graham R, Mancher M, Wolman DM, Greenfield S, Steinberg E, editor(s). Clinical
practice guidelines we can trust. Washington (DC): National Academies Press; 2011. 2p. Also
available: http:/ /nationalacademies.org/hmd/Reports/2011/Clinical-Practice-Guidelines-We-CanTrust.aspx
External Web Site Policy.
2. Institute of Medicine. Committee on Standards for Systematic Reviews. Eden J, Levit L, Berg A, Morton
S, editor(s). Finding what works in health care: standards for systematic reviews. Washington (DC):
National Academies Press; 2011 Mar 23. Also
available: http://www.nationalacademies.org/hmd/Reports/2011/Finding-What-Works-in-Health-CareStandards-for-Systematic-Reviews.aspx
External Web Site Policy.
3. Institute of Medicine. (1990). Clinical Practice Guidelines: Directions for a New Program, M.J. Field and
K.N. Lohr (eds.) Washington, DC: National Academy Press. page 38.
National Quality Measures Clearinghouse (NQMC) Inclusion Criteria
To be included in NQMC, a measure had to meet all of the following requirements:
1. Themeasure must address some aspect(s) of health care delivery or population health that can be
classified into one of the domains described in the Domain Definitions
.
2. The measure must be in current use or have been pilot tested within the last three years and must be the
most recent version if the measure has been revised. A measure is in current use if at least one health
care organization has used the measure to evaluate or report on quality of care within the previous three
years.
3. The submitter must provide English-language documentation that is available upon request in print or
electronic format (for free or for a fee) that includes at least each of the four following items:
o
Rationale for the measure
The rationale is a brief statement describing the specific aspect of health care and the recipients to which
the measure applies. The rationale may also include the evidence basis for the measure, and an
explanation of how to interpret results, if that information is provided.
o
Description of the denominator and numerator of the measure (including specific variables for inclusion or
exclusion of cases/events from either the denominator or numerator)
A continuous variable statement (e.g., "time to thrombolysis") may be an acceptable alternative and
measures whose metric is other than a rate or percentage will be considered on an individual basis. If
structure measures lack a numerator and/or denominator, evidence must be provided that an association
exists between the structure measure and one of the other four domains of quality (e.g., process,
outcome, access, and patient experience).
o
Data source(s) for the measure
o
Documentation of evidence supporting the measure and the criterion of quality is required for Quality
Measures, and for the quality component of Efficiency Measures
Note: Any Related Measures must be part of a set or collection that includes Quality Measures to be
considered for inclusion.
4. At least one of the following criteria must be satisfied with specific information attached in each case
(evidence from peer-reviewed literature is preferred)
o
The measure has been cited in one or more reports in a National Library of Medicine (NLM) indexed,
peer-reviewed journal, applying or evaluating the measure's properties.
o
The submitter provides documented evidence evaluating the reliability and validity of the measure.
Reliability is the degree to which the measure is free from random error.
Validity is the degree to which the measure is associated with what it purports to measure.
o
The measure has been developed, adopted, adapted, or endorsed by an organization that promotes
rigorous development and use of measurement in health care. Such an organization may be at the
international, national, regional, state or local levels (e.g., a multi-state consortium, a state Medicaid
agency, or a health organization or delivery system).
Adapted measures are those measures developed by one organization, and then subsequently
adopted and modified in some way by another organization.
Note: If the measure(s) does not meet one or more of these inclusion criteria, the submission forms will
be returned to the submitter with a request for further documentation or development in the identified
area. The submitter may revise and resubmit measures.
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