These guidelines were approved in February 2006 by the Preventive Health
Subcommittee. Guidelines will be reviewed every two years. The ultimate judgment regarding care of a
particular patient must be made by the physician and patient in light of circumstances specific to that
patient.
ADHD
Attention Deficit / Hyperactivity Disorder
Summary: The citations address the assessment, diagnosis, and treatment of children, adolescents, and adults who present with symptoms of attention-deficit/hyperactivity disorder.
Diagnostic and Statistical Manual of Mental Disorders , 4 th ed, Text Revision. Arlington, VA: American Psychiatric Press, Inc.; 2000.
Summary: The Alcohol and Other Drug Treatment Clinical Practice Guideline were developed as an educational tool for
Primary Care Physicians (PCPs), to raise PCP awareness of the disorders. Questions about alcohol and
drug use should be included among routine behavioral and lifestyle questions asked of all persons at
preventive care visits or as indicated by the PCP.
The Alcohol and Other Drug Treatment Clinical Practice Guideline contains information about the CAGE
questionnaire, which is commonly used to screen for alcohol abuse and the CAGE - AID for drug abuse.
"CAGE" is an acronym that can be used to remember the questions.
The Alcohol and Other Drug Treatment Clinical Practice Guideline contains information on diagnosis,
screening, and treatment options.
Background The site is a collaborative effort between the New York State Department
of Health AIDS Institute, Office of the Medical Director and the Johns Hopkins University School of
Medicine, Division of Infectious Diseases.
Vision The web site has been developed as a central, on-line resource that equips
individuals who provide services to people with HIV infection with current, state-of-the-art tools to
ensure delivery of the highest quality HIV clinical care.
Mission It is the mission of
www.hivguidelines.org to provide clinicians,
administrators and policy makers with the necessary information and tools to deliver the highest quality
HIV clinical care.
AIDS Institute Office of the Medical Director Clinical Guidelines Program
The AIDS
Institute Office of the Medical Director consists of public health professionals dedicated to enhancing
the quality of life for persons with HIV by improving prevention and health care services through
performance measurement and science-based initiatives. The Office of the Medical Director oversees
numerous programs and initiatives including:
Clinical Guidelines Program
Quality of Care Program
Clinical Education Initiative
The Nicholas A. Rango HIV Clinical Scholars Program
The HIVQUAL Project
Education and Training Initiative
Treatment Adherence Initiative
Materials Initiative
The HIV Clinical Guidelines Program, of which the web site is a product, directly oversees the
development, publication and dissemination of state-of-the-art clinical practice guidelines, in
collaboration with the Johns Hopkins University - Division of Infectious Diseases. These include
guidelines for the medical management of adults, adolescents and children with HIV infection;
guidelines in clinical settings; standards of care for oral and mental health of adults and children
with HIV/AIDS, and informational brochures for providers and the public. AIDS Institute clinical
guidelines are developed by distinguished committees of clinicians and others with extensive
experience providing care to people with HIV infection.
Summary:AIDSinfo is a U.S. Department of Health and Human Services (DHHS)
project that offers the latest federally approved information on HIV/AIDS clinical research,
treatment and prevention, and medical practice guidelines for people living with HIV/AIDS, their
families and friends, health care providers, scientists, and researchers.
All of the information from the AIDSinfo staff, Web site, and other project resources is from
federal government agencies, including the National Institutes of Health, Centers for Disease
Control and Prevention (CDC), Health Resources and Services Administration (HRSA) and others.
The AIDSinfo project is 100% federally funded. This project neither allows advertising on this site
nor endorses any company or products.
Clinical Trials:AIDSinfo offers information on federally and privately funded
clinical trials for AIDS patients and others infected with HIV. AIDS clinical trials evaluate
experimental drugs and other therapies for adults and children at all stages of HIV infection - from
patients who are HIV positive with no symptoms to those with various symptoms of AIDS.
Medical Guidelines:AIDSinfo serves as the main dissemination point for federally
approved HIV treatment and prevention guidelines; AIDSinfo provides information about the current
treatment regimens for HIV infection and AIDS-related illnesses, including the prevention of HIV
transmission from occupational exposure and mother-to-child transmission during pregnancy.
Summary: Practice Guidelines developed by the
American College of Rheumatology for Rheumatoid Arthritis,
Osteoporosis, Osteoarthritis, and other topics including Systemic Lupus Erythematosus
in Adults. The Guidelines address treatment options, the critical
decisions, and the essential skills and knowledge necessary for
optimal patient care.
Practical Guide for the Diagnosis and Management of Asthma
Based on the Expert Panel Report 2 - Guidelines for the Diagnosis and Management of Asthma (NIH 97-4053)
(October 1997). A concise manual emphasizing practical information from the recommendations in the
NACPP's 1997 Clinical Practical Guidelines. This concise manual was designed to help the busy primary
care provider implement the recommendations in the NAEPP's 1997 clinical practice guidelines. Emphasizing
practical information, it outlines key actions clinicians and patients can take to effectively work
together in managing asthma. A variety of implementation aids are provided, including medication dosage
charts, glossaries of medication brand names, patient self-assessment forms, and several reproducible
patient handouts.
National
Asthma Education and Prevention Program Expert Panel Report 2 - Guidelines for the Diagnosis and
Management of Asthma (NIH Publication No. 97-4051) (July 1997). Updates the 1991 Expert Panel Report.
State-of-the-art clinical practice guidelines for diagnosing and managing asthma that update the 1991
expert panel report and incorporate the most recent scientific information available on the care of
patients with asthma. Provides information on treating asthma at all severity levels and stresses both
clinical and self-management strategies. Also provides a comprehensive discussion of current medications
and their appropriate use.
NAEPP Expert
Panel Report: Guidelines for the Diagnosis and Management of Asthma-Update on Selected Topics 2002.
EPR--Update 2002 provides timely and updated information on several priority asthma
topics covered in 1997's Guidelines for the Diagnosis and Management of Asthma. The priority topics
addressed include medications, including corticosteroids' role in long term asthma management in
children, combination therapy, monitoring and prevention, and modifications to the EPR's Stepwise
Approach for Managing Asthma. 2003. (NIH Publication: No. 02-5074 June 2003).
Summary: The website is designed to provide accurate, current and useful information
for people with asthma and for the people who care for them. New York State DOH advises that new
resources will be added often and the web site should be checked frequently.
Managing Asthma During Pregnancy: Recommendations for
Pharmacologic Treatment Update 2004: Quick Reference, Full Report, Evidence Tables.
Summary:Managing Asthma During Pregnancy: Recommendations for Pharmacologic Treatment--Update
2004 updates the
Report of the Working Group on Asthma and Pregnancy published by the National Asthma Education and
Prevention Program (NAEPP) in 1993. Since then, modification to the general asthma treatment guidelines,
Expert Panel
Report: Guidelines for the Diagnosis and Management of Asthma (1997) and a subsequent
Update 2002
, release of new asthma medications, revisions to the severity classification of asthma, and
publication of new gestational safety data were sufficient to warrant an evidence-based update of the
1993 report. In addition, the new guidelines offer recommendations regarding the use of allergy
medications in pregnancy based on recent studies of these medications. Information about the expert
panel and their financial disclosures is included in the full report.
Summary: The Bipolar Disorder Clinical Practice Guideline was developed to complement the Clinical Practice
Guideline on Depression and to act as an educational tool for Primary Care Physicians (PCPs), who
suspect Bipolar Disorder. The CPG reiterates that PCPs should refer all cases of Bipolar Disorder to
a Mental Health Practitioner.
Bipolar Disorder is more prevalent than previously thought and can easily be overlooked or
misdiagnosed. As per the American Psychiatric Association (APA), the prevalence rates in the general
population for Bipolar I (Mania) is 0.08% and Bipolar II (Depression) 0.05%. One of the reasons for
misdiagnosis is that people with Bipolar Disorder rarely volunteer information about manic or
hypomanic episodes.
The Bipolar Disorder Clinical Practice Guideline includes a validated mood disorder-screening tool -
Mood Disorder Questionnaire (MDQ) that can be administered either by the PCP or self-administered by
the patient. The Bipolar Disorder Clinical Practice Guideline contains information on screening,
diagnosis, treatment, co-morbidity, and psychosocial treatment.
Summary: Clinical practice guidelines, written jointly by the American Heart
Association and the American College of Cardiology (ACC) —suggest appropriate use of diagnostic
procedures, therapeutic interventions, and/or therapies in managing cardiovascular diseases.
Summary: This Guideline focuses on the development of performance measures
concerning the diagnosis and treatment of both ST-Elevation Myocardial Infarction (STEMI) and
Non-ST-Elevation Myocardial Infarction (NSTEMI).
Summary: This update of the 2002 American College of Cardiology/American Heart
Association Guidelines for the Management of Patients with Unstable Angina and Non-ST-Segment Elevation
Myocardial Infarction (UA/NSTEMI) provides an evidence-based approach to the diagnosis and treatment of
these patients in the emergency department, in-hospital, and after hospital discharge.
Angina
ACC/AHA 2002 Guideline Update for the Management of Patients with Chronic Stable Angina -
Full Text,
Summary Article
Summary: The primary focus of this guideline is on symptomatic patients;
asymptomatic patients with known or suspected coronary disease are included in this update.
Heart Failure
ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult -
Full Text,
Summary Article
Summary: Report of the American College of Cardiology/American Heart Association
Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation
and Management of Heart Failure)
Summary: The American College of Cardiology (ACC) and the American Heart
Association (AHA hope that these clinical data standards will:
Improve cross-comparison of results and clinical outcomes between different trials and registries.
Facilitate the development and conduct of future registries, at both hospital and national levels,
by providing a list of major variables, outcomes, and definitions.
Facilitate measurement for quality improvement programs.
Become the basis for a standardized medical documentation process with the anticipation that the
medical record will progress to an electronic format.
GOLD Patient Guide: What You and Your Family Can Do About COPD. (NIH Publication No. 02-2701C, May 2002)
Summary: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) works
with health care professionals and public health officials around the world to raise awareness of
Chronic Obstructive Pulmonary Disease (COPD) and to improve prevention and treatment of this lung
disease.
Through the development of evidence-based guidelines for COPD management, and events such as the
annual celebration of World COPD Day, GOLD is working to improve the lives of people with COPD in every
corner of the globe.
Summary: The American Psychiatric Association (APA) practice guidelines are intended
to assist psychiatrists in clinical decision-making and to improve patient care. They also document
evidence available to determine appropriate care. A practice guideline is not a "standard of care." The
ultimate judgment regarding a particular clinical procedure or treatment plan must be made by the
psychiatrist in light of the clinical data presented by the patient and the diagnostic and treatment
options available.
Summary: The ADA Clinical Practice Guidelines are based on a complete review of the
relevant literature by a diverse group of highly trained clinicians. After weighing the quality of
evidence, from rigorous double-blind clinical trials to expert opinion, recommendations are drafted,
reviewed, and submitted for approval to the ADA Executive Committee; they are then revised on a regular
basis, and subsequently published in Diabetes Care.
Beginning with the 2005 supplement, the Clinical Practice Recommendations contained only the
"Standards of Medical Care in Diabetes" and selected other Position Statements. Per the ADA, this
change was made to emphasize the importance of the "Standards" s the best source to determine ADA
recommendations. The Position Statements in the Supplement are updated yearly. Position Statements
not included in the Supplement, as per the ADA, will be updated as necessary and republished when
complete.
Summary: The ATP III guidelines provide detailed
information on topic areas such as classification of lipids and
lipoproteins, coronary heart disease (CHD) risk assessment, lifestyle
interventions, drug treatment, specific dyslipidemias, and adherence
issues. Recommendations for special populations such as patients
with CHD, patients at high risk for developing CHD, patients with
diabetes, women, older Americans, young adults, and racial and ethnic
groups are provided.
(Available as Executive Summary and Full Report)
Summary: The Adult Treatment Panel III (ATP III)
of the National Cholesterol Education Program issued an evidence-based
set of guidelines on cholesterol management in 2001 (Executive Summary
published in JAMA,
2001;285:2486-2497). Since the publication of ATP III, 5 major
clinical trials of statin therapy with clinical end points have
been published. These trials addressed issues that were not examined
in previous clinical trials of cholesterol-lowering therapy. The
present document reviews the results of these recent trials and
assesses their implications for cholesterol management. Circulation.
2004;110:227-239.
Summary: This American College of Cardiology/ American Heart Association/National
Heart, Lung and Blood Institute (ACC/AHA/NHLBI) Clinical Advisory summarizes the current understanding
of statin use, focused on myopathy, and to provide updated recommendations for the appropriate use of
statins, including cautions, contraindications, and safety monitoring for statin therapy. Included in
the Advisory is recent myopathy information compiled by the FDA, information from clinical trials, and
summaries from the recently released report of the Adult Treatment Panel III (ATP III) of the National
Cholesterol Education Program.
Diagnosis and Management of the Metabolic Syndrome - An American Heart Association/National Heart,
Lung, and Blood Institute Scientific Statement:
Executive Summary, Full Text
Summary: Metabolic syndrome has received increased attention in the past few years.
This statement from the American Heart Association (AHA) and the National Heart, Lung, and Blood
Institute (NHLBI) is intended to provide up-to-date guidance for professionals on the diagnosis and
management of the metabolic syndrome in adults.
Summary: The “Seventh Report of the Joint
National Committee on Prevention, Detection, Evaluation, and Treatment
of High Blood Pressure” provides a new guideline for hypertension
prevention and management.
(Available JNC 7 Express and Full Report)
Summary: Development of a large national database
on normative BP levels throughout childhood, the ability to identify
children who have abnormally elevated BP has improved. It is now
apparent that primary hypertension is detectable in the young and
occurs commonly. Long-term health risks for hypertensive children
and adol. Can be substantial; therefore, it is important that clinical
measures be taken to reduce these risks and optimize health outcomes.
This Report updates clinicians on the latest scientific evidence
regarding BP in children and provides recommendations for diagnosis,
evaluation, and treatment of hypertension.
Summary: The article begins with a case vignette highlighting a common clinical
problem. Evidence supporting various strategies is then presented, followed by a review of formal
guidelines, when they exist. The article ends with the authors' clinical recommendations.
Summary: To provide recommendations for the diagnosis and treatment of
community-acquired pneumonia in patients 16 years of age and older. This document also provides
recommendations for outpatient management and indications for hospitalization, taking into
consideration ongoing changes in antibiotic resistance. This guideline excludes patients with HIV
infection and pneumonia in immunocompromised patients.
Summary: The goal of prenatal and postpartum care is to optimize the health of the mother as well as that of the fetus and newborn. Prenatal care includes a comprehensive history, genetic screening/tetatology counseling, physical examination, laboratory tests, risk, nutrition, and psychosocial assessments as well as counseling. The American College of Obstetrics and Gynecology (ACOG) strongly encourages pregnant females to schedule an appointment with her OB/GYN before the 12 th week of pregnancy. Prenatal care is then recommended every four (4) weeks up to 28 weeks; every 2 weeks until 36 weeks; and weekly after 36 weeks. A postpartum visit is strongly encouraged 21 to 56 days after delivery and includes details of the delivery, physical examination, laboratory tests, and counseling. Counseling should include, but is not limited to breast-feeding, postpartum depression, contraceptive methods, future health and pregnancies.
Summary: The American College of Radiology (ACR) Practice Guidelines and Technical
Standards define principles and technical parameters of radiologic and radiation oncology practice
designed to provide consensus-based scientifically valid and medically credible information to assist
health care providers in delivering effective, efficient, consistent and safe medical care.
Summary: : The recommendations in this document are intended to guide the treatment
of tuberculosis in settings where mycobacterial cultures, drug susceptibility testing, radiographic
facilities, and second-line drugs are routinely available. In areas where these resources are not
available, the recommendations provided by the World Health Organization, the International Union against
Tuberculosis, or national tuberculosis control programs should be followed.
Summary: : In the MMWR Recommendations and Reports, "Treatment of Tuberculosis:
American Thoracic Society, CDC, and Infectious Diseases Society of America," two errors occurred. In
Table 3 (pages 4--5), the subheading of the second column under "Doses" should read, "1x/wk." On page 25,
column 2, in section 3.2.1 Cycloserine, the adult dosage should read, "Serum concentration measurements
aiming for a peak concentration of 20--35 mg/l are often useful in determining the optimum dose for a
given patient."
Update -
Adverse Event Data and Revised American Thoracic Society/CDC Recommendations Against the Use of Rifampin
and Pyrazinamide for Treatment of Latent Tuberculosis Infection---United States, 2003 (August 8, 2003/52
(31); 735-739)
Summary: : Center for Disease Control and Prevention Morbidity and Mortality Weekly
Reports addressing the trends in tuberculosis for the United States, 1998-2003 and recommendations for
the treatment of tuberculosis.
Erratum - (March 26, 2004 / 53(11);246) (use same web link as in Trends as the link for the Erratum is in that article)
Summary: : In the report, "Trends in Tuberculosis---United States, 1998--2003," on
page 212, the last sentence of the sixth paragraph of the report should read, "Among U.S.-born persons in
2003, the non-Hispanic black population had the largest number of TB cases (3,041 cases, 45.0%)."
Summary: : The mission of the Division of Tuberculosis Elimination (DTBE) is to
promote health and quality of life by preventing, controlling, and eventually eliminating tuberculosis
from the United States, and by collaborating with other countries and international partners in
controlling tuberculosis world-wide.
These guidelines were approved in February 2006 by the Preventive Health
Subcommittee. Guidelines will be reviewed every two years. The ultimate judgment regarding care of a
particular patient must be made by the physician and patient in light of circumstances specific to that
patient.
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