A new article in the Milwaukee Journal Sentinel looks at evidence-based guidelines. Here is an excerpt:
[P]hysician societies, business groups, health insurers and consumer groups have called for more research on the effectiveness of different treatments. The results of that research should help doctors develop better guidelines – and better care for patients.
Despite the contention that it will lead to “one-size-fits all” care, comparative effectiveness research is a step removed from the guidelines themselves. The contention also ignores how guidelines are designed to be used.
“It’s a mistake to think of guidelines in black and white,” said Helen Blumen, a physician and managing editor of Milliman Care Guidelines LLC, which develops guidelines.
The words to live by, she said, are “most of the time.”
The science for developing guidelines is relatively new, and guidelines are far from perfect. The thousands that exist vary in quality and at times conflict. And a treatment that works equally well for all patients is rare.
But guidelines stillcan reduce the unnecessary variation in how doctors practice medicine and encourage them to follow what are considered best practices.
“The job of guidelines is to make it easy for physicians to do the right thing and hard to do the wrong thing,” Blumen said.