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Toward trustworthy, useful and independent guidelines - acknowledging conflicts when they exist
Tejani and Perry talks about Dr. Wei-Yi Song's letter to CMAJ outlining the Canadian Psychiatric Association's concerns regarding Dr. Ismail Jatoi and Dr. Sunita Sah's CMAJ commentary about guideline reform. Dr. Song contends that "Guidelines developed by nonspecialists and that...
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Published in: | Canadian Medical Association journal (CMAJ) 2019-12, Vol.191 (50), p.E1387-E1387 |
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Main Authors: | , |
Format: | Article |
Language: | English |
Subjects: | |
Online Access: | Get full text |
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Summary: | Tejani and Perry talks about Dr. Wei-Yi Song's letter to CMAJ outlining the Canadian Psychiatric Association's concerns regarding Dr. Ismail Jatoi and Dr. Sunita Sah's CMAJ commentary about guideline reform. Dr. Song contends that "Guidelines developed by nonspecialists and that are based solely on clinical trial data may oversimplify treatment and ignore clinical scenarios that require comprehensive judgment in addition to data, and may be harmful to patients," but did not reference this statement. This is an important issue in the interpretation of even the best large randomized trials in fields as diverse as diabetes, cardiovascular disease, nephrology, respirology, intensive care, infectious disease, pain and psychiatry. Surrogate outcomes favored by specialists to the exclusion of more clinically important outcomes have led us into innumerable "evidence traps" and invalid if not foolish guidelines over the last decades. Methodological problems guarantee that many apparently obvious findings are almost certainly not true. |
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ISSN: | 0820-3946 1488-2329 |
DOI: | 10.1503/cmaj.73669 |