Understanding and Using Evidence-Based Clinical Practice Guidelines

Photo by Osakabe Yasuo

The Role of Clinical Practice Guidelines

The Department of Defense (DoD) has made it a priority for health professionals to implement evidence-based clinical practice guidelines (CPGs) to improve and standardize the quality of care provided to its beneficiaries. “CPGs are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances.”¹ [1] CPGs contain recommendations based on evidence from a systematic review and synthesis of published medical literature.

The DoD, with support from the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE), collaborates with the Department of Veterans Affairs (VA) to produce evidence-based guidelines to maximize the psychological health of warriors and their families.

Potential Benefits for Health Professionals

CPGs can improve the quality of clinical decisions. If carefully followed and implemented under the right circumstances, CPGs can further benefit health professionals by:

• Offering clear recommendations for practitioners who are uncertain about how to proceed.
• Providing a more rational basis for referral.
• Promoting efficient use of resources.
• Providing authoritative recommendations that reassure practitioners about the appropriateness of their treatment decisions.
• Improving the consistency of care.

Understanding VA/DoD CPGs

Since 1998, VA and DoD have worked together to develop internationally recognized CPGs to meet the requirements of the military and veterans health care systems. VA/DoD Working Groups create the guidelines based, in part, on readiness needs of the military. DCoE assists with refining and monitoring existing CPGs and establishing new guidelines when necessary. CPGs for treating wounded warriors dealing with post-traumatic stress disorder (PTSD), traumatic brain injury (TBI) and other psychological health (PH) issues are available for download in the table below.

Where Can I Find VA/DoD Clinical Practice Guidelines?

Current VA/DoD Clinical Practice Guidelines, including those listed in the table, are available at several online locations.² [7]

• Veterans Health Administration’s Office of Quality and Performance website [8]
• U.S. Army Medical Command Quality Management Office [9] (This site also provides an online ordering system for CPG Tool Kits and their contents)
• National Guideline Clearinghouse [10]

Additional Resources

• "The Role of Deployment-Related Clinical Practice Guidelines in Primary Care [11]," [PPT 31.3MB] Deployment Health Clinical Center (DHCC), Nov 2008
• VA/DoD Manual for Facility Clinical Practice Guideline Champions [12], Oct 2007 [PDF 201.12KB]
• “Clinical Practice Guidelines Archive [13],” U.S. Department of Health and Human Services Agency for Healthcare Research and Quality

Sources for Health Professionals: Evidence-Based Clinical Practice Guidelines

¹Field MJ, Lohr KN (Eds). Clinical Practice Guidelines: Directions for a New Program, Institute of Medicine, Washington, DC: National Academy Press, 1990, last accessed 2/12/09
²Deployment Health Clinical Center Online, Clinicians. VA/DoD Clinical Practice Guidelines [14], last accessed 2/12/09