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Thank You, Dr. Greenfield
Dear Dr. Shelly Greenfield and the Institute of Medicine’s Committee Members on Standards for Developing Trustworthy Clinical Practice Guidelines,
The Committee was wise to have “establishing transparency” as the first standard for clinical practice guidelines. Your collective wisdom also drafted standards for group composition of guideline committees, rating the strength of the evidence and recommendations, external review and updating.
Should we be questioning the validity of some existing practice guidelines as there’s no way to tell if they adhere to your new standards?
Will the Secretary of HHS consequently develop an organization to certify that institutions are using an adherence process or can specialty societies self-regulate and abide by the standards? Maybe a separate public-private organization can be tasked with this role.
How will the public know if the studies used in the practice guidelines are using good scientific method and don’t have a bias caused by pharmaceutical support? Shelly, I worry as a future patient how it can be OK to have 49% of a practice guideline committee have a conflict of interest due to their relationships with the pharmaceutical and device industries. (I do understand you would not be able to get expertise in the area being studied because so many have relationships with the industry, which is unfortunate.)
Shouldn’t we have researchers working in the field of medicine without conflict of interest?
Would we build the research enterprise differently if we had to do this all over again?
How much does it cost the taxpayers if we have distorted medical decisions because the guidelines are built on faulty science? Yes, I know researchers given monies currently available have to go to industry for support but we could change all of this.
Shelly, I know these standards aren’t perfect but I don’t know what we were doing without them all these years. Thank you and the Committee — your efforts are greatly appreciated.
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