Lights Out on National Guideline Clearinghouse

Megan Brooks

June 20, 2018

The Agency for Healthcare Research and Quality (AHRQ) will shut down its National Guideline Clearinghouse (NGC) website next month, owing to a lack of federal funding.

"AHRQ decided to end funding for the NGC based on strategic priorities and lack of funds to continue the contract that supports the operations of NGC," AHRQ spokesperson Alison Hunt, in the Office of Communications at AHRQ, told Medscape Medical News.

Funding for NGC in fiscal year 2017 was $1.2 million.

After July 16, 2018, the NGC website, www.guidelines.gov, will shut down and the content will not be available, she said.

However, AHRQ has received "expressions of interest" from stakeholders interested in carrying on NGC's work.

"AHRQ knows that many individuals and organizations have built routines and processes around the presence of NGC, so we are exploring a path(s) to sustain NGC or some evolution of NGC and will continue to do so even after the site is offline," said Hunt.

For now, however, it's not clear when or if NGC (or something like NGC) will be online again, according to an announcement on the website.

There is no one to replace it — and bringing together these resources was useful. Dr Harlan Krumholz

It's also unclear whether AHRQ would have an ongoing role if a stakeholder were to continue to operate the NGC. The AHRQ said it will continue to post summaries of new and updated evidence-based clinical practice guidelines until July 2, 2018.

Clinical Guidelines Evolving

Reached for comment, Harlan Krumholz, MD, from Yale University School of Medicine in New Haven, Connecticut, noted that clinical guidelines are "in evolution, but this has been a good, nonpartisan repository that was useful for research and practice.

"There is no one to replace it — and bringing together these resources was useful. I am sorry to see it go," he told Medscape Medical News.

"Even more importantly," said Krumholz, "it is time for the nation to realize what an essential role that AHRQ fills. And if we are truly interested in a high-functioning, equitable, efficient, effective healthcare system, then we need to make a more substantive investment in the agency that is truly pushing to provide the science underlying the learning health system.

"Even a small percentage of the health budget would provide ample support to transform healthcare. But for now, the ridiculously low budget markedly limits what they can do," Krumholz added.

Claire Neely, MD, chief medical officer of the Institute for Clinical Systems Improvement in Bloomington, Minnesota, is also sorry to see the clearinghouse go.

"For years the National Guideline Clearinghouse has been a valuable repository for evidence-based clinical guidelines to support clinicians and care systems to use available evidence to provide care for patients," she told Medscape Medical News.

"Additionally, the Clearinghouse has been instrumental in holding guideline writing groups accountable to constantly improve the quality of their guidelines to assure that patients receive care based on the best available knowledge. It is unfortunate that federal funding through AHRQ is no longer available to support the Clearinghouse," Neely said.

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