VA/DoD Process Ensures Guidelines Reflect Current Research

James L. Sall, PhD

By Annette M. Boyle

WASHINGTON—Clinicians treating veterans and military patients can expect new guidelines in the coming year on sleep disorders, stroke, asthma, suicide prevention and chronic kidney disease.

The VA/DoD guidelines for major diseases and common conditions in the active-duty and veteran populations provide recommendations that federal healthcare providers rely on every day. Ensuring those guidelines reflect current best practices involves a host of researchers, clinical leaders and senior members of both organizations’ leadership.

Formed in 2004, the VA/DoD Evidence-Based Practice Guideline Work Group leadership has two co-chairpersons, one from the VA and the other from the DoD, and representatives from each military branch and the VHA Veterans Integrated Service Networks. Together, they work to identify topics for which new guidelines would provide the most value based on the number of patients seen with the condition, the cost of care, the risk of the condition or procedure and the frequency of problems associated with the condition.

“When you incorporate evidence, you can eliminate treatments and tests that have been shown to be ineffective and use healthcare dollars more effectively,” said James L. Sall, PhD, clinical quality program specialist in the Evidence-Based Practice Program in the VA’s Office of Quality, Safety and Value.

Updating a guideline takes about a year, while developing a new one can run closer to 18 months, he told U.S. Medicine.

“Typically, we have clinical champions who provide leadership in updates, one from the VA and one from the DoD, and then nine other experts from each organization, for a total team of 20,” Sall said. Having representation from the VA and DoD ensures that someone who starts treatment while active duty and then transitions to the VA does not experience a disruption in care. “We don’t want people saying, “That treatment doesn’t work. Let’s put you on something that does’ when they switch to the VA because that undermines confidence in the care received,” he added.

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