In recent years, a deluge of publications addressing nearly every aspect of patient care has enhanced clinical decision making, However, some feel it may also have encumbered it, owing to the tremendous volume of new and often conflicting information.
Clinical practice guidelines were developed to aid clinicians in improving patient outcomes and streamlining health care delivery by analyzing and summarizing data from all relevant publications. Lately, these guidelines have also been used as tools for educational purposes, performance measures and policy making. They are also meant to assist in the delivery of patient care. Not surprising then, that both physicians and patients assume that following such guidelines means practicing evidence-based medicine.
However, according to a new study published in the Archives of Internal Medicine, more than half of recommendations included in infectious disease guidelines rely on low-quality evidence.
Researchers examined 41 guidelines published by the Infectious Diseases Society of America (IDSA) since 1994. Of the 4200 recommendations in those guidelines, only 14% were guided by randomized controlled trials (level I evidence) while 55% were supported by expert opinions only (level III evidence).
Five guidelines were updated during the study period. In these updates, the number of recommendations increased between 20% and 400%, but only two updates saw an increase in the number of recommendations based on high-quality evidence.
An accompanying editorial advises physicians to be wary of falling into the trap of ‘cookbook medicine.’ “Guidelines may provide a starting point for searching for information, but they are not the finish line.” said John H. Powers, MD of the National Institute of Allergy and Infectious Diseases.
Ultimately, the existence of guidelines is probably better than no guidelines, but clearly guidelines should never replace critical thinking in patient care and physicians should avoid using guidelines as their only source when making clinical decisions.
For better critical thinking or to discuss the development of true evidence based guidelines for your brand, contact SRxA today. Learn how our teams of expert Advisors in Allergy, Pulmonology, ENT, Ocular Medicine and Surgery, Aesthetics, Reproductive Medicine and Behavioral Health can help you and your brand.
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