Anesthesiology, V 118 • No 4 767 April 2013 S INCE 1992, practice parameters created by the American Soci- ety of Anesthesiologists (ASA) have been useful references for optimiz- ing patient care. As a result, they are among the most sought-after docu- ments in anesthesiology and medi- cine. Of the millions of queries to the ASA website annually, the single most visited URL after the home page is the one on practice parameters. Polls of ASA members conducted in 2009 and again in 2012 by the ASA revealed that members believe that standards, guidelines, and practice parameters are the single most valued resource ofered to them. ASA practice parameters have made signifcant contributions to clinical practice. In a 1999 report, the Institute of Medicine noted that anesthesiology is the only medical specialty that has made substantial gains in the area of patient safety: “Te gains in anesthesia are very impressive and were accomplished through a variety of mechanisms including improved monitoring techniques, the development and widespread adoption of practice guidelines, and other systematic approaches to reduc- ing errors.” 1 Te ASA continues its commitment to patient safety and, since 1999 has produced 12 additional practice parameters and 18 updates. In addition to providing guidance for clinical practice, these documents have scholarly interest and value. Between 2008 and 2012, 15 of the 50 most viewed articles in ANESTHESIOLOGY were ASA practice parameters, and four of these were in the top 10. Since 2000 the top two cited articles have been ASA practice parameters. 2,3 What Are Practice Parameters? Practice parameters are developed by and for the members of the ASA and serve to improve patient safety and clinical practice in our profession. Tey are information resources for the systemization of clinical practice and take the form of guidelines, advisories, or other state- ments (e.g., practice standards, prac- tice alerts, consensus statements). Evidence-based practice parameters are an important subset of practice parameters. Tese documents, pro- duced only in the form of guidelines or advisories, are developed from a systematic and standardized method for the collection, assessment, and analysis of evidence from the sci- entifc literature, survey responses from independent expert consul- tants, and randomly selected sam- ples of practicing anesthesiologists. Te goals of collecting evidence for these evidence-based practice parameters are as follows: (1) to maximize the accumulation of evidence by accessing infor- mation from multiple sources (i.e., scientifc, observational, and consensus opinion); (2) to enhance the accuracy of evi- dentiary fndings and reduce bias; (3) to be transparent in reporting the fndings; and (4) to evaluate the feasibility and practicality of implementing proposed recommendations. How Did ASA Practice Parameters Become Essential Resources for Clinical Practice? Te ASA practice parameters have served as important resources for anesthesiologists and other healthcare workers for more than 20 yr. Te early practice parameters were 2012 Emery A. Rovenstine Memorial Lecture The Genesis, Development, and Future of the American Society of Anesthesiologists Evidence-based Practice Parameters EDITORIAL VIEWS Illustration: A. Johnson. Accepted for publication December 30, 2012. The authors are not supported by, nor maintain any financial interest in, any com- mercial activity that may be associated with the topic of this article. Copyright © 2013, the American Society of Anesthesiologists, Inc. Lippincott Williams & Wilkins. Anesthesiology 2013; 118:767–8 Presented at the American Society of Anesthesiologists Annual Meeting, October 2012. “Practice parameters are developed by and for the members of the ASA and serve to improve patient safety and clinical practice in our profession.” Downloaded from anesthesiology.pubs.asahq.org by guest on 06/30/2020