AFTER a "near-death experience" that nearly wiped it out of existence 2 years ago, the Agency for Health Care Policy and Research (AHCPR) appears to be remarkably robust these days.
In 1995, the agency, known for developing evidence-based clinical practice guidelines, came under fire when it published a guideline on back pain that said that most spinal surgery was unnecessary and that more conservative treatment was usually as effective and far less expensive.
Angry surgeons lobbied Congress to cut the agency off at the knees. Congress responded, slashing the Rockville, Md-based agency's budget from $159 million for 1995 to $125 million for 1996.
But AHCPR, which is part of the Public Health Service in the US Department of Health and Human Services, has survived, keeping its mission of quality improvement and cost containment intact while changing how it pursues this mission.
While it no longer develops its own clinical practice