Wennberg John E
Center for the Evaluative Clinical Sciences, Dartmouth Medical School, Hanover, New Hampshire, USA.
Health Aff (Millwood). 2003 Jan-Jun;Suppl Web Exclusives:W3-308-10. doi: 10.1377/hlthaff.w3.308.
The unfortunate political history of the Agency for Health Care Policy and Research (AHCPR) illustrates the risks to the agencies attempting to evaluate the common practices of medicine and reform clinical decision making to take account of patients' preferences. The evaluative sciences have yet to regain the congressional attention they had when Senators George Mitchell and David Durenberger championed their cause. But the fundamental problems remain, and they are getting worse. Sooner or later Congress will need to revisit the debate over where in the federal government the evaluative sciences should find their base, and questions concerning the role of the National Institutes of Health (NIH) will be raised once again, as they were at the time of AHCPR's founding.
医疗保健政策与研究机构（AHCPR）不幸的政治历史表明，那些试图评估医学常规做法并改革临床决策以考虑患者偏好的机构面临着诸多风险。评估科学尚未重新获得参议院乔治·米切尔和大卫·杜伦伯格参议员为其事业奔走时所得到的国会关注。但根本问题依然存在，而且愈发严重。国会迟早需要重新审视关于评估科学应在联邦政府何处立足的辩论，有关国立卫生研究院（NIH）作用的问题将再次被提出，就像AHCPR成立时那样。
