About the NIH Consensus Development Program

About the Consensus Development Program

The National Institutes of Health (NIH) Consensus Development Program has been organizing major conferences since 1977. The program generates evidence-based consensus statements addressing controversial issues important to healthcare providers, policymakers, patients, researchers, and the general public. The NIH Consensus Development Program holds an average of three conferences a year. The program is administered by the Office of Medical Applications of Research within the NIH Office of the Director. Typically, the conferences have one major NIH Institute or Center sponsor, with multiple cosponsoring agencies.

Topic Selection

NIH Consensus Development and State-of-the-Science Conference topics must satisfy the following criteria:

Broad public health importance. The severity of the problem and the feasibility of interventions are key considerations.
Controversy or unresolved issues that can be clarified, or a gap between current knowledge and practice that can be narrowed.
An adequately defined base of scientific information from which to answer conference questions such that the outcome does not depend primarily on subjective judgments of panelists.

Conference Type

Two types of conferences fall under the purview of the NIH Consensus Development Program: State-of-the-Science Conferences and Consensus Development Conferences. Both conference types utilize the same structure and methodology; they differ only in the strength of the evidence surrounding the topic under consideration. When it appears that there is very strong evidence about a particular medical topic, but that the information is not in widespread clinical practice, a Consensus Development Conference is typically chosen to consolidate, solidify, and broadly disseminate strong evidence-based recommendations for general practice. Conversely, when the available evidence is weak or contradictory, or when a common practice is not supported by high-quality evidence, the State-of-the-Science label is chosen. This highlights what evidence about a topic is available and what directions future research should take, and alerts physicians that certain practices are not supported by good data.

Conference Process

Before the conference, a systematic evidence review on the chosen topic is performed by one of the Agency for Healthcare Research and Quality’s Evidence-based Practice Centers. This report is provided to the panel members approximately 6 weeks prior to the conference, and posted to the Consensus Development Program Web site once the conference begins, to serve as a foundation of high-quality evidence upon which the conference will build.

The conferences are held over 2-1/2 days. The first day and a half of the conference consists of plenary sessions, in which invited expert speakers present information, followed by “town hall forums,” in which open discussion occurs among the speakers, panelists, and the general public in attendance. The panel then develops its draft statement on the afternoon and evening of the second day, and presents it on the morning of the third day for audience commentary. The panel considers these comments in executive session and may revise its draft accordingly. The conference ends with a press briefing, during which reporters are invited to question the panelists about their findings.

Panelists

Each conference panel comprises 12 to 16 members, who can give balanced, objective, and informed attention to the topic. Panel members:

Must not be employees of the U.S. Department of Health and Human Services.
Must not hold financial or career (research) interests in the conference topic.
May be knowledgeable about the general topic under consideration, but must not have published on or have a publicly stated opinion on the topic.
Represent a variety of perspectives, to include:

Practicing and academic health professionals
Biostatisticians and epidemiologists
Clinical trialists and researchers
Non-health professionals with expertise in fields relevant to the specific topic (ethicists, economists, attorneys, etc.)
Individuals representing public-centered values and concerns

In addition, the panel as a whole should appropriately reflect racial and ethnic diversity. Panel members are not paid a fee or honorarium for their efforts. They are, however, reimbursed for travel expenses related to their participation in the conference.

Speakers

The conferences typically feature approximately 21 speakers: 3 present the information found in the Evidence-based Practice Center’s systematic review of the literature; the other 18 are experts in the topic at hand, have likely published on the topic, and may have strong opinions or beliefs on the topic. Where multiple viewpoints on a topic exist, every effort is made to include speakers who address all sides of the issue.

Conference Statements

The panel’s draft report is released online late in the conference’s third and final day. The final report is released approximately 6 weeks later. During the intervening period, the panel may edit its statement for clarity and correct any factual errors that might be discovered. No substantive changes to the panel’s findings are made during this period.

Each Consensus Development or State-of-the-Science Conference Statement reflects an independent panel’s assessment of the medical knowledge available at the time the statement is written; as such, it provides a “snapshot in time” of the state of knowledge on the conference topic. It is not a policy statement of the NIH or the Federal Government.

Dissemination

Consensus Development and State-of-the-Science Conference Statements have robust dissemination:

A press briefing is held on the last day of the conference to assist journalists in preparing news stories on the conference findings.
The statement is published online at consensus.nih.gov.
The conference statement is published in a major peer-reviewed journal.
Print copies are mailed to a wide variety of targeted audiences and are available at no charge through a clearinghouse.

For conference schedules, past statements, and evidence reports, please contact us:

NIH Consensus Development Program Information Center
P.O. Box 2577
Kensington, MD 20891
888–NIH–CONSENSUS (888–644–2667)
http://consensus.nih.gov

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