The NIH CDCs are a highly visible, public forum to evaluate controversial medical technologies by synthesizing current medical science data. The consensus statements, although not intended as medical practice guidelines, may form part of the database preceding guideline formulation. It is difficult to assess the effect of the conferences on physician practice, in part reflecting the interference of the many other influences, medical and nonmedical, on physician behavior. Yet the program has had some success in influencing reimbursement policy for some technologies here and abroad and in influencing specialty organization policy, thereby indirectly affecting physician behavior. On the other hand, OMAR's dissemination activities have apparently been so successful that demand for CDC statements has more than doubled over the past five years, prompting OMAR to establish an information service (including fax and the Internet). And finally, the program has spawned consensus conferences throughout the world, including Canada, Western Europe, and Israel (Goodman & Baratz 1990).