Using Behavioral Science Strategies for Defining the State-of-the-Art

Abstract

The author describes an innovative, iterative review paradigm for synthesizing the knowledge base of a given subject, leading to a state-of-the-art consensus document regarding "best practice" in that field, namely, chronic obstructive pulmonary diseases (COPD). The method consisted of bringing together a project team of eminent physicians concerned with treatment and comprehensive care of COPD patients. The project director (a psychologist) served as process facilitator and project administrator. The state-of-the-art document went through five drafts that were carefully examined by the team members before the paper was deemed "fit" for review by peers. After eight more iterative critiques by 60 respected outside reviewers, the thirteenth draft was published in the Journal of the American Medical Association (1975). Over 8,500 reprint requests have been received; the paper has been endorsed by all of the medical groups in the U.S. that have a major concern with pulmonary disease; the article (and subsequent monograph) are being used for continuing medical education; and a 45-minute documentary of the treatment-in-action has been filmed by Warner-Chilcott Laboratories.