ACP American College of Physicians - Internal Medicine - Doctors for Adults

Clinical Information

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    • CEAP
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CEAP

What is CEAP?

In 1981, the Clinical Efficacy Assessment Project, or CEAP, began as a three-year grant. The goals were:

1. To assemble and review the clinical literature on a specified topic;
2. To identify the best scientific papers; and
3. To analyze, reformulate, and present such information so that practitioners can readily determine the usefulness of diagnostic tests, procedures, or treatments.

The initial charge from CEAP was to evaluate medical advances. Early ACP guidelines addressed diagnostic tests and technologies. These guidelines focused on topics developed through surveys of the ACP membership and were chosen based on the interest of the internal medicine community. Because of CEAP's success, the program was given permanent status at ACP.

Today, CEAP is administered by the Clinical Efficacy Assessment Subcommittee (CEAS) and by the staff of the Clinical Programs Department of the ACP.

How are ACP Guidelines developed?

If you thought that the ACP Guidelines were produced "by a bunch of old guys sitting around a board room," you're not alone in this misperception. ACP guidelines are produced through a team effort involving the Clinical Programs staff, the steering committee known as the Clinical Efficacy Assessment Subcommittee (CEAS), and expert scientific collaborators.

How are topics chosen?

Choosing a topic for a clinical practice guideline is the first step in the CEAP process. Evidence reports commissioned by the Agency for Health Care Research and Quality (AHRQ) and generated by Evidence-based Practice Centers are the basis of our guidelines. These comprehensive evidence reports are systematic literature reviews and are available to the public.

Data gathering

Systematic literature reviews follow a strict protocol, and each article is assessed using standardized scoring techniques. Randomized clinical trials are given the highest evidential weight followed by prospective and retrospective cohort studies and case-control studies. The weighting is assigned based on the type of study and its methodological strength. Gaps in knowledge are also identified.

The evidence is summarized as evidence tables, the data is analyzed, and a report synthesizing the evidence is written. This evidence report, along with consensus statements where there are gaps in the evidence, becomes the foundation for the College's background paper and evidence-based clinical practice guideline.

Review

Both the background paper and the guideline undergo a lengthy and thorough review process. These papers are first reviewed by CEAS, and then outside reviewers are invited to comment on the manuscripts. After CEAS approves the papers, they are sent to the committee that oversees CEAS, the Education Committee.

Once the Education Committee approves the documents, they go for final approval as ACP policy to the Board of Regents, the highest body of ACP. Simultaneously, the Board of Governors, who represent members from all 50 states and territories as well as our international members, reviews the manuscripts.

The goal is to provide clinicians with a clinical practice guideline based on the best evidence available; to make recommendations based on that evidence; to inform clinicians of when there is no evidence; and finally, to help them deliver the best health care possible.