Developing sexually transmitted disease guidelines in the USA and the UK

Abstract

Management guidelines for sexually transmitted diseases are reviewed and updated every four years at a workshop of experts convened by the US Centers for Disease Control and Prevention. They are disseminated in paper and electronic formats, and are widely accessed. Their recommendations are graded according to quality of evidence, benefits versus harms, and applicability. In the UK, guidelines are commissioned by the Clinical Effectiveness Group, following a specific methodology, then modified after consultation within the specialty of genitourinary medicine. Some issues are problematic for both guidelines, notably areas where the evidence is weak, where diagnostics and treatments are changing rapidly, and in knowing the extent to which guidelines actually influence practice.

Evaluation of imiquimod for the therapy of external genital and anal warts in comparison with destructive therapies

“…Imiquimod is effective and safe for the treatment of external genital and anal warts. It is part of the recommendations of several international guidelines 22–25 and has the advantages of self‐administration by the patient and very low recurrence rates after successful treatment. Human papillomaviruses are not eliminated by imiquimod but controlled by the patient’s immune system.…”

BASHH CEG guidelines: which guidelines are popular?

“…In the USA, the CDC not only has a website for its STI guidelines (with over 200,000 hits a year it is one of the CDC's most visited sites), but it also prints hard copies of documents for dissemination as well as producing online slide sets and downloads for palm-top computers. 6 It will be difficult to fully understand why certain guidelines are visited more than others. Nevertheless, it is clear that the CEG guidelines are an important and very popular part of BASHH's work.…”

“…In the USA, the CDC not only has a website for its STI guidelines (with over 200,000 hits a year it is one of the CDC's most visited sites), but it also prints hard copies of documents for dissemination as well as producing online slide sets and downloads for palm-top computers. 6…”

“…3,4 Guidelines for the specific management of sexually transmitted infections (STIs) have been produced for a number of years, initially in the USA in the 1980s by the Centers for Disease Control and Prevention (CDC), a government health agency developed at the end of World War II, evolving from a malaria control programme. 5,6 In the UK, the production of national evidence-based STI management guidelines began in the mid-1990s with the publication of a guideline on gonorrhoea, 7 followed by one for chlamydia. 8 The process of regular formal guideline production began in October 1997 when the two national specialist societies at the time, the Association for Genitourinary Medicine (AGUM) and the Medical Society for the Study of Venereal Diseases (MSSVD) established a Clinical Effectiveness Group (CEG).…”

“…3,4 Guidelines for the specific management of sexually transmitted infections (STIs) have been produced for a number of years, initially in the USA in the 1980s by the Centers for Disease Control and Prevention (CDC), a government health agency developed at the end of World War II, evolving from a malaria control programme. 5,6…”