-excellent paper, Ben
-i know more about psychiatric problems
http://onlinelibrary.wiley.com/doi/10.1111/jep.12016/abstract;jsessionid=C42625918F6541C06ED58354F924C720.f03t04?deniedAccessCustomisedMessage=&userIsAuthenticated=false
-in any case, the Infectious Diseases Society of America (IDSA) is
usually very close to pharmaceutical industries, as demonstrated at
the beginning of the year with the "Tamiflu-Relenza" saga
-un saludo
-juan gérvas
2014-08-01 21:21 GMT+02:00, Djulbegovic, Benjamin <[log in to unmask]>:
> This definitively deserves a debate: in May of 2008, the Attorney General of
> Connecticut conducted antitrust investigation into the development of Lyme
> disease treatment guidelines by the Infectious Diseases Society of America
> (IDSA). The thrust of his argument is that the IDSA developed guidelines
> based on flawed methodology that in turn forced false standard of care,
> which cannot benefit the patients ( see
> http://www.peh-med.com/content/5/1/9).
> Lyme disease is one of those diseases that has been politicized leading to a
> number of conspiracy theories accusing the (US) government of suppression of
> evidence , all kinds of conflict of interests, etc, etc. The battle is now
> taken to the EBM: which methods are right ones and which guidelines are
> trustworthy? This is a paradigmitic example where science intersects with
> politics, ethics and public health policy.
> I look forward to some interesting and stimulating insights.
> thanks
> ben d
>
>
>
>
> From: Evidence based health (EBH)
> [mailto:[log in to unmask]] On Behalf Of Kate Bloor
> Sent: Thursday, July 31, 2014 11:05 AM
> To: [log in to unmask]
> Subject: Fw: New Standard of Care Guidelines for Treating Lyme and Other
> Tick-borne Illnesses
>
>
>
> I've not seen any discussion on the list on the IDSA/ ILADS divide related
> to testing, diagnosis and treatment for lyme disease and other TBI's.
>
> One have claimed jurisdiction over the other - on grounds of the evidence
> base, and professional legitimacy. However some claim that key european
> research related to european tests, diagnosis and lyme disease clinical
> presentations, has not often been included, and that this control of the
> diagnostic agenda is no more than 'traditional authority'.
>
> Given that lyme infection, is the fastest growing vector borne disease in
> the Northern Hemisphere, it is perhaps one the most major public health
> threats of its kind in europe and beyond, this is a worthy debate. Also
> given its contraversial nature, and the general climate of tensions between
> doctors, patients, and health services, it deserves a wider debate amongst a
> broader range of academic and professional groups, and patients advocacy
> groups.
>
> I bring this to your attention. See new guidelines from ILADS below.
>
> Kate Bloor
>
>
>
>
> New Standard of Care Guidelines for Treating Lyme and Other Tick-borne
> Illnesses Released by International Lyme and Associated Diseases Society
> (ILADS)
> Bethesda, Maryland, July 31, 2014
> How doctors treat patients with suspected Lyme infections needs to change so
> as to avoid potential long term illness and suffering. To that end, the
> International Lyme and Associated Diseases
> Society<http://ilads.us8.list-manage1.com/track/click?u=618a4780f78630b439260ac0a&id=851d1c7c84&e=bd3361534c>
> (ILADS) today released updated guidelines for the treatment of Lyme and
> other tick borne infections which call on physicians to provide
> evidence-based, patient-centered care for those with Lyme disease.
>
> Published in the August 2014 edition of the journal Expert Review of
> Anti-infective
> Therapy<http://ilads.us8.list-manage1.com/track/click?u=618a4780f78630b439260ac0a&id=7437aebf44&e=bd3361534c>,
> the new guidelines, titled: Evidence Assessments and Guideline
> Recommendations in Lyme disease: The Clinical Management of Known Tick
> Bites, Erythema Migrans Rashes and Persistent Disease, say current
> antibiotic protocols used by many physicians to prevent or treat Lyme
> disease are inadequate, leading to an increased risk of Lyme disease
> developing into a chronic illness.
>
> “Chronic manifestations of Lyme disease can continue long after other
> markers of the disease, such as the erythema migrans rash, have resolved,”
> said Daniel Cameron, M.D., M.P.H., and lead author. “Understanding this
> reality underlies the recommendation for careful follow-up to determine
> which individuals with Lyme disease could benefit from additional antibiotic
> therapy.”
>
> ILADS is the first organization to issue guidelines on Lyme disease which
> comply with the standards set by the Institute of
> Medicine<http://ilads.us8.list-manage.com/track/click?u=618a4780f78630b439260ac0a&id=eda720d448&e=bd3361534c>
> for developing trustworthy protocols. The document provides a rigorous
> review of the pertinent medical literature and contains recommendations for
> Lyme disease treatment based on the Grading of Recommendations Assessment,
> Development, and Evaluation
> (GRADE<http://ilads.us8.list-manage1.com/track/click?u=618a4780f78630b439260ac0a&id=02e3f60668&e=bd3361534c>)
> process. This review format is used by other well-respected medical
> organizations<http://ilads.us8.list-manage1.com/track/click?u=618a4780f78630b439260ac0a&id=c4e0518851&e=bd3361534c>
> including the Cochrane
> Collaboration<http://ilads.us8.list-manage.com/track/click?u=618a4780f78630b439260ac0a&id=1b574891f5&e=bd3361534c>
> and the World Health
> Organization<http://ilads.us8.list-manage1.com/track/click?u=618a4780f78630b439260ac0a&id=1fbf9a278f&e=bd3361534c>.
>
> ILADS’ GRADE-based analyses discovered research studies guiding current
> treatment protocols were of very low quality; and, the regimens based on
> these randomized controlled trials often failed. “For this reason, we moved
> away from designating a fixed duration for antibiotic therapy for tick borne
> illnesses and instead encourage clinicians to tailor therapy based on the
> patient’s response to treatment,” noted Dr. Cameron.
>
> “We not only recommend clinicians perform a deliberate and individualized
> assessment of the potential risks and benefits of various treatment options
> before making their initial selection,” said guidelines coauthor Elizabeth
> Maloney, M.D., “we also recommend careful follow-up. Monitoring a patient
> allows clinicians to adjust therapy as circumstances evolve. This more
> selective approach should reduce the risk of inadequate treatment giving
> rise to a chronic illness,” added Dr. Maloney.
>
> The guidelines encourage shared medical decision making and taking patient
> values into consideration. Lorraine Johnson, J.D., MBA, a coauthor and
> Executive Director of
> LymeDisease.org<http://ilads.us8.list-manage.com/track/click?u=618a4780f78630b439260ac0a&id=e4e94524b4&e=bd3361534c>,
> noted, “A lot of the treatment decisions in Lyme disease depend on
> trade-offs. How sick is the patient? How invasive is the treatment? What is
> valued by the patient? Patients need to understand the risks and benefits of
> treatment options to make informed medical choices,” added Ms. Johnson.
> “These guidelines provide that information.”
>
>
>
> ILADS is a nonprofit, international, multidisciplinary medical society
> dedicated to the appropriate diagnosis and treatment of Lyme and associated
> diseases.
>
>
> For more information:
>
> www.ilads.org<http://ilads.us8.list-manage.com/track/click?u=618a4780f78630b439260ac0a&id=52166ff08d&e=bd3361534c>
>
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>
>
>
>
>
> Copyright © 2014 International Lyme and Associated Disease Society, All
> rights reserved.
> You are receiving this because you attended or requested information about
> our conferences or to support the fight against Lyme Disease.
>
> Our mailing address is:
> International Lyme and Associated Disease Society
> PO Box 341461
> Bethesda, MD 20827-1461
>
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