Practice parameters: strategies for survival into the nineties.

Area of Science:

• Health Policy
• Medical Informatics
• Evidence-Based Medicine

Background:

• Escalating healthcare costs necessitate cost-containment strategies.
• Clinical practice guidelines have emerged as a potential solution for cost containment.
• Historical methods for developing practice standards have been diverse.

Purpose of the Study:

• To review historical, governmental, and health organization approaches to developing practice parameters.
• To examine the mechanism and mission of the American Academy of Neurology Quality Standards Subcommittee.
• To clarify the terminology and types of recommendations within practice parameters.

Main Methods:

• Literature review of historical, governmental, and health organization approaches.
• Analysis of the American Academy of Neurology Quality Standards Subcommittee's framework.
• Examination of the classification of practice parameter recommendations (standards, guidelines, options).

Main Results:

• Various approaches exist for developing scientifically sound and clinically relevant practice parameters.
• The American Academy of Neurology uses the term "practice parameter" for consistency with AMA terminology.
• Practice parameters encompass standards, guidelines, and options, reflecting varying levels of clinical certainty based on evidence.

Conclusions:

• Practice parameters are crucial for achieving cost containment in healthcare.
• Developing robust practice parameters requires integrating scientific knowledge and patient preferences.
• Clear definitions and evidence-based classifications enhance the utility of practice parameters.