title: The more things change...: the federal government's role in the evaluative sciences.
abstract: 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.
authors.affiliation: Center for the Evaluative Clinical Sciences, Dartmouth Medical School, Hanover, New Hampshire, USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Wennberg
mesh_terms: D006302:Health Services Research; D006801:Humans; D009316:National Institutes of Health (U.S.) / Q000458:organization & administration; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011057:Politics; D012109:Research Support as Topic; D014481:United States; D016270:United States Agency for Healthcare Research and Quality / Q000458:organization & administration*