Literature DB >> 22807603

Time to detoxify medical literature from guideline overdose.

Dinesh Vyas, Arpita K Vyas.   

Abstract

The current financial turmoil in the United States has been attributed to multiple reasons including healthcare expenditure. Health care spending has increased from 5.7 percent of the gross domestic product (GDP) in 1965 to 16 percent of the GDP in 2004. Healthcare is driven with a goal to provide best possible care available at that period of time. Guidelines are generally assumed to have the high level of certainty and security as conclusions generated by the conventional scientific method leading many clinicians to use guidelines as the final arbiters of care. To provide the standard of care, physicians follow guidelines, proposed by either groups of physicians or various medical societies or government organizations like National Comprehensive Cancer Network. This has lead to multiple tests for the patient and has not survived the test of time. This independence leads to lacunae in the standardization of guidelines, hence flooding of literature with multiple guidelines and confusion to patients and physicians and eventually overtreatment, inefficiency, and patient inconvenience. There is an urgent need to restrict articles with Guidelines and develop some strategy like have an intermediate stage of pre-guidelines and after 5-10 years of trials, a systematic launch of the Guidelines. There can be better ways than this for putting together guidelines as has been suggested by multiple authors and researchers.

Entities:  

Keywords:  Conflict of interest; Controversies in medicine; Guidelines; Health economics; Standard of care

Mesh:

Year:  2012        PMID: 22807603      PMCID: PMC3396186          DOI: 10.3748/wjg.v18.i26.3331

Source DB:  PubMed          Journal:  World J Gastroenterol        ISSN: 1007-9327            Impact factor:   5.742


  23 in total

1.  [Evidence-based clinical practice guidelines development. From the bottom, to the top].

Authors:  G Browman; A Gómez de la Cámara; B Haynes; A Jadad; R Gabriel
Journal:  Med Clin (Barc)       Date:  2001-02-24       Impact factor: 1.725

2.  The trials and tribulations of clinical practice guidelines.

Authors:  D Cook; M Giacomini
Journal:  JAMA       Date:  1999-05-26       Impact factor: 56.272

3.  Finding high quality, efficient providers for value purchasing: cohort methods better than methods based on events.

Authors:  John E Wennberg; Elliott S Fisher
Journal:  Med Care       Date:  2002-10       Impact factor: 2.983

4.  Connections between quality measurement and improvement.

Authors:  Donald M Berwick; Brent James; Molly Joel Coye
Journal:  Med Care       Date:  2003-01       Impact factor: 2.983

5.  More variation in use of care, more flat-of-the-curve medicine.

Authors:  Victor R Fuchs
Journal:  Health Aff (Millwood)       Date:  2004       Impact factor: 6.301

6.  Is PSA testing still useful?

Authors:  Mike Mitka
Journal:  JAMA       Date:  2004-11-17       Impact factor: 56.272

7.  Evidence-based medicine: a unified approach.

Authors:  David M Eddy
Journal:  Health Aff (Millwood)       Date:  2005 Jan-Feb       Impact factor: 6.301

8.  Reassessment of clinical practice guidelines: go gently into that good night.

Authors:  Terrence M Shaneyfelt; Robert M Centor
Journal:  JAMA       Date:  2009-02-25       Impact factor: 56.272

9.  The Oxford Database of Perinatal Trials: developing a register of published reports of controlled trials.

Authors:  I Chalmers; J Hetherington; M Newdick; L Mutch; A Grant; M Enkin; E Enkin; K Dickersin
Journal:  Control Clin Trials       Date:  1986-12

10.  Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations.

Authors:  J M Grimshaw; I T Russell
Journal:  Lancet       Date:  1993-11-27       Impact factor: 79.321

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  1 in total

1.  Fecal transplant policy and legislation.

Authors:  Dinesh Vyas; Apoorva Aekka; Arpita Vyas
Journal:  World J Gastroenterol       Date:  2015-01-07       Impact factor: 5.742

  1 in total

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