Title |
The Infectious Diseases Society of America Lyme guidelines: a cautionary tale about the development of clinical practice guidelines
|
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Published in |
Philosophy, Ethics, and Humanities in Medicine, June 2010
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DOI | 10.1186/1747-5341-5-9 |
Pubmed ID | |
Authors |
Lorraine Johnson, Raphael B Stricker |
Abstract |
Flawed clinical practice guidelines may compromise patient care. Commercial conflicts of interest on panels that write treatment guidelines are particularly problematic, because panelists may have conflicting agendas that influence guideline recommendations. Historically, there has been no legal remedy for conflicts of interest on guidelines panels. However, in May 2008, the Attorney General of Connecticut concluded a ground-breaking antitrust investigation into the development of Lyme disease treatment guidelines by one of the largest medical societies in the United States, the Infectious Diseases Society of America (IDSA). Although the investigation found significant flaws in the IDSA guidelines development process, the subsequent review of the guidelines mandated by the settlement was compromised by a lack of impartiality at various stages of the IDSA review process. This article will examine the interplay between the recent calls for guidelines reform, the ethical canons of medicine, and due process considerations under antitrust laws as they apply to the formulation of the IDSA Lyme disease treatment guidelines. The article will also discuss pitfalls in the implementation of the IDSA antitrust settlement that should be avoided in the future. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 9 | 33% |
Spain | 2 | 7% |
Canada | 2 | 7% |
Italy | 1 | 4% |
France | 1 | 4% |
Serbia | 1 | 4% |
United Kingdom | 1 | 4% |
Unknown | 10 | 37% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 21 | 78% |
Practitioners (doctors, other healthcare professionals) | 2 | 7% |
Science communicators (journalists, bloggers, editors) | 2 | 7% |
Scientists | 1 | 4% |
Unknown | 1 | 4% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 1 | 1% |
United States | 1 | 1% |
Norway | 1 | 1% |
Unknown | 67 | 96% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 13 | 19% |
Researcher | 13 | 19% |
Student > Bachelor | 8 | 11% |
Student > Ph. D. Student | 8 | 11% |
Professor > Associate Professor | 7 | 10% |
Other | 17 | 24% |
Unknown | 4 | 6% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 33 | 47% |
Agricultural and Biological Sciences | 9 | 13% |
Psychology | 5 | 7% |
Social Sciences | 5 | 7% |
Nursing and Health Professions | 4 | 6% |
Other | 6 | 9% |
Unknown | 8 | 11% |