Intended for healthcare professionals

Rapid response to:

Feature Evidence Based Medicine

Why we can’t trust clinical guidelines

BMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f3830 (Published 14 June 2013) Cite this as: BMJ 2013;346:f3830

Rapid Response:

Re: Why we can’t trust clinical guidelines

We believe that we have some unique insight into how ties to industry may result in advocacy for a particular intervention due to our extensive experience training health care professionals and students in critical appraisal of the medical literature. We think it is very possible that the outcomes Lenzer describes are less due to financial influence than are due to lack of knowledge. The vast majority of physicians and other health care professionals do not have even rudimentary skills in identifying science that is at high to medium risk of bias or understand when results may have a high likelihood of being due to chance. Having ties to industry would likely result in greater exposure to science supporting a particular intervention.

Without the ability to evaluate the quality of the science, we think it is likely that individuals would be swayed and/or convinced by that science. The remedy for this and for other problems with the quality of clinical guidelines is ensuring that all guideline development members have basic critical appraisal skills and there is enough transparency in guidelines so that appraisal of a guideline and the studies utilized can easily be accomplished.

Competing interests: No competing interests

29 June 2013
Sheri A. Strite
Medical Evidologist
Michael Stuart MD
Delfini Group
3961 NE 10th Ave. Portland OR 97212