Good point,
Being unfortunate norm, almost all specialty guidelines are not based on evidence, but rather on "old club" mentality and "standard practice" based on circular logic of what constitutes "good"...
Laboratory testing in hospital setting is one of the bad examples of abuse of such practice. It leads to system overload and staff burn-out.
Over-testing in western medicine is a mere parasite (and it fuels overdiagnosis big deal), and it's stemming from lack of evidence-based diagnosis guidance. Most common arguments is that we overtest our patients in fear of litigation (also supported only by anecdotal evidence, which is propelled by malpractice insurance providers).
NMyles,
Vancouver
-----Original Message-----
From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of Nathalie Vermeulen
Sent: Friday, February 02, 2018 1:57 AM
To: [log in to unmask]
Subject: Question : what about recommendations for good practice?
Our society has been developing EB guidelines since 2010 and new topics for our guidelines come from our users. Often, they are requesting guidelines to be developed on how to do ultrasound, how to approach surgery, how to organize a lab, ..
These topics are often very relevant and the resulting recommendations are very helpful in guiding professionals on how to do certain procedures in an accepted way.
However, I do not see how such topics can be addressed with an evidence-based approach, and I think they will always be 90% expert opinion.
You can do an evidence-based guideline on whether or not to use ultrasound, but not on the technical aspects of how to use your device and which images to store.
There are documents called "Guidelines for Ultrasound" https://www.bmus.org/policies-statements-guidelines/professional-guidance/guidelines-for-professional-ultrasound-practice/
In my opinion, these documents should not be labeled as guidelines (giving the impression that they are evidence-based)..
As transparency is key, I would suggest to strictly separate Evidence-based guidelines (really EB) and Recommendations for Good Practice (expert opinion with evidence-based approach were possible), and I am attempting to implement this in our society .
I am curious on whether you have encountered the same "misuse" of the word guidelines, and what your opinion is on such 'Recommendations for Good Practice' ?
Thank you,
Nathalie
Nathalie Vermeulen, PhD I Senior Research Specialist European Society of Human Reproduction and Embryology The leading society in reproductive science and medicine
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