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Trump administration shutters clinical guidelines database

Lauren Vogel | CMAJ | June 19, 2018

Clinicians and health policy makers will soon lose a key source of evidence-based advice.

The United States government has defunded the Agency for Healthcare Research and Quality (AHRQ)’s national guidelines clearinghouse, a one-stop shop for clinicians and policy makers to access the latest evidence-based recommendations on care.

The online database will shut down on July 16. It houses and summarizes more than 4000 clinical practice guidelines and draws an average 200,000 visitors each month. Although this information will continue to exist scattered across the internet and other sources, it will now be harder to track down. Clinical practice guidelines are often controversial and the AHRQ has been unpopular with some clinicians whose autonomy and earnings were threatened by its recommendations.

“Killing these resources to save a few hundred thousand dollars per year is a penny-wise, pound-foolish decision, and your health and mine will be poorer for it,” said Dr. Kenneth Lin, a family physician on the faculty of Georgetown University’s medical school.

Lin claimed that the AHRQ’s work is more necessary than ever as the number of conflicting and questionable guidelines increases. “This is research and evidence that no one, healthy or ill, can afford to lose.”

The elimination of the clearinghouse comes after nearly a decade of cuts to the AHRQ, which supports research into making health care safer, less wasteful and more effective. Adjusting for inflation, AHRQ’s annual budget is $120 million short of its 2010 level. President Donald Trump’s administration is also proposing to dissolve the agency into the National Institutes of Health (NIH) with a 21% budget cut from 2017.

“The coupling of a potential re-organization of AHRQ within the NIH with a proposal for a major budget cut to the NIH should raise significant warning flags for the health services and primary care research communities,” according to Dr. Andrew Bindman, former AHRQ director.

According to the ARHQ, it’s possible another organization will take over managing the guidelines clearing house. However, “it is not clear” when or if the clearinghouse or something like it will be online again.

Photo credit: alvarez/iStock

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