COGS: The Conference On Guideline Standardization



The COGS Statement on Guideline Standardization

Welcome to the home page for COGS, the Conference on Guideline Standardization. The COGS statement was produced following an invitational meeting of experts -- bringing together developers, disseminators, and implementers for a common purpose — held in New Haven, Connecticut on April 26, 2002.



  • The purpose of the COGS statement is to define a standard for guideline reporting that will promote guideline quality and facilitate implementation.
  • The COGS statement includes 18 items that are critical for understanding a guideline's development process, its recommendation statements, and potential issues in its application. The checklist includes key elements that should be present in guidelines to enhance validity and usability. Applying a formal consensus process, the expert panel reviewed a set of proposed elements and rated the necessity of their inclusion in guideline documents. Facilitated discussion addressed disagreements in ratings, after which the elements were reevaluated. These ratings serve as the basis for a guideline content template that can be used by developers to improve their product.
  • A secondary purpose of the Conference was to describe barriers to effective implementation that exist in current guideline documents and to define approaches to overcome them. For example, guideline authors strive to make recommendations that accurately reflect scientific evidence, sometimes intentionally introducing ambiguity into guideline recommendations to reflect real world uncertainties. Implementers must resolve these ambiguities in order to devise pragmatic strategies to influence clinicians' behavior. COGS provided a forum for interaction among guideline developers, disseminators, and implementers to reconcile conflicting goals.

The Conference on Guideline Standardization was supported by the Agency for Healthcare Research and Quality (AHRQ) through grant R13 HS10962.
It was convened by the Yale Center for Medical Informatics.
For problems or questions regarding this website contact George Michel
Last updated: August 28, 2003.