Most practice guideline recommendations based on less-than-ideal quality of evidence, study says

(Medical Xpress)—A study published in the January issue of Mayo Clinic Proceedings shows that most clinical practice guidelines for interventional procedures (e.g., bronchoscopy, angioplasty) are based on lower-quality medical evidence and fail to disclose authors' conflicts of interest.

"Guidelines are meant to create a succinct roadmap for the diagnosis and treatment of by analyzing and summarizing the increasingly abundant medical research," write Joseph Feuerstein, M.D., and colleagues from Beth Israel Deaconess Medical Center. "Guidelines are used as a means to establish a standard of care … However, a guideline's validity is rooted in its development process."

In an accompanying editorial, Jayant Talwalkar, M.D., associate medical director of the Value Analysis Program in the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, says that the study further illustrates that existing guidelines are highly variable with respect to evidence quality and transparency.

"Most of the current practice guidelines in circulation do not meet criteria that represent trustworthiness as defined by the Institute of Medicine," Dr. Talwalkar says.

Dr. Talwalkar also points out that more attention needs to be paid to potential conflicts of interest among guideline authors and guideline development panels.

This video is not supported by your browser at this time.

"There is a growing body of literature documenting the existence of one or more potential conflicts of interest reported for authors or members of guideline development panels," he says. "As a result, the influence of external activities such as consulting or speaking fees, research grant funding and stock ownership has the potential to create significant bias and uncertainty for issued recommendations."

Dr. Talwalkar notes that up to 80 percent of recommendations from most are supported by evidence from non-randomized studies or expert consensus opinion, making conflict of interest disclosure crucial.

Dr. Talwalkar says that, in the future, the guideline-writing process must evolve to include more concise and up-to-date recommendations as well as more transparency about the management of potential .

More information: www.mayoclinicproceedings.org/… (13)00872-0/fulltext

add to favorites email to friend print save as pdf

Related Stories

Wider statin use recommended for chronic kidney disease

Dec 10, 2013

(HealthDay)—New guidelines for lipid management in chronic kidney disease (CKD) recommend wider statin use, according to a clinical practice guideline published online Dec. 10 in the Annals of Internal Me ...

Evidence-based guidelines developed for disc herniation

Dec 26, 2013

(HealthDay)—Evidence-based clinical guidelines have been developed for management of lumbar disc herniation with radiculopathy; the guidelines have been published in the Jan. 1 issue of The Spine Journal.

Recommended for you

Heart's own immune cells can help it heal

1 hour ago

(Medical Xpress)—The heart holds its own pool of immune cells capable of helping it heal after injury, according to new research in mice at Washington University School of Medicine in St. Louis.

Making lab-grown tissues stronger

1 hour ago

Lab-grown tissues could one day provide new treatments for injuries and damage to the joints, including articular cartilage, tendons and ligaments.

The 'ultimate' stem cell

2 hours ago

In the earliest moments of a mammal's life, the developing ball of cells formed shortly after fertilisation 'does as mother says' – it follows a course that has been pre-programmed in the egg by the mother. ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.