[EXTERNAL] [IMPROVEDX] What comes first

Hamm, Robert M. (HSC) Robert-Hamm at OUHSC.EDU
Mon Mar 13 21:25:01 UTC 2017


There are guidelines on making guidelines. 
https://cebgrade.mcmaster.ca/guidecheck.html
Maybe if one paid attention to whether the guidelines had been produced with due attention to the quality of evidence supporting them, there would be less of a problem of "conflicting guidelines" and eventually, more clinician willingness to be aware of guidelines and adhere to them (most of the time). 

Rob Hamm


-----Original Message-----
From: Samuel, Rana [mailto:Rana.Samuel at VA.GOV] 
Sent: Monday, March 13, 2017 3:19 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] [EXTERNAL] [IMPROVEDX] What comes first

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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