FAQ

NGC uses a systematic approach to decide when it is appropriate to include author, year citations in the Major Recommendations field and full citations in the References Supporting the Recommendations field. Two criteria drive the decision-making process: (1) the recommendations are explicitly stated, and (2) those explicit statements are referenced. The first criterion means that the recommendations in the guideline document are easily identified, stand-alone, action-oriented statements. Explicit recommendation statements are not interspersed among rationale in the guideline document. Rationale for the recommendations may be provided in sections before or after the actual recommendations but not within the same body of content as the recommendations. The second criterion means that the reference(s) supporting the explicit recommendation is (are) provided at the end of the statement. References cited in the rationale for the recommendation are not captured.

NGC will not display a field when the original guideline lacks relevant content.

The U.S. National Library of Medicine (NLM) has developed the Unified Medical Language System (UMLS) to "facilitate the development of computer systems that behave as if they ‘understand’ the meaning of the language of biomedicine and health. The UMLS consists of three knowledge sources, the Metathesaurus, the Semantic Network, and the Specialist Lexicon, as well as computer tools to help developers integrate the information from these sources.

The Metathesaurus is a collection of more than 100 controlled vocabularies, thesauri, and code sets linked together via high-level semantic concepts. NGC's master's level indexers apply terms from selected UMLS vocabularies to each guideline summary, expert commentary, and guideline synthesis to facilitate searching and browsing and to create relationships between similar documents. These vocabularies are:

• Healthcare Common Procedure Coding System (HCPCS)
• International Classification of Diseases – Clinical Modification (ICD-9-CM)
• Medical Subject Headings (MeSH)
• Physician Data Query (PDQ)
• Standard Product Nomenclature (SPN)
• Systemized Nomenclature of Medicine (Clinical Terms) (SNOMED CT)
• UMLS Metathesaurus (MTH)
• Universal Medical Device Nomenclature System (UMDNS)

See the Inclusion Criteria page.

See the Submit Guidelines page.

There are no copyright restrictions that prevent users from copying and/or distributing content found on NGC, provided that all content is appropriately identified. NGC's content (i.e., guideline summaries, guideline syntheses, and expert commentaries) is available for public use, and we encourage the distribution of our content, particularly for educational purposes. NGC content may not be used for commercial and/or product endorsement purposes.

Although most of NGC's content is free of restrictions, exceptions occur where individual guideline developers have requested otherwise. Refer to the Copyright Statement field at the end of each summary to determine if whether such restrictions apply and if users need to contact the guideline developer.

NGC seeks and receives permission from guideline developers to include summaries of the original full-text guidelines that appear at www.guideline.gov. NGC does not have the authority to grant copyright clearance for the original full-text guidelines upon which the summaries are based. If you are interested in using/distributing the original full-text guideline, you must contact the guideline developer.

Guideline developers submit a variety of documents to NGC including the following:

• Guideline documents/recommendations statements (published journal articles, unpublished documents, documents published electronically)
• Technical manuals describing the developer's process for guideline development
• Documents detailing the specific methodology for the guideline (evidence syntheses, systematic reviews, assessment reports)
• Patient resources (fact sheets, patient versions of guideline recommendations, pamphlets/brochures)
• Tools to assist in implementation (quick reference guides, PDA downloads, pocket guides, algorithms, order sets, chart documentation, slide sets, etc.)
• Continuing Medical Education (CME) material
• Other companion documents (background material, costing statements)

This documentation is reviewed against the Inclusion Criteria and subsequently used to develop summaries of guidelines that meet these criteria.

See the New this Week page.

You can register for the NGC update e-mail service to receive notices of weekly additions and updates posted to the Web site. Go to the Subscribe to Weekly E-mail page to register for this service.

Users can go to the Guidelines in Progress browse to see a list of guidelines in the work queue. Guidelines on this page include new and updated content that meet Inclusion Criteria and have the necessary copyright permissions.

NGC summaries reflect the most recent version of a guideline. NGC does not retain summaries of earlier versions of guidelines that have been updated or withdrawn by the developer. Contact the guideline developer directly for information regarding earlier versionsof a particular guideline.

See the Guideline Archive for more information. This feature provides a complete list of summaries that have been withdrawn from the NGC Web site. Information regarding a current NGC summary, where available, is provided. The listings are organized alphabetically by guideline developer.

As part of the NGC Annual Verification, many guidelines are withdrawn from the Web site at the end of every year because they no longer meet our Inclusion Criteria with respect to date. NGC's inclusion criteria specifically require that guidelines represented in our database have been developed, reviewed, or revised within the last five years. All guidelines that no longer meet this criterion are removed from the Web site at the end of each calendar year. See the Guideline Archive for a list of withdrawn or updated summaries.

To learn whether a guideline update is in progress, contact the guideline developer directly.

You can type your search term in the search box accessible in the masthead of all NGC Web pages to quickly search the database. You can also browse the NGC database by Topic (Disease/Condition, Treatment/Intervention, Health Services Administration) or Organization.

The About Search page contains useful tips on how to search the NGC database for guidelines of interest. You can also use Advanced Search to perform refined searches of the NGC database. This feature allows you to filter your search by one or more guideline attributes (e.g., Clinical Specialty, Intended Users, Guideline Category).

Advanced Search allows users to limit their search of the NGC database by the following guideline methodology components:

• Methods Used to Assess the Quality and Strength of the Evidence
• Methods Used to Analyze the Evidence
• Methods Used to Formulate the Recommendations

No. The main search engine searches the contents of the guideline summary as well as its metadata (i.e., UMLS concepts). In Advanced Search, NGC searches the specific field(s) in the database corresponding to the criteria you select. For more information on searching guidelines, see About Search.

No. NGC searches do not recognize the difference between uppercase and lowercase letters. For more information on searching, see About Search.

Your search may not yield content matching the criteria you specified. This can happen for several reasons:

• You may have misspelled a word (see suggested terms provided).
• Your search may be too specific. If you are using the search box, try using more general terms. If you are using the Advanced Search, select fewer options.
• NGC may not yet have the guideline you are seeking. Content is constantly changing, with new guidelines added frequently. Bookmark this site and make sure to check back often. To be notified by e-mail on a weekly basis when new and updated content is added to the site, see the Subscribe to Weekly E-mailpage.

For more information on searching guidelines, see About Search.

See the Help page for a current list of compatible browsers.

NGC welcomes links from appropriate Web sites to www.guideline.gov. For more information, see the For Web Developers page.

Each guideline summary provides a printable view via the Print link and several download types: PDF (download the free Adobe Reader ), Word (compatible with Word 1997 and higher), HTML, and XML. A citation for individual guideline summaries can also be downloaded into EndNote by clicking on the Citation Manager link.

NGC has developed several tools for system developers interested in using the content on the Web site. See the For Web Developers page.

Users can subscribe, unsubscribe, or modify their subscription to the NGC weekly e-mail service using the subscription management utility linked from the Subscribe to Weekly E-mail page.

Guidelines produced by AHRQ are no longer included in NGC because these documents are more than five years old. AHRQ also considers these guidelines, either in whole or in part, out of date. For more information, see the AHRQ Web site . Users can also see the Guideline Archive.

Evidence-based clinical guidance documents are heterogeneous, as is the terminology utilized to describe and/or label them. The phrases "guideline," "protocol," "practice parameter," "pathway," "standard," etc., are used in many different contexts by different guideline developers.

NGC's Inclusion Criteria rely on the Institute of Medicine (IOM) definition of clinical practice guideline:

Clinical practice guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. Institute of Medicine. (1990). Clinical Practice Guidelines: Directions for a New Program, M.J. Field and K.N. Lohr (eds.) Washington, DC: National Academy Press. page 38.

Any document meeting NGC's Inclusion Criteria is eligible for inclusion, regardless of how it is labeled.

Interested users may want to search NGC's Annotated Bibliographies for additional information. This feature allows users to search for publications and resources about guidelines.

For guidelines for which NGC has received the necessary permissions from the guideline developer, links are provided from the NGC summary to the full-text document at the developer's Web site. Users can find this link by referring to the "Related Content" tab at the top of each summary or by going to the Guideline Availability field that appears near the end of each summary. NGC is unable to fulfill orders for printed copies of the original full-text document.

NGC plans to develop a tutorial that will instruct users on how to navigate the Web site.

See the Contact Us page.

NGC does not have medical professionals or physicians on staff to answer patients' questions and/or to advise on health-related issues or experiences. If you think you may have a medical emergency, call your doctor or 911 immediately.

The suggested citation format for a Guideline Summary:

• National Guideline Clearinghouse (NGC). Guideline summary: [insert title of summary]. In: National Guideline Clearinghouse (NGC) [Web site]. Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); [cited YYYY Mon DD]. Available: http://www.guideline.gov.
  
  Example: National Guideline Clearinghouse (NGC). Guideline summary: Screening for breast cancer. In: National Guideline Clearinghouse (NGC) [Web site]. Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); [cited 2010 Jul 21]. Available: http://www.guideline.gov.

The suggested citation format for a Guideline Synthesis:

• National Guideline Clearinghouse (NGC). Guideline synthesis: [insert title of synthesis]. In: National Guideline Clearinghouse (NGC) [Web site]. Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); [cited YYYY Mon DD]. Available: http://www.guideline.gov.
  
  Example: National Guideline Clearinghouse (NGC). Guideline synthesis: Screening for breast cancer. In: National Guideline Clearinghouse (NGC) [Web site]. Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); [cited 2010 May 7]. Available: http://www.guideline.gov.

If you are citing the original guideline upon which the summary or synthesis is based, please refer to the Source field included in each guideline summary or the sources listed under the Guidelines Being Compared section found at the top of each guideline synthesis.

The suggested citation format for an Expert Commentary:

• Author [insert Commentary author]. Commentary title. In: National Guideline Clearinghouse (NGC) [Web site]. Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); [cited YYYY Mon DD]. Available: http://www.guideline.gov.
  
  Example: Wachter RM. Is the Measurement Mandate Diverting the Patient Safety Revolution? In: National Guideline Clearinghouse (NGC) [Web site]. Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); [cited 2009 Nov 8]. Available: http://www.guideline.gov.