These experts serve as volunteers to address critical national issues and give unbiased advice to the federal government and the public. Most of this advice is provided either by the National Research Council--the chief operating arm of the Academy of Sciences and the Academy of Engineering--or by the Institute of Medicine, which was established in 1970 under the charter of the National Academy of Sciences and according to Research Council rules.

The National Academies provide science and technology advice in several different forms: written reports reflecting the consensus reached by an expert study committee; symposia and convocations engaging large audiences in discussion of national issues; proceedings from conferences and workshops; or "white papers" on policy issues of special interest. Each project is conducted or overseen by a committee serving pro bono, whose members are selected for their expertise on the subject.

This document focuses primarily on the IOM study committee process, in which a committee of 10 to 20 members, with a diverse range of expertise and perspectives, is convened to address a particular question or set of questions.

IOM issues approximately 50 reports a year. The Institute's work centers principally on committee reports or studies on subjects ranging from HIV prevention to how to provide clinical care in extended space flight; from research opportunities at the National Institute of Health (NIH) to protecting the nation's food supply.

IOM also conducts Roundtables, workshops or symposia that provide an opportunity for public- and private-sector experts to openly discuss contentious issues in an environment that facilitates evidence-based dialogue. The majority of IOM studies and other activities are requested and funded by the federal government. However, foundations, other private-sector organizations, and state and local governments also initiate studies, as does the IOM itself.

Before the committee meets, one of the volunteer experts is appointed to serve as the committee chair, and a member of the staff is assigned as the study director.

Each committee meets periodically to investigate the many facets of the problem described in its statement of task and to develop a report of its findings, conclusions, and recommendations, based on the available scientific evidence.

This report is subjected to review by a group of independent, anonymous experts. After revisions are made by the committee to satisfy the institution's rigorous review process, the report is transmitted to the agency or organization that sponsored the study, and then released to the public. Names and affiliations of principal reviewers are made public when the report is released.

The National Academies and its operations are distinctive in several ways:

• Committee members serve without compensation, except for reimbursement of expenses.
• Most projects originate from requests made by outside sponsors such as Congress, federal agencies, and foundations. However, volunteer members of the institution's boards and commissions often develop the ideas for studies that subsequently are funded by external sources. In addition, The Academies have been building their own endowments through private contributions so that they can address important issues of science and policy, irrespective of government or foundation interest.
• The institution has no research laboratories. In reaching conclusions and recommendations, study committees hear invited testimony and evaluate published research from the relevant scientific literature, as part of an educational process designed to enable the committee to reach consensus.
• The resulting reports often present a novel synthesis of ideas unique to the committee; these reports are highly regarded by the sponsoring agencies and the public for their thorough analysis and carefully supported recommendations.
• The reputation of the institution for objectivity, integrity, independence, and competence is one of its most valuable assets. For this reason, procedures designed to ensure excellence apply to each study undertaken.
• The Academies do not compete in response to federal requests for proposals. Its one-of-a-kind service, not duplicated by other organizations, was reaffirmed in a January 1993 executive order from President Bush.
• The Academies are not subject to the Federal Advisory Committee Act in the way government agencies are; neither is it subject to the Freedom of Information Act. However, the Federal Advisory Committee Act Amendments of 1997 (Public Law 105-153) requires The Academies to provide opportunities for public access and involvement in the study process. Those requirements are discussed in the Public Access section of this document.

TABLE OF CONTENTS

The Study Process

• Consensus Reports
• Roundtables and Forums
• IOM Organizational Structure

Project Start-Up

• Institutional Oversight
• The Proposal
• Committee Selection

Study Conduct

• Bias and Conflict Of Interest
• Committee Deliberations
• Writing the Report
• Role of Staff
• Confidentiality
• Public Access

Report Review

Report Production and Dissemination

• The News Media
• Publishing Services