I finally watched the video, and I LOVE the theatrics... And the Cameos! This will get an airing at our Journal club this week.

More seriously, while I completely agree that there needs to be more emphasis on shared discussion and less on directing this or that course of action, I also have to say I've been startled Dwyer discussing recent and, I think, well researched guidelines, to hear people (who I THINK would espouse support of EBM), knock the guidelines for their CONCLUSIONS, without engaging a discussion of their evidence base. Cases in point: 2013 cholesterol guidelines, and the recent USPSTF ASA guideline - both with good evidence reviews, both with (I think) appropriate discussions of shared decisions. They may not be perfect, but they seem to be about the best we can get to. (Conversely, the recent CDC opiate guideline is a particularly "good" example of over extrapolation from weak evidence to over-strong directives.

Hmmm..... It seems we have (with apologies to Q) a "Continuum" of guidelines!   

LLAP
 
Bill Cayley, Jr, MD MDiv
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"I think some of the most celebrated moments in human achievement should be those times when everything is going against a person and they are down in the dumps but they simply choose to get up. That's real greatness."   -- Ryan Hall

On May 3, 2016, at 17:42, Brian Alper MD <[log in to unmask]> wrote:

Resistance is futile – they will be assimilated.

 

But if that occurred, would the forced vergence (Are your eyes crossing yet?) be the end of guidelines?

 

 

Brian S. Alper, MD, MSPH, FAAFP

Founder of DynaMed
Vice President of Innovations and EBM Development

www.dynamed.com, health.ebsco.com

Twitter: @BrianAlperMD

 

CAN’T is more often a choice than a fact …  https://www.linkedin.com/pulse/cant-brian-alper

 

 

From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of McCormack, James
Sent: Tuesday, May 03, 2016 6:14 PM
To: [log in to unmask]
Subject: Re: The End of Guidelines - a parody

 

I’m more of a Trekkie :) - so I think it should be an “assimilation" of guidelines

 

On May 3, 2016, at 2:33 PM, Glyn Elwyn <[log in to unmask]> wrote:

 

i think you are sightly over informed ;)

 

A vergence was a phenomenon of the Force that was centered around an object, place, or person. Meetra Surik was the center of a vergence. Jedi Master Qui-Gon Jinn believed that a vergence in the Force was located in Anakin Skywalker.


 

Professor Glyn Elwyn http://www.glynelwyn.com/

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On Tue, May 3, 2016 at 4:34 PM, McCormack, James <[log in to unmask]> wrote:

Certainly a vergence (the simultaneous movement of both eyes in opposite directions) is what I do when I see all these guidelines. But I like the term in the context of guidelines.

 

James

 

On May 3, 2016, at 12:59 PM, Brian Alper MD <[log in to unmask]> wrote:

 

Guidelines may be convergent or divergent.   So a name for a group of guidelines (if looking for a made-up word like gaggle or new use for a word like pride) could be a vergence.

 

Wouldn’t it be nice to recognize when the guidelines converge or diverge?  (That’s a separate concept)

 

Brian S. Alper, MD, MSPH, FAAFP

Founder of DynaMed
Vice President of Innovations and EBM Development

Twitter: @BrianAlperMD

 

CAN’T is more often a choice than a fact …  https://www.linkedin.com/pulse/cant-brian-alper

 

 

From: Evidence based health (EBH) [mailto:[log in to unmask]]On Behalf Of Glyn Elwyn
Sent: Tuesday, May 03, 2016 3:39 PM
To: [log in to unmask]
Subject: Re: The End of Guidelines - a parody

 

Tempted to suggest 'a divergence' of guidelines - or should we be more optimistic and say 'a convergence'

 

glyn 


 

Professor Glyn Elwyn http://www.glynelwyn.com/

@glynelwyn Twitter

glynelwyn Skype 

+1-603-653-0806 Robin Paradis Montibello Laboratory Coordinator

[log in to unmask] Calendar

 

Level 5 Williamson Translational Research Building

One Medical Center Drive

Lebanon NH 03756

 

 

 

On Tue, May 3, 2016 at 11:10 AM, Anthony Cummins <[log in to unmask]> wrote:

James

 

Go for it!

 

Anthony

Sent from my iPhone

 

Dr. Anthony Cummins MB BCh BAO MRCGP
Clinical lecturer

<image001.jpg>

RCSI Department of General Practice
Royal College of Surgeons in Ireland
Beaux Lane House, Lower Mercer Street, 2, Ireland
T: 01-402-8604 
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RCSI DEVELOPING HEALTHCARE LEADERS
WHO MAKE A DIFFERENCE WORLDWIDE 

On 3 May 2016, at 22:31, McCormack, James <[log in to unmask]> wrote:

Anthony - that is a great idea - I may steal it - see attached image

<A confusion of.jpg>

 

On May 3, 2016, at 4:23 AM, Anthony Cummins <[log in to unmask]> wrote:

 

There are collective nouns specifically for lions (a pride of), geese (a gaggle of) etc but what is the collective noun for the unending collection of guidelines issuing from all and sundry? Let me venture my suggestion: a confusion of!

 

Prof. Anthony Cummins

Department of Family Medicine

Perdana University

Serdang 

43400 Selangor

Malaysia



Sent from my iPhone

 

Dr. Anthony Cummins MB BCh BAO MRCGP
Clinical lecturer

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RCSI Department of General Practice
Royal College of Surgeons in Ireland
Beaux Lane House, Lower Mercer Street, 2, Ireland
T: 01-402-8604 
E: [log in to unmask] W: www.rcsi.ie

RCSI DEVELOPING HEALTHCARE LEADERS
WHO MAKE A DIFFERENCE WORLDWIDE 

On 3 May 2016, at 08:04, Evelyn Cornelissen <[log in to unmask]> wrote:

 

Peace...EC

Evelyn Cornelissen, RD, PhD

Clinical Assistant Professor

University of British Columbia

 

Co-Lead Faculty for Scholarship

Post-Graduate Program

Department of Family Practice

 

Site Faculty – Scholarship (Research and EBM)

Family Medicine Rural Residency Program

 

Research Associate

Centre for Clinical Epidemiology and Evaluation

Vancouver Coastal Health Research Institute

 

FLEX and DPAS 420 Advisor

Southern Medical Program

 

Email:  [log in to unmask]

 

The information in this email is privileged and confidential, and is intended only for the individual(s) to whom it is addressed.  Any other use, dissemination, distribution, disclosure, copy or forwarding is strictly prohibited.  If you have received this email in error, please contact me immediately and delete the email received.  Thank you.

 

From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of McCormack, James
Sent: Saturday, April 30, 2016 10:44 AM
To: [log in to unmask]
Subject: The End of Guidelines - a parody

 

Hi Everyone:

As many of you know I have fun creating educational musical parodies about "evidencey" stuff and I just released one on clinical practice guidelines using the great song, End of the Line - redone to be End of Guidelines.

Would love it if you would check it out.

The link to the video is here

https://youtu.be/DHDnqQ_mCBA

 

James McCormack, BSc(Pharm), Pharm D
Professor
Faculty of Pharmaceutical Sciences
UBC, Vancouver, Canada
Co-host - Best Science (BS) Medicine Podcast