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THE POLICY SC(IENCES CENTER, INC.
127 W,lJI Stwel, Rool1l 322
.
p.o. Box 2PB2'15
New 1-IZlven, Connecticut ()(,S:W-1I215 USA.
Tel: (103) 432-1')93 • F;1X: (203) 432-7247
Ple,w: Reply to: DR, LLOYD ETHEREDGE
7106 Bells Mill Road
Bethesda, MD 20817
Tel: (301) 365·5241
FJx: (301) 657-4214
Internet: Iloyd.elheredge@Y,lle.edu
MYRES S. McDOUGAL
Ch;1inn;lI1 (190h-1 998)
. W MICHAEL REISMAN
Yin' CI1;)irl11;)11
ANDREW R. WILLARD
President
July 16,2000
JEREMIAH B McKENNA
To:
Interested Colleagues
Re:
Executive Director
Restarting Progress
56 Bay Street, 7th Floor
Staten IslJnd, NY 10301
Tel: (718) 727-6043
FZlx: (71m 720-S419
You might be interested in the new proposal to create a responsive national
research network of Evidence-Based Policy Centers, described on pp. 4 - 9 of
the enclosed paper.
The Centers will be established by NSF, through competitive grants, in
each area of high priority for national progress. They will receive nominations
of questions from Governors and mayors; city, state, and county agencies; and
. any other organization or individual with civic interests - e.g., individual budget
analysts, advocacy groups, individual citizens. The Centers will, through
advisory panels, prioritize this open list ofquestions and begin to answer them.
Today, ifa local school board wants to know whether reducing class size
below N=15 in grades K-3 increases academic achievement, it does not have
the resources to answer the question. But with the new national network of
Centers, such questions will automatically be linked to a national coalition of
agencies, officials, and civic groups who also want an answer to the question,
and a focused research program will get underway.
.
This innovation builds upon a successful prototype for responsive research
developed by HHS's Agency for Health Care Policy and Research, described in
the enclosed paper.
In public policy, I think that we have massively underutilized intellectual
capacity. We have the best-educated citizenry in history, but people who
completed college, and minds that mastered calculus, currently have' little to
work with: the evidentiary base remains fragmentary, and there are no
institutions who can respond to good questions.
The PoliCY Sciences Cent,?!', Inc. i~ Zl puhlic iOlln<lZllion.
The Center was founded in I '):lI\ by Myres S. l'vll:i)nug;ll, l-i:1rold D. L;1sswell and Ceorge Dession.
,
.
�It is painful and unnecessary for a country that has unraveled the billions of
components of the human genome to conduct public policy discussion at all
levels with sound bites "and without any highly visible institutions for rapid
progress to answer shared questions of civic relevance. Ifyou agree, and if there
is anything that you can do to move the idea along, I think that it would be in a
good cause.
With best regards,
~j[~
(Dr.) Lloyd S. Etheredge, Trustee; Director
Government Learning Project
(http://www.policyscience.net)
�,
l'
\
DRAFT
Evidence-Based Polic;)' Centers:
A Proposal to Reinvent Government through Social Science
by .
Lloyd S. Etheredgel
[Paper prepared for presentation to the Policy Sciences Institute meetings at Yale Law
School, New Haven, CT. October 22-24,1999.]
Confiden.ce in the ability of the social sciences to improve public policy has eroded
during the past 35 years since the Gre~t Society.2 President Clinton's proposed "Golden
Age" science budget of $78.2 billion increased many areas in medical research, energy
efficiency, and other priorities in the natural sciences and technology. Yet the budget also
made it clear that, even with anticipated surpluses, the social sciences are not making a
comeback: the Administration's request assigned 0.0014 of the total to the social, behav
ioral and economic research budget of the National Science Foundation. 3
The author is Director of the Government Learning Project at the Policy Sciences
Center, Inc;, 127 Wall St. - Room 322, P. O. Box 208215, New Haven, CT 06520-8215.
Email address: lloyd.etheredge@yale.edu.
1
2For historical.overviews see Harold Lasswell, "Research in Policy Analysis: The
Intelligence and Appraisal Functions," in Fred Greenstein and Nelson Polsby (Eds.),
Handbook of Political Science (Reading, MA: Addison-Wesley, 1975), vol. 6 and refer..:
ences therein; Bruce Mazlish, The Uncertain Sciences (New Haven, CT: Yale University
Press, 1998); George W. Downs and Patrick D. Larkey, The Search for Government
Efficienc;)': From Hubris to Helplessness (NY: Random House, 1986).
Curt Suplee, "Clinton Asks Big Increase for Science, Technology Research,"
Washington Post, February 3, 1998, p. A9. Former Speaker Gingrich is playing a leading
role to double the current nation~ science budget but also expects the most beneficial
3
1
�DRAFT
One part of the problem is that the social sciences are ineffective lobbyists. But a larger
part ofthe problem appears to be hesitation, within th.e scientific community itself, about
:
'
public support for the social sciences. Our nation's highest scientific advisory body, the
President's Committee ofAdvisers on Science and Technology, while recognizing the
distinction between belief-based v. empirically-based social and economic policy, has
continued to defer recommendations for renewed progress in achieving empirically-based
government policy, expressing doubt about "the relative importance ofthese issues to the
broader public."4 Another concern - from distinguished social scientists themselves - may
be skepticism that increased funding oftheir colleagues will, if channeled through tradi
tional NSF and other mechanisms, actually produce civic benefit rather than unproductive
academic arguments and an embarrassing level ofgoofiness.s
breakthroughs to occur in the physical and ,biomedical sciences. See Newt Gingrich, "We'
Must Fund the Scientific Revolution," The Washington Post, October 18, ,1999, p. A19.
4 Letter on behalf of Norman Augustine from Angela Phillips Diaz, Executive
Secretary, October 26, 1995. ,
' ,
E.g., "[The current imitation ofphysics is self-limiting because] the part of
economics that is independent of history and social context is not only small but dull.. ;"
"[And] there is a tendency to undervalue keen observation and shrewd generalization..."
"[By contrast] there is a lot to be said in favor ofstaring at the piece.of reality you are
studying, and asking just what is going on here?" Robert M. Solow, "How Did Economics
Get That Way and What Way Did It Get?" Daedalus, 126:1, Winter, 1997, pp. 39-58. p.
56.
For a broader critique that, like Solow, remains unfortunately deficient in causal theory,
see Charles E. Lindblom, Inquiryand Change: The Troubled Attempt to Understand and
Shape Society (New Haven, CT: Yale University Press, 1992). Concerning problems that
S
'2
�THE POLICY SCIENCES CENTER, INC.
1'27 W"II Street, Rool1l :122
P.O. Box 2PB215
New l'laven, Connecticut O(.520·B215 U.s.A.
Tel: (2()\l 432·1 ()93 • F,lX: (203) 432·7247
Ple:1se Reply to: OR, LLOYD ETHEREDGE
7106 Bells Mill Road
Bethesda, MD 20817
Tel: (301) 365·5241
Fax: nOl) 657·4214
Internet: lIoyd.etheredge@yale.edu
MYRES S. McDOUGAL
Ch;lirman (1906·1998)
. W MICHAEL REISMAN
Vin' Ch:1irl11<11l
ANDREW R. WILLARD
President
July 16, 2000
JEREMIAH B McKENNA
To:
Staten Island, NY 10301
Interested Colleagues
Re:
Executive Director
56 Bay Street, 7th Floor
Restarting Progress
Tel: (7ltl) 727·6043
Fax' (71 III 720·5419
You might be interested in the new proposal to create a responsive national
research network of Evidence-Based Policy Centers, de'scribed on pp. 4 - 9 of
the' enclosed paper.
.
The Centers will be established by NSF, through competitive grants, in
each area of high priority for national progress. They will receive nominations
of questions from Governors and mayors; city, state, and county agencies; and
. any other organization or individual with civic interests' - e.g., individual budget
analysts, advocacy groups, individual citizens. The Centers will, through
advisory panels, prioritize this open list ofquestions and begin to answer them.
Today, ifa local school board wants to know whether reducing class size
below N=15 in grades K-3 increases academic achievement, it does not have
the resources to answer the question. But with the new national network of
Centers, such questions will automatically be linked to a national coalition of
agencies, officials, and civic groups who also want an answer to the question,
and a focused 'research program will get underway.
.
This innovation builds upon a successful prototype for responsive research
developed by HHS's Agency for Health Care Policy and Research, described in
the enclosed paper.
In public policy, I think that we have massively underutilized intellectual
capacity. We have the best-educated citizenry in history, but people who
completed college, and minds that mastered calculus, currently have' little to
work with: the evidentiary base fe.mains fragmentary, and there are no
institutions who can respond to good questions.
'\
!
The Policy Sciences Center, 11lc' is :1 plIlJlic fOllnd;llioll,
The Center W;lS founded ill I' )411 IIY Myres S, !'vh:[)nllg:ll, H:1I'old D. Lasswell ,mel George Dession.
!
�It is painful and unnecessary for a country that has unraveled the billions of
components of the human genome to conduct public policy discussion at all
levels with sound bites 'and without any highly visible institutions for rapid
progress to answer shared questions of civic relevance. Ifyou agree, and if there
is anything that you can do to move the idea along, I think that it would be in a
good cause.
'
With best regards,
J71
[~
(Dr.) Lloyd S. Etheredge, Trustee; Director
Government Learning Project
.(http://www.policyscience.net)
�,
I'
I
1\
~
DRAFT
Evidence-Based Policy Centers:
A Proposal to Reinvent Government through Social Science
by .
Lloyd S. Etheredge l
[Paper prepared for presentation to the Policy Sciences Institute meetings at Yale Law
School, New Haven, CT. October 22-24,1999.]
Confiden,ce in the ability of the social sciences to improve public policy has eroded
during the past 35 years since the
Gre~t Society.2 President Clinton's proposed "Golden
Age" science budget ofS78.2 billion increased many areas in medical research, energy
efficiency, and other priorities in the natural sciences and technology. Yet the budget also
made it clear that, even with anticipated surpluses, the social sciences are not making a
comeback: the Administratiori's request assigned 0.0014 ofthe total to the social, behav
ioral and economic research budget ofthe National Science Foundation. 3
The author is Director of the Government Learning Project at the Policy Sciences
Center, Inc~, 127 Wall St. - Room 322, P. O. Box 208215, New Haven, CT 06520-8215.
Email address: lloyd.etheredge@yale.edu.
1
2 For historical overviews see Harold Lasswell, "Research in Policy Analysis: The
Intelligence and Appraisal Functions," in Fred Greenstein and Nelson Polsby (Eds.),
Handbook of Political Science (Reading, MA: Addison-Wesley, 1975), vol. 6 and refer
ences therein; Bruce Mazlish, The Uncertain Sciences (New Haven, CT: Yale University
Press, 1998); George W. Downs and Patrick D. Larkey, The Search for Government
Efficiency: From Hubris to Helplessnes~ (NY: Random House; 1986).
Curt Suplee, "Clinton Asks Big Increase for Science, Technology Research,;'
Washington Post, February3, 1998, p. A9. Former Speaker Gingrich is playing a leading
role to double the current national science budget but also expects the most beneficial
3
1
/
�DRAFT
One part ofthe problem is that the social sciences are ineffective lobbyists. But a larger
part of the problem appears to be hesitation, within th.e scientific community itself, about
public support for the social sciences. Our nation's highest scientific advisory body, the
President's Committee ofAdvisers on Science and Technology, while recognizing the
distinction between belief-based v. empirically-based social and economic policy, has
continued to defer recommendations for renewed progress in achieving empirically-based
government policy, expressing doubt about "the relative importance of these issues to the
broader public."4 Another concern .: from distinguished social scientists themselves - may
be skepticism that increased funding oftheir colleagues will, ifchanneled through tradi
tional NSF and other mechanisms, actually produce civic benefit rather than unproductive
academic arguments and an embarrassing level ofgoofiness.s
breakthroughs to occur in the physical and biomedical sciences. See Newt Gingrich, ~e'
Must Fund the Scientific Revolution," The Washington Post, October 18,1999, p. A19.
. 4 Letter on behalf of Norman Augustine from Angela Phillips Diaz, Executive
Secretary, October 26, 1995.
.
E.g., "[The current imitation ofphysics is self-limiting because] the part of
economics that is independent ofhistory and social context is not only small but dull.. ~"
"[And] there is a tendency to undervalue keen obserVation and shrewd generalization..."
"[By contrastlthere is a lot to be said in favor of staring at the piece-of reality you are
studying, and asking jus.t what is going on here?" Robert M. Solow, "How Did Economics
Get That Way-and What Way Did It Get?" Daedalus, 126:1, Winter, 1997, pp. 39-58.. p.
56.
.
For a broader critique that, like Solow, remains unfortunately deficient in causal theory,
see Charles E. Lindblom, Inquiry and Change: The Troubled Attempt to Understand and
Shape Society (New Haven, CT: Yale University Press, 1992). Concerning problems that
S
2
�,
\
;
DRAFT
Nevertheless - the doubts ofseveral leading scientists not withstanding - the American
people probably do want reality-grounded government policies that work. The bipartisan
National Performance and Results Act (the Reinvention process) recommends a de facto
scientific framework to improve government performance.·Agencies are expected to identify
the "customers" they serve, develop measurements of performance, and be accountable for
improved results. 6 To be sure, the National Science Foundation has partly sought to evade
accountabilityfor pro~ess in public policy (e.g., it has defined "customers" as grant
applicants and boldly vowed to process applications for funds more efficiendy). But it is
difficult to imagine how any of this progress can occur without research to achieve '
"empirically-based" policy.7
can be attributed to deficiencies in political courage (e',g., the end ofadvocacy for testing
ideological assumptions, especially the failure to test policy assumptions ofthe political
Right in the same manner as those ofthe Great Society) see Lloyd S. Etheredge, "Prob
lems of Scientific Integrity that Affect Unfunded Research." Testimony to the US Com
mission on Research Integrity, April 10, 1995. Harvard Medical School. Boston, MA.
Xerox .and idem, "Commentary: The Scientific Scandal of the 1980s," Political Psychology.
15:3 (1994), pp. 531-539.
See, for example, David Osborne and Peter Plastrik, Banishing Bureaucracy: the
Five Strategies for Reinventing Government (Reading, MA: Addison-Wesley, 1997) and
references therein.
6
7 See for example Gerald Garvey's useful historical perspective, "False Promises: The
NPR in Historical Perspective" in Donald F. Ketd and John J. Delulio, Jr., (Eds.), Inside
the Reinvention Machine: Appraising Governmental Reform (Washington, DC:
Brookings Institution, 1995), pp. 87-106; Downs and Larkey, op. cit.
3
�DRAFT
Evidence-Based Policy Centers
By a simple innovation we can begin to improve the effectiveness ofgovernment policies
at all levels, increase the rate ofscientific progress, and rebuild confidence in the contribu
tion of social science in our- national life.
Proposal' That Congress create, through competitive grants administered by the,National
Science Foundation, a network ofEvidence-Based Policy (EBP) Centers in each area ofhfgh
. priorityfor nationalprogress:
1.) These Centers will receive nominations ofquestions from Governors and
Mayors; city, state, county, and national agencies; and any other organization or Individual
with civic interests - e.g., individual budget analysts or program managers,. group purchas
ers, advocacY groups, individual citizens. The questions may request summaries ofcurrent
evidenc~ or ansWers, that requife new research; The only. requirement will be that nomina
tors have plans to use the answer.
2.) The Centers will, through advisory panels, develop and prioritize this open list of
questions and begin to answer them. The criteria to prioritize the questions will include: a.)
4
�DRAFT
the commonality ofthe question; b.) the potential benefits of knowing the answer; c.) the
existence of unexplained variations, neVv ideas, or theoretical disputes suggesting that
research can be productive; d.) the availability ofexisting research that can be drawn upon;
e.) a cost of answering the question that makes it prohibitive for local or state governments
to undertake the research themselves. s
3.) Annually, with their budget requests to Congress, the Centers ~ submit their
prioritized lists, and quantitative measures ofannual scientific progress, by categorie~
similar to reporting the development and testing of new drugs (e.g., the number of new
questions received; the total number ofquestions awaiting research funds; the number of
questions undergoing evidence review; the n~mber that have moved to the next stage and
are currently undergoing exploratory or large-N definitive studies; the number ofquestions
answered during the previous year, etc.).
4.) The (peer reviewed) analyses ofevidence and new results developed by the
Centers will be available to the public and agencies ofgovernment at all levels through·
cost to answer the question will not affect the ranking. Whether the cost is
prohibitive is a determination to be made by Congress. (It is not uncommon to spend·
hundreds ofmillions ofdollars to build particle accelerators that can answer high priority
questions in physics. And· if equally good questions can be answered about the best ways to
teach reading skills to slow learners, Congress may consider the money well-spent.)
S The
5
�,DRAFT
Web sites and publication in scientific journals. Centers also Will be encouraged to create
regularly-scheduled Internet-based colloquia series to bring news about best practices and
new research developments to their constituencies as quickly as possible~
This national innovation - creating a ,highly visible and well-focused question.:.posing
and question-answering enterprise for public policy and enrolli~g the participation ofmany
"customers" beyond academic applicants - should build a stronger constituency for new
research funding. And it should create the best ally of social science, a well-represented
desire (user-driven) to know the answer: For example, if many local School Boards want to
know whether reducing class size below N=15 in grades K-3 increases academic achieve
ment, Congress will receive information about who wishes to know the answer; the current
evidence; how long it will take to get better evidence at current funding levels, etc~
,
/
(This coalition-building across levels ofgovernment may be especially useful to achieve a
more rational level offunding. Economlc theory has shown that scientific research is a
"public good" that - in part because ids so widely beneficial to so 'many people - will be .
underfunded by the private sector and requires a role for government. But economic theory
has been si1e~t about which lev~ls ofgovernment, and which agency's budgets, should pay'
the bill. Thus, by the saI11e"public goods" logic, each individual city, county, and state
6
�DRAFT
agency Will tend to underfund research that, in the common interest of all public sector
agencies (and the public), should be undertaken. For example, by now we ought to know
whether (if at all) - and by how much - a local School Board can, by increasing homework,
. accelerate the rate at which elementary school kids learn addition. But the labor and
expense involved in organizing research among those who want to know the answer makes
this one of many policy areas where traditional practices (rather than empiriCally-based
findings) govern.)6
- The independence of Evidence-Based Policy Centers should help to insulate the
evaluation of hypotheses from partisan and interest-group pressures, and speed the benefits
of empirical research for democratic problem-solving. Because questions will arise from (for
example) state and local governments who want more workable and effective programs, and
support a vigorous federalism, the EBP Centers should avoid the implication that
federally~funded research in social, behavioral, and ~conomic sciences is linked to political
agendas to expand the role of the federal government.
6This "public good" underfunding of science may even be true at the level of nation
states. For example, if there is a single universal answer to the question of the relation of
class size to academic achievement in elementary school, it would be beneficial to all of the
world's educational systems, in all countries (now, and forever) to know the answer.
See also the discussion, "Inadequate Representation of the Efficiency Value in Politics,"
in Downs and Larkey, of. cit., pp. 253-257. '
.
7
�DRAFT
- Because the EBP Centers will be problem-focused, they should have incentives to use
multi-disciplinary approaches and be less likely to be entrapped into activities of discon
nected academic interest. My instinct is that this complementary approach to funding
social science can make EBP Centers the catalysts and new leaders in the social sciences
themselves: In medical research, the goal ofcuring disease pr?vides a shared and powerful
framework that breaks-through disciplinary boundaries, recognizes achievements that serve
. common goals, and spurs astonishing progress.
- EBP Centers will be permitted - indeed, encouraged - to solicit questions. Because
EBP CenterS will be funded by competitive and renewable grants, the Centers - with an
eye to their grant-renewal process - will have incentives to pose and answer questions of
wide in,terest and impact. 7
A final thought about this proposal: The federal government already is developing
experience with an analog to'these Evidence-Based Policy Centers in medical research.
These 12 Evidence-Based Practice Centers, funded by the Agency for Health Care Policy
and Research in the US and Canada (McMaster University), began in 1997, have received
7 While
EBP CenterS can be created de novo, existing institutions (e.g., the
National Governors Association, policy research cent~rs in leading states or at universities,
for-profit research companies) also can apply and lise these grants to strengthen their.
programs.
8
�DRAFT
requests for more than 250 topics, and are providing a steady stream ofreports to inform
choices, and the (empirically-based) effectiveness and quality of care for the Medicare and
Medicaid populations. 8
AgencY for Health Care Policy and Res.earch, AHCPR Fact Sheet: AHCPR's ..
Evidence-based Practice Centers. (Rockville, MD: US Dept. ofHealth and Human
Services, Public Health Service, 1999). AHCPR Pub. No. 98-P005. Revised January 11,
1999. I am indebted to Lynn Etheredge for bringing the AHCPR model to my attention.
The criteria for establishing priorities, used in this paper, draw upon the AHCPR model.
.8
9
�AHCPR
FACT SHEET'
Agency for Heolth Core Policy o'nd Reseorch • 210 I East Jefferson Street. Rockville, MD
20852
AHCPR's Evidence-based Practice Centers
.'
Program Purpose.
In 1997 the Agency for Health Care Policy and
Research (AHCPR) launched its initiative to
promote evidence-based practice in everyday care
through establishment of 12 Evidence-based
Practice Centers (EPCs). The EPCs develop
evidence reports and technology assessments on
clinical topics that are common, expensive, and/or
are significant for the Mdicare and Medicaid
populations. With this program, AHCPR became a
"science partner" with private and public ,
organizations in their efforts to improve the quality,
effectiveness. and appropriateness of clinical care by
facilitating the translation of evidence-based
research findings into clinical practice.
Develo~ment of Evidence Reports
and Technology Assessments
The EPCs develop evidence reports and
technology assessments based on rigorous.
comprehensive reviews of relevant scientific
literature. emphasizing explicit and detailed
documentation of methods. rationale. and
assumptions. These scientific syntheses may include
meta-analyses and COSt analyses. All EPCs
collaborate with other medical and research
organizations so that a broad range of experts is
included in the development p'rocess. (See box.
next page. for a list of the 12 EPCs and topics
announced through October 1998.)
Potential Users
Evidence reports and technology assessments
provide a foundation that public and private .'
entities may use to develop and implement their
own· practice guidelines. performance measures,
review criteria, and other clinical quality
improvement tools. In addition, they may give ,
/
(
health plans and payers information needed to
. make informed decisions about coverage policies
for new and changing medical devices and
procedures. Potential ~ers of these evidence reports
and technology assessments include clinicians,
medical and professional associations, health system
managers, researchers, group purchasers. program
managers, consumer organizations, and
policymakers.
Topic, Nomination Procedure
Nominations of topics for EPC evidence reports
and technology assessments are soliCited routinely
through notices in the Fednal Registu. Topic
nominations also are accepted on an ongoing basis.
Specific inform~tion that should accompany
nominations includes the potential questions to be
answered by the report or assessment, availability of
scientific data. disease prevalence and/or severity.
practice variation patterns. and descriptions of
plans for using the evidence report or technology
. assessment to improve quality of care. (See the,
Fednal &gistn-. Nov. 28,1997. vol. 62. No. 229.
63345-63346 for complete details on the
nomination and selection process.)
Professional associations, health plans, providers,
and others that nominate topics may act as
partners with EPCs, providing technical expertise
arid serving as peer reviewers of the final product.
Partners are expected to translate the findings from
the evidence reports and teChnology assessments
into practice guidelin~ or other implementation
tools to improve quality of care within their
respective organizations. AHCPR expeCts th;lt
future evidence reports and technology assessments
will be developed in the following broad topic
areas: child and adolescent health, maternal health,
geriatrics, dental health. mental health and
substance abuse. rehabilitation, and preventive care.
...........
~
,;Sr
U,S. DEPARTMENT OF HEAlTH AND HUMAN SERVICES- Public Heallh Service
�EPCs and Their Topics
Evidence-based Practice CenterS
Blue CrosslBlue Shield Association, Technology
Evaluation Center, Chicago, IL
1)Testosterone suppression treatment for prostatic
cancer 2) Use of erythropoietin in hematology and
oncology
Duke University, Durham, NC
1) Evaluation of cervical cytology 2) Management of
acute chronic obstructive pulmonary disease
ECRI,Plymouth Meeting, PA
1) Diagnosis and'treatment of dysphagia/swallowing
problems in the elderly 2) Criteria for determining
disability in patients with end stage renal disease
Johns Hopkins University, Baltimore, MD
1) Evaluation and treatment of new onset of atrial
fibrillation in the elderly 2) Treatment of acne
3) Anesthesia 'management during cataract surgery
McMaster University, Hamilton, Ontario, Canada
1) Treatment of attention deficitlhyperactivity disorder
2) Criteria for weaning from mechanical ventilation
MetaWorks, Inc., Boston, MA '
1) Diagnosis of sleep apnea
New England Medical Center, Boston, MA ,
1) Diagnosis and treatment of acute sinusitis
2) Management of cancer pain
3) Evaluation of technologies for identifying acute
cardiac ischemia in the emergency department
Oregon Health Sciences University;'Portland, OR*
1) Rehabilitation of persons with traumatic brain
injury
Southern California Evidence-based Practice
Center-RAND Corporation, Santa Monica, CA
1) Prevention and management of urinary
tract infections in paralyzed persons
2) Management of acute otitis media
3) Prevention of venous mboembolism after injury
Research Triangle Institute and University of
North Carolina at Chapel Hill, NC*
1) Pharmacotherapy for alcohol dependence
2) Management of preterm labor
University of California, San Francisco, CA,
and Stanford University, Stanford, CA
1) Management of stable angina 2) Management of
unstable angina
University ofTexas Health Sciences Center,
San Antonio, TX
'
...
'J'
Evidence Report Topics
1) Depression treatment with new drugs
2) Management of chronic hypertension during .
pregnancy
.
:~.
*Technical support for U.S. Preventive Services Task Force
For More Information '.
AHCPR's Center for Practice and Technology
Assessment oversees the evidence-based practice
program. For more information about the program,
~PCs. and topic nominations, contact:
Jacqueline Besteman, JD, MA
EPC Project Officer
Center for Practice and Technology Assessment
Agency for Health Care Policy and Research
6010 Executive Boulevard, Suite,300
Rockville. MD 20852
Phone: 301/594-4017
Fax: 301/594-4027
E-mail: jbestema@ahcpr.gov
AHCPR
AHCPR Pub. No. 99-POI0
Replaces AHCPR Pub. No. 98-P006
1:'~1.~.~~.A
1000
,
�AHCPR Evidence-based Practice Centers
.. ;~
- ,;:/-.' - !
~-'
.
. Blue Cross and Blue Shield Association
Technology Evaluation Center (TEC)
Naomi Aronson, PhD
225 North Michigan Avenue
Chicago, IL 60601
312/297-5530; fax 312/297-6575
e-mail: naomi.aronson@bcbsa.com ' .
Duke University·
David Matchar, M.D.
Center for Health Policy Research and
Education
2200 West Main Street, Suite 230
Durham, NC 27705
.
9191286-3399; fax 919/286-5601
e-mail: matchOO l@mc.duke.edu
ECRI
Jeffrey Lerner, Ph.D.
Vice President for Strategic Planning
5200 Butler Pike
Plymouth Meeting, PA i 9462-1298
61 0/825-6000 (ext. 142); fax 610/834-1275
e-mail: Jlerner@ECRI.org
Johns Hopkins University
.
Neil Powe, M.D., M.P.H., M.B.A.
School of Hygiene and Public Health
Welch Center, Suite 2-600
.
2024 E. Monument Street
Baltimore, MD 21205-2223
410/955-4128; fax 410/955-0476
e-mail: npowe@jhsph.edu· .
McMaster University
Alejandro Jadad, M.D., D.Phil.
Dept of Clinical Epidemiology & Biostatistics
1200 Main Street West, Room 3H7
Hamilton, Ontario, Canada L8N 3Z5
·905/525-9140 (ext. 22520);
fax 905/546-0401
e:..mail: jadada@fhs.mcmaster.ca
MetaWorks, Inc.
Susan Ross, M.D.
Chief Scientific Officer
470 Atlantic Avenue
Boston, MA 02210
617/368-3575; fax 617/368-3590
e-mail: SDR@Metawork.com.
New England Medical Center
Joseph Lau, M.D.
.
Division of Clinical Care Research
750 Washington Street, Box 63
Boston, MA 021 11 .
617/636-7670; fax 617/636-8023
e-mail: joseph.lau@es.nemc.org
Oregon Health Sciences University
Mark Helfand, M.D., M.S., M.P.H. .
School of Medicine
Division of Medical Informatics and Outcomes
Research
3181 SW Sam Jackson Park Road
Portland, OR 97201-3098
503/494-4277; fax 503/494-4551
e-mail: 'helfand@ohsu.edu
Southern California Evidence-based
Practice Center-RAND
Paul Shekelle, Ph.D.
Senior Natural Scientist
1700 Main Street
Santa Monica, CA 90401
31 0/393-0411 (ext. 6669); fax 310/451-6930
e-mail: paul shekelle@rand.org
Research Triangle Institute/Univ Of
North Carolina, Chapel Hill
Kathleen Lohr, Ph.D.
Director, Health Services and Policy Research
3040 Cornwallis Road (for FEDEX mail)
Hobbs, Room 253
or
P.O. Box 12194 (for regular US mail)
Research Triangle Park, NC '27709-2194
919/541-6512; fax 919/541-5945
e-mail: klohr@rtLorg
UCSF-Stanford.
A. Eugene Washington, M.D., M.Sc.
Department of Obstetrics, Gynecology &
Reproductive Sciences
University of California, San Francisco
505 Parnassus Ave, Room M-1490, Box 0132
San Francisco, CA 94143-0132 .
415/476-2564; fax 415/476-1811
e-mail: wash@obgyn.ucsf.edu
San Antonio EPC
Univ of Texas Health Sciences Center
Cynthia Mulrow, M.D., M.Sc.
University of Texas Health Science Center
7400 Merton Minter Blvd. (11 C6)
San Antonio, TX 78284
210/617-5190 or 210/617-5238;
fax 210/617-5234
.
e-mail: mulrowc@uthscsa.edu
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NHCPR'
�AHCPR
FACT SHEET
Agency lor Health Care Policy and Research.. 2101 East Jefferson Street • Rockville. MD
20852
The National Guideline Clearinghouse™
www.guideline.gov
Purpose
The Agency for Health Care
Policy and R.escarch (AHCPR). in
partnership with the American
Association of Health Plans
<MHP) and the American Medical
Association (AMA). is sponsoring a
World Wide Web-based National
Guiddine Clearinghouse
(NGC)TM. The NGCTM is a
publicly available decuonic·
repository for clinical practice
guidelines and related materials that
provides online access to guidelines
at www.guideline.gov.
widespread access to guidelines than
is currently available to the general
public. The NGCTM accomplishs
this by including the following
dements:
• A stIltlIiartIizeJ abstrlld
containing information about
each guideline and how it 'W3S
developed;
.'
comprehensive sources of
information to assist them with
clinical decisionmaking and
patient counseling ~ me practice
setting.
. • Health an systems anti inkgnlteJ
Jelivny systmu may use the
information aa:essible through
the NGCTM to adopt, or adapt.
guidelines in their provider
netWorks..
• MetikaJ sp~ tmtlp1'Ofosional
socidia can we guidelines nom
several sources c::overing similar
health conditions in their own
guideline devdopment efforts.
• Full text of guiddines (if possible)
or links to fiill. tea (if not) and
information on how to obtain
the fiill. text of the guiddinc;
• umparisons ofguit/e/ines that
cover similar topic areas, with
major interventions and areas of
agreement and disagreement; and • Employm antiother /argt
Rationale
pure/Nlsm can use information
• .Topic-wlateJ elmronic mailflTJU/'I
. The dcvdopmen,rand ~ of
where registcn:d users may:
;i;,.~, from the·NGCTM to assiSt them
clinical practice guidelines bas .
in making more infonned health
c:xchangc infonnadon about
grown ma.dccd1y in the past 5 y=-s.
care benefits pwchasing
aspects ofguideline development,
This growth is due to increased
.
decisions.
content. and implementation.
intc:rcst in improving the quality of
• .EtiueaJional institutions can
health care. reducing uncc:n:ainty
Operational oversight of the
incorpor.ue information
and variability in health care
NGCTM resides within AHCPR's
accessible through the NGO""
decisionmaking. and reducing
. Center for Practice and Technology
into their curricula and
health care costs. & a IeSU!t ofthe
Assessment.
continuing education drom.
. ncrease in the number ofClinical
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practice guidelines. many health
• State anti load gwernmmts can
NGCTM Audiences and
care providers. systems (including
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Uses
. from the N(;C'1'M to hdp meet
health plans). purchasers. and
The NGCTM bas its oWn website
consumers have difficulty gaining
their quality assurance and
access to and keeping abreast ofthe
on the World Wide Web
program oversight
(www.guideline.gov) and is available
many guidelines in use. Moreover.
responsibilities. .
guidelines 0fU:n differ in content,
free of charge. Internet users axe
able to 6nd guidelines by searching.
recommendations. and
Criteria for Inclusion of
.on the guideline topic. developer. or
development methodology. further
Guidelines in the NGC1M
.
complicating their use.
other criteria. Thousands of
A clinical practice guideline must
guidelines 'ultimatdy will be
meet the following aiteria to be
indexed. allowing rapid access to
Functions of the
included in the NGCTM:
key recommendations and
National Guideline
assessments on hundreds of topics
• It contains systematically
Clearinghouse1M'
for varied audiences:
developed statements including
.The National Guideline
. recommendations. strategies. or
• In.Jividtudphytkians anti other
Clearinghousc™ facilitates more
information that assists
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DEPARTMENT OF HEAlTH AND HUMAN SERVICES • P,bllc H•• llh S... I..
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physicians andlor other health care
practitioners and patients to make
decisions about appropriate health
care for specific clinical
circumstances. This is in accord
with the definition of "clinical
practice guidelines" as set forth by
the Institute of Medicine in 1990.
• It 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.
• Corroborating documentation can
be produced, verifying that a
systematic literature search and
review of c:x.isting scientific
evidence published in peer
reviewed journals was performed
during the guideline development
process.
• The guideline is in English,
current, and the most recent
version (i.e., developed, reviewed,
or revised within the last 5 years).
How To Submit·
Guidelines to the NGCTM
Organizations interested in
cOriuibuting to the National
Guideline Oearinghouse™ should
. submit two typed paper copies of
each guideline and related
background information. An.
electronic version on disk should be
submitted as well, if available. Name,
business address, telephone, and e
mail address of a contact person
should be included. The information
should be senr to:
For More Information
. More information on the National
Guideline OearinghouseTM can be
obtained from:
Jean Slutsky
NGCIM Project Officer,
Agency for Health Care Policy
and Research
Center for Practice and
Technology Assessment
6010 Executive Blvd., Suite 300
Rockville, MD 20852
Telephone: 301~594-4042
Fax: 301-594-4027
E-mail: jslutsky@ahcpr.gov
Vivian Coates
NGCTM Project Direaor
ECRI
5200 Buder Pike
Plymouth Meeting. PA 19462
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By using /he National Guideline Clearinghouse, )'011 have agreed 10 /he TI!t!l!$ sod Cpodjljcm
no 1998 NaUooal Gutdftljo.. Clc!adnql!qw
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AHCPR Pub. No. 98·POO5
Revised January 11, 1999
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Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Kendra Brooks - Subject Series
Creator
An entity primarily responsible for making the resource
Domestic Policy Council
Kendra Brooks
Is Part Of
A related resource in which the described resource is physically or logically included.
<a href="http://clinton.presidentiallibraries.us/items/show/36031" target="_blank">Collection Finding Aid</a>
<a href="https://catalog.archives.gov/id/647992" target="_blank">National Archives Catalog Description</a>
Description
An account of the resource
The Kendra Brooks Subject Files contain correspondence, reports, articles, memos, and various printed material. Other documents include background information for education events and meetings. The files include material pertaining to charter schools, national testing, SAT preparation, school safety, school modernization/construction, affirmative action, Blue Ribbon Schools, class–size reduction, teacher quality, Limited English Proficiency (LEP), the White House Initiative on Education Excellence for Hispanic Americans, Tribal Colleges and Universities, Historically Black Colleges and Universities (HBCU’s), the Individuals with Disabilities Education Act (IDEA), and Title 1 of the Elementary and Secondary Education Act of 1965.
Provenance
A statement of any changes in ownership and custody of the resource since its creation that are significant for its authenticity, integrity, and interpretation. The statement may include a description of any changes successive custodians made to the resource.
Clinton Presidential Records: White House Staff and Office Files
Publisher
An entity responsible for making the resource available
William J. Clinton Presidential Library & Museum
Extent
The size or duration of the resource.
157 folders in 16 boxes
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Original Format
The type of object, such as painting, sculpture, paper, photo, and additional data
Paper
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Policy Sciences Center
Creator
An entity primarily responsible for making the resource
Domestic Policy Council
Kendra Brooks
Subject Files
Is Part Of
A related resource in which the described resource is physically or logically included.
Box 16
<a href="http://clintonlibrary.gov/assets/Documents/Finding-Aids/Systematic/KendraBrookssubjectfile.pdf" target="_blank">Collection Finding Aid</a>
<a href="https://catalog.archives.gov/id/647992" target="_blank">National Archives Catalog Description</a>
Provenance
A statement of any changes in ownership and custody of the resource since its creation that are significant for its authenticity, integrity, and interpretation. The statement may include a description of any changes successive custodians made to the resource.
Clinton Presidential Records: White House Staff and Office Files
Format
The file format, physical medium, or dimensions of the resource
Adobe Acrobat Document
Publisher
An entity responsible for making the resource available
Clinton Presidential Library & Museum
Medium
The material or physical carrier of the resource.
Reproduction-Reference
Date Created
Date of creation of the resource.
1/17/2012
Source
A related resource from which the described resource is derived
647992-policy-sciences-center.pdf
647992