Lyme guidelines: a cautionary tale about development of clinical practice guidelines.

Here is a journal article Abstract on the problem often found with clinical practice guidelines, using the controversial IDSA Lyme disease guidelines as a model for the conflicts of interest that often put patients’ best interests last when medical societies (often comprised of doctors who do not actually treat patients) write treatment guidelines. One of the authors on this article, Dr. Stricker, is a well-known and highly respected Lyme Literate Doctor (LLMD).

Philos Ethics Humanit Med. 2010 Jun 9;5(1):9. [Epub ahead of print]

The Infectious Diseases Society of America Lyme guidelines: a cautionary tale about development of clinical practice guidelines.

Johnson L, Stricker RB.

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.

PMID: 20529367 [PubMed – as supplied by publisher]