The American Psychiatric Association (APA) began developing practice guidelines in 1991. Practice guidelines are defined as systematically developed documents in a standardized format that present patient care strategies to assist psychiatrists in clinical decision making. Although APA guidelines may be used for a variety of reasons, their primary purpose is to assist psychiatrists in their care of patients.

Both the American Medical Association (AMA) and the Institute of Medicine (IOM) have sought to define the key features necessary to ensure that practice guidelines are of high quality. The AMA's attributes apply to the development process, stating that practice parameters or guidelines should 1) be developed by or in conjunction with physician organizations, 2) explicitly describe the methodology and process used in their development, 3) assist practitioner and patient decisions about appropriate health care for specific clinical circumstances, 4) be based on current professional knowledge and reviewed and revised at regular intervals, and 5) be widely disseminated. The IOM's attributes are criteria for evaluating the finished product; these criteria include 1) validity, based on the strength of the evidence, expert judgment, and estimates of health and cost outcomes compared with alternative practices; 2) reliability and reproducibility; 3) clinical applicability and flexibility; 4) clarity; 5) attention to multidisciplinary concerns; 6) timely updates; and 7) documentation. Taken together, the IOM and AMA prescriptives have essentially set national standards for guideline efforts.


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