guidelines

Leonard Berlin lberlin at LIVE.COM
Mon Dec 12 15:47:41 UTC 2016


I'm a radiologist and not an ED doc, but I think my answer is short, simple, and applies to all physicians under the circumstances you describe, namely:


    Read all three  guidelines carefully, and then use your own judgment to determine   what you believe  to be the standard of care,  and then treat the patient accordingly.


Lenny Berlin


________________________________
From: Tom Benzoni <benzonit at GMAIL.COM>
Sent: Monday, December 12, 2016 7:30 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: [IMPROVEDX] guidelines

Group challenge:
3 societies publish guidelines on ER treatment of A fib.
ESC, ACC, Canada
-Give strong recommendations based on weak evidence (their own finding) of expert opinion, not clinical trials
-Among 21 questions addressed, 5 completely different recommendations, 6 partial agreements, 10 agreements
-Only 1 group recommended absence of conflict of interest for >50% of its panel.

Thus:

Do you:
-Take the result with which you disagree, find a guideline that agrees with you and pronounce the care bad
or
-Do the opposite
or
Poclaim guidelines are useless and take pity on the person having to select these at the point of care?

tom

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