What happens to a practice guideline after it is published? Does it live in obscurity in a journal back issue? Does it recede into the nether-regions of internet archives? With effective dissemination strategies, it is hoped, the answer to these questions will be no. In this first of several blog entries on guideline dissemination, I will explain why investment in dissemination is important. I also will describe the main components of a dissemination campaign and approaches to carrying out the steps needed for an effective guideline launch.

Practice guidelines—particularly those that are evidence based—are the result of years of rigorous effort from methodologists, clinician authors, and association staff. Yet practice guidelines frequently are dismissed or criticized as “cookbook” medicine.^1,2 So why invest so much effort? The reason is clear: the plethora and pace of medical research publications make maintaining knowledge of medical advances quite daunting. In fact, as Davidoff and colleagues (1995) argue, in order to keep up to speed clinicians would need to read 19 articles daily every day of the year.³ Contrast this with the limited time clinicians have available for such reading^4,5—less than an hour per week by some calculations⁴—and the need for guidance becomes clear. 

To address this need, AAN members and staff, with the enthusiastic backing of the AAN Board of Directors, decided in the mid-2000s to invest in guideline dissemination campaigns to increase awareness—with the goal that greater awareness would lead to widespread use of the guidelines.

It is difficult for us at the AAN to ascertain whether increased use of guidelines follows from increased awareness of them. However, we can point to evidence that AAN guidelines are frequently accessed and are held in high regard by our members and others:

·         Ninety-eight percent of AAN members are aware of and use AAN guidelines.⁶

·         AAN guidelines are one of the top three reasons AAN members access the AAN website.⁷

·         AAN guidelines have been cited thousands of times in other societies’ peer-reviewed journals.

·         Thousands of media sources, including both medical and nonmedical outlets, have reported on AAN guidelines.

·         Insurance companies regularly consult evidence-based guidelines developed by the AAN and other specialty societies as part of their process for developing coverage policies.⁸

How has the AAN achieved this profile as a guideline developer? Through targeted dissemination campaigns, including media releases for most efforts. Look for more on this in a future blog entry.

In upcoming installments on this topic, I will detail the main components of the AAN’s dissemination process, which are:

·         Assembling a dissemination panel

·         Identifying campaign goals and how to achieve them

·         Implementing the project plan

·         Measuring success

Stay tuned for more on the AAN’s dissemination process.

Julie Cox, MFA

Senior Program Manager, Clinical Practice Publications

1. Cabana M, Rand C, Powe N. Why don’t physicians follow clinical practice guidelines? A framework for improvement. JAMA 1999;282:1458–1465.

2. Salber P. Cookbook medicine saves lives. http://www.thedoctorweighsin.com/cookbook-medicine-saves-lives/. Published July 26, 2007. Accessed July 19, 2012.

3. Davidoff F, Haynes B, Sackett D, Smith R. Evidence based medicine: a new journal to help doctors identify the information they need. BMJ 1995;310:1085–1086.

4. Sackett DL, Rosenberg WM, Muir Gray JA, Haynes RB, Richardson WS. Evidence-based medicine: what it is and what it isn’t. BMJ 1996;312:71–72.

5. Neale T. Doctor's Orders: Practicing Evidence-Based Medicine Is a Challenge. Medpage Today. http://www.medpagetoday.com/PracticeManagement/PracticeManagement/17486. Published December 12 2009. Accessed July 19, 2012.

6. Practice Issues Survey Final Report [member needs assessment survey]. St. Paul, MN: American Academy of Neurology; January 9, 2009.

7. Result of end user interviews, stakeholder interviews and Google Analytics findings. Evantage User Experience Consultants, 2012.