To the Editor: In a brief report in the July 2002 issue, Drs. Milner and Valenstein (1) compared guidelines for the treatment of schizophrenia. They stated that the format of the practice guideline developed by the American Psychiatric Association (APA) (2) makes it more difficult to use and operationalize than some of the other available guidelines. Since the publication of the guideline, APA has addressed these important issues through separate but linked initiatives.
Although not part of the originally published version of the practice guidelines, the Quick Reference Guides are, as their name implies, designed for easy use by busy clinicians. They consist of algorithmic flowcharts and condensed bulleted lists of the key recommendations in each guideline. The Quick Reference Guides are available in a compendium (3) and on the Internet (4).
In addition to facilitating the use of guidelines in clinical practice, the Quick Reference Guides should promote operationalizing the guideline recommendations. For the practice guideline on major depressive disorder, the APA committee on quality indicators is collaborating with physicians in other specialties to identify and operationalize quality indicators. Available indicators may be obtained from APA (firstname.lastname@example.org). Opportunities are being sought to develop quality indicators based on recommendations of the other APA guidelines, such as the guideline on the treatment of schizophrenia.
With the development of the Quick Reference Guides and continuing work on operationalizing quality indicators, APA aims to promote ease of implementation while simultaneously preserving a major strength of the APA guidelines—the provision of a detailed yet readable summary of the current evidence base for key recommendations.
Finally, readers may be interested in knowing that a revision of the APA "Practice Guideline for the Treatment of Patients With Schizophrenia" is under way. Publication of the revised guideline and its Quick Reference Guide is scheduled for spring 2004.
Dr. Fochtmann is medical editor of APA's practice guideline project. Dr. McIntyre is chair of the APA steering committee on practice guidelines. Ms. Hart is director of APA's office of quality improvement and psychiatric services.