{"id":1206,"date":"2016-12-19T11:57:43","date_gmt":"2016-12-19T11:57:43","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/?p=1206"},"modified":"2017-08-21T09:45:00","modified_gmt":"2017-08-21T09:45:00","slug":"tracking-guidelines-errors","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2016\/12\/19\/tracking-guidelines-errors\/","title":{"rendered":"Tracking Guidelines\u2019 Errors"},"content":{"rendered":"<p style=\"text-align: center\"><strong>Tracking Guidelines\u2019 Errors<\/strong><\/p>\n<p style=\"text-align: center\"><strong>Guest Blog Post<\/strong><br \/>\n<strong>Authors:\u00a0<\/strong>Primiano Iannone, MD, Monica Minardi, MD, James Doyle, MD<br \/>\n<strong>Institution:<\/strong> <span class=\"addr-line\">Emergency Department<\/span>, <span class=\"institution\">Ospedale del Tigullio<\/span>, <span class=\"addr-line\">Lavagna, Genova<\/span>, Italy<br \/>\n<strong>Email:<\/strong> <a href=\"mailto:p.iannone@live.com\" target=\"_blank\">p.iannone@live.com<\/a><\/p>\n<p>Perspective: <a href=\"http:\/\/ebm.bmj.com\/content\/early\/2016\/12\/16\/ebmed-2016-110606.full\">Wrong guidelines: why and how often they occur<\/a><\/p>\n<p>Methods: <a href=\"http:\/\/ebm.bmj.com\/content\/early\/2016\/12\/16\/ebmed-2016-110607.full\">Wrong guidelines: how to detect them and what to do in the case of flawed recommendations<\/a><\/p>\n<p>Despite being used by most physicians to offer the best option of care for their patients, guidelines \u00a0\u00a0can often suffer from serious flaws making them untrustworthy, even though considered evidence based tools.<\/p>\n<p>We \u00a0identified three categories of guidelines\u2019 untrustworthiness: 1) <strong>method related<\/strong>, when incorrect methods have been used (including inadequate management of conflict of interests, panel composition ; 2) <strong>content related<\/strong>, when there is discrepancy between recommendations and primary evidence which they refer to; and 3) <strong>outcome related, <\/strong>in the case of outcomes diverging from those expected by following the recommendation. \u00a0We considered quality of primary evidence against trustworthiness of guidelines, and\u00a0 identified the need to set a trustworthiness threshold to be reached before adopting a recommendation as true, depending on quality of guideline and the amount of evidence available.\u00a0 Furthermore, we searched the possible causes of guidelines\u2019 untrustworthiness not only amongst the traditional factors commonly considered (conflict of interests, poor methods, panels not representing all of the stakeholders, lack of external and independent assessment of recommendations) but also with regards to the \u201cwaste\u201d of biomedical research, as depicted by sir Iain Chalmers, which raises concerns regarding relevance of clinical research and coherence with existing knowledge. Additionally the lack of addressing \u00a0public health outcomes is considered.<\/p>\n<p>Ultimately, we offered a \u201csafety bundle\u201d to help users to navigate guidelines with confidence, since current quality assessment tools (AGREE, GIN, IOM instruments) and guidelines repositories and databases do not express a quality rating which is directly useful in order to reliably discriminate between \u00a0right and wrong guidelines.<\/p>\n<p>We identified and collected a substantial number of guidelines untrustworthy for either methods, content, or evidence of unexpected outcomes. We hope the readers will find this approach valuable in highlighting the awareness on flaws and errors, discussing guidelines trustworthiness hence cautiously interpreting their recommendations.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tracking Guidelines\u2019 Errors Guest Blog Post Authors:\u00a0Primiano Iannone, MD, Monica Minardi, MD, James Doyle, MD Institution: Emergency Department, Ospedale del Tigullio, Lavagna, Genova, Italy Email: p.iannone@live.com Perspective: Wrong guidelines: why and how often they occur Methods: Wrong guidelines: how to detect them and what to do in the case of flawed recommendations Despite being used [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2016\/12\/19\/tracking-guidelines-errors\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[14283],"tags":[],"class_list":["post-1206","post","type-post","status-publish","format-standard","hentry","category-archive"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts\/1206","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/comments?post=1206"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts\/1206\/revisions"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/media?parent=1206"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/categories?post=1206"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/tags?post=1206"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}