Role of Institute of Medicine

IOM's Role in Evidence-based Healthcare

The Institute of Medicine (IOM) is an independent, nonprofit organization that works outside of government to provide unbiased and authoritative advice to decision makers and the public. Established in 1970, the IOM is the health arm of the National Academy of Sciences, which was chartered under President Abraham Lincoln in 1863. Nearly 150 years later, the National Academy of Sciences has expanded into what is collectively known as the National Academies, which comprises the National Academy of Sciences, the National Academy of Engineering, the National Research Council, and the IOM.

The goal of the IOM is to help those in government and the private sector make informed health decisions by providing evidence upon which they can rely.

The IOM asks and answers the nation's most pressing questions about health and health care.

When the U.S. Congress initiated the Medicare Improvements for Patients and Providers Act of 2008, they directed the IOM to develop rigorous new standards for the development of evidence-based guidelines.   The IOM, through the Agency for Healthcare Research and Quality (AHRQ), issued two reports in March 2011: Clinical Practice Guidelines We Can Trust and Finding What Works in Health Care: Standards for Systematic Reviews.

In Clinical Practice Guidelines We Can Trust, the IOM redefined CPGs as follows:

"Clinical practice guidelines are statements that include recommendations intended to optimize patient care that are informed by a systematic review of the evidence and an assessment of the benefits and harms of alternative care options."

According to the Agency for Healthcare Research and Quality (AHRQ) and the IOM, evidence-based guidelines must be:

·    Based on a systematic review of the existing evidence;
·    Developed by a knowledgeable, multidisciplinary panel of experts and representatives from key affected groups;
·    Based on an explicit and transparent development process to minimize bias and conflicts of interest;
·    Graded for both the quality of evidence and the strength of recommendations;
·    Contain articulated and precise clinical recommendations, produced in a standardized form;
·    Reviewed, completing an external and peer review process; and
·    Reviewed every 2-5 years and revised when new evidence warrants.