[EXTERNAL] [IMPROVEDX] What comes first

Edward Winslow edbjwinslow at GMAIL.COM
Mon Mar 13 23:44:34 UTC 2017


Close on Guidelines, but it is worse than we might expect. In November 2015
The National Guideline Clearing House claimed that there were:

   - 486 guidelines for "Hypertension"
   - 517 guidelines for "Heart Failure"
   - and "only" 129 for "Atrial Fibrillation"

There is certainly guideline bloat. We had hoped, I think, that the
Coordinating Committee for Comparative Effectiveness Research would help
clarify what worked and what was adding little. This group will be
abolished by the American Health Care Plan.

I posted on this topic about a year and a bit ago. If you want, I can
direct you to the post.



On Mon, Mar 13, 2017 at 3:19 PM, Samuel, Rana <Rana.Samuel at va.gov> wrote:

> The place to start would be by tidying up the guidelines themselves. What
> credibility do guidelines have when multiple differing guidelines exist on
> a topic? I believe someone on this listserve mentioned earlier that there
> were 6 guidelines on Atrial fibrillation, and they all had differing
> recommendations!
>
> First set the standard, then promote / facilitate use of the standard!
>
> Rana
>
> Rana Samuel, MD, FCAP
> Chief, Pathology and Laboratory Medicine Service (PALMS, 113)
> Lead pathologist - VISN 2
> VA western New York Healthcare System (VAWNYHS)
> 3495 Bailey Avenue, Buffalo, NY 14215
> Ph:    716-862-8701
> Fax:  716-862-7824
> Rana.samuel at va.gov
>
> -----Original Message-----
> From: Robert Bell [mailto:0000000296e45ec4-dmarc-request at LIST.
> IMPROVEDIAGNOSIS.ORG]
> Sent: Monday, March 13, 2017 11:55 AM
> To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
> Subject: [EXTERNAL] [IMPROVEDX] What comes first
>
> Could I add one big item to my list to tidy up medicine, and that is the
> number of medical guidelines not followed by so many HCPs.
>
> It reminds me of doing surgery today without a sterile environment as was
> done in the 1800s. As we learn should we not change? Does the guideline
> field need studying? Do computers need to remind us of critical aspects of
> a guideline. What is a critical aspect?
>
> Rob Bell, MD
>
> Sent from my iPad
>
>
>
>
>
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-- 
*Edward B, J. Winslow, MD, MBA*
Home 847 256-2475; Mobile 847 508-1442
edbjwinslow at gmail.com
winslowmedical.com

"The only thing new in the world is the history that you don't know"
       Harry S. Truman, 33rd President of US (1945-1953)


"... it can be argued that underinvestment in assessing the past is likely
to
lead to faulty estimates and erroneous prescriptions for future action."
        Eli Ginzberg, 1997






Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine

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