In 1989, Congress created the Agency for Health Care Policy and Research (AHCPR) and authorized it "...to enhance the quality, appropriateness, and effectiveness of health care services and access to these services." In fulfilling this mission the AHCPR facilitated the development of clinical practice guidelines. The Agency's Clinical Practice Guideline Program ran from 1990-1996 and was perceived to have advanced significantly the science of practice guideline development and to have created guidelines that represented "state of the art" management for the selected conditions.

However, it has now been at least five years and in some cases as long as ten years, since the clinical practice guidelines were developed. Parts or all of some of the clinical practice guidelines may no longer represent the best in clinical practice. In the fall of the year 2000 the Agency, now renamed the Agency for Healthcare Research and Quality (AHRQ), asked the Southern California Evidence-based Practice Center to conduct a systematic assessment of the current validity of the Agency's existing clinical practice guidelines and make recommendations about which of those guidelines should be withdrawn from circulation.