Evidence-based health care: making health policy and management decisions.

The paradigm for health care delivery in the United States continues to evolve. Patients and physicians are beginning to reject guidelines for treatment that are solely based on cost reduction and are not evidence based. Future managed care guidelines will rely on the best external clinical evidence about the value of any given therapeutic intervention combined with individual physician experience and patient choice. Managed care organizations will need to play a greater role in the development, evaluation, and incorporation of clinical trials into their strategies.