In this report, the Institute of Medicine and its Council on Health Care Technology demonstrate a pilot approach to setting national priorities for the evaluation of medical practice that addresses the diverse assessment interests that arise in a changing research, health care delivery, and policy environment. This approach to setting national priorities is based on the broad-based participation of diverse parties and on a conceptual framework that integrates their perspectives. Although individual patients, providers, payers, and others continue to set priorities based on their respective needs and resources, a national agenda may stimulate evaluations of broader interest or capture assessment topics of national importance that are not being addressed. The priority-setting group that chose the 20 national assessment priority areas identified in this pilot study represents major health care constituencies, including academia, government, health care providers, industry, and third-party payers. In addition, the conceptual framework for setting priorities was developed after considering background information provided by 14 major health care organizations which span the field of health care delivery (see Appendix C).

Contents

• Acknowledgments
• Council on Health Care Technology
• Council on Health Care Technology Priority-Setting Group
• Institute of Medicine
• Foreword
• Summary
• 1. Introduction
• 2. A Pilot Process for Setting National Assessment Priorities
  • Elements of a National Approach
  • Nationally Applicable Priority-Setting Criteria
  • A Conceptual Framework for Priorities
  • Method of this Pilot Study
• 3. Twenty Priority Assessment Areas
  • Clinical Conditions
  • Technologies
• 4. Next Steps
• 5. Conclusions and Recommendations
• Appendixes
  • A Clinical Conditions and Medical Technologies Considered by the Priority-Setting Group
  • B Comparison of Priority-Setting Criteria
  • C Organizations Providing Background Information
• Bibliography
• Glossary

Support for this project was provided by the National Center for Health Services Research and Health Care Technology Assessment, grant number HS 05526.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competencies and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education.