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July 8, 1974

PSROs and Norms of Care: A Report by the Task Force on Guidelines of Care: American Medical Association Advisory Committee on PSRO

JAMA. 1974;229(2):166-171. doi:10.1001/jama.1974.03230400028026

GUIDELINES for the treatment of various diseases have been outlined in texts and professional publications for many years. However, statements from these sources are often contradictory and disorganized, and give comparatively little attention to items of economic significance such as length of hospital stay. Three factors have contributed to this situation: therapy often undergoes rapid change, so that precise standards seem useless; rigid standards may impair scientific progress; and strict interpretation may lead to fear of legal implications.

Nevertheless, patients may receive less than optimal diagnosis and therapy because basic criteria of care are neglected. Consequently, the development of dynamic treatment guidelines devoid of compulsory and legal implications has been supported by physicians who believe that such guidelines have educational benefits.

Attempts to Establish Guidelines  It was in this atmosphere of opposing opinion that utilization committees began to emerge. As they developed, the need for data