AAFP finds collaborations key to developing guidelines.

It’s an oft-repeated phrase: Two heads are better than one. Likewise, the AAFP has found that when developing clinical practice guidelines, 2 organizations are often better than one. In fact, of the last 9 AAFP clinical practice guidelines, 8 involved other organizations. What does this trend toward collaboration mean? “We’re leaders,” states AAFP Scientifi c Activities Division Director Herbert Young, MD. “Other organizations recognize this and want to work with us.” While bringing organizations together results in a larger team and thus a lengthier approval process, says Young, the benefi ts abound. According to Young, collaborating on guidelines serves 2 purposes. First, it brings together 2 or more organizations, each having a perspective specifi c to its membership. Second, the collaboration usually guarantees more impact and wider dissemination than would occur if just 1 organization worked on a guideline. “The Academy is making a conscious effort not to have guidelines that duplicate those of other organizations,” says Richard Clover, MD, of Louisville, Ky, chair of the Commission on Clinical Policies and Research. “It’s more effi cient to work together.” If 2 organizations developed separate guidelines on the same topic, confusion could ensue, Clover said. “Management of Newly Detected Atrial Fibrillation,” the result of work by the Joint Panel of the AAFP and the American College of Physicians on Atrial Fibrillation, premiered in the December 16, 2003, Annals of Internal Medicine, reaching 115,000 internists and medical students. News of the guidelines also appeared in AAFP communications vehicles, reaching its 93,700 members. The joint panel reviewed almost 200 studies to devise its recommendations and determined that the literature did not support the conventional treatment to try to achieve sinus rhythm in patients with newly detected atrial fi brillation, says panel Co-chair Michael LeFevre, MD, a professor of family medicine at the University of Missouri–Columbia School of Medicine. “This guideline asserts that the best approach for most patients with atrial fi brillation is to focus on control of heart rate and stroke prevention, rather than attempt to restore sinus rhythm.” ACP and AAFP fi rst collaborated as partners in the Headache Consortium, which comprised more than 20 medical societies. AAFP and ACP worked further to develop the Headache Consortium guidelines into a set that focused more on primary care. That set was published in the November 19, 2002, Annals of Internal Medicine. Two more clinical practice guidelines—on deep venous thrombosis and pulmonary embolism—are in the works between the 2 organizations.