Ensuring the integrity of clinical practice guidelines: a tool for protecting patients

Lenzer, Jeanne; Hoffman, Jerome R.; Furberg, Curt D.; Ioannidis, John P. A.

doi:10.1136/bmj.f5535

Cited by 172 publications

(189 citation statements)

References 41 publications

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“…Pre-registration of study protocols for randomized controlled trials in clinical medicine has become standard practice 46 . In its simplest form it may simply comprise the registration of the basic study design, but it can also include a detailed pre-specification of the study procedures, outcomes and statistical analysis plan.…”

Section: Reporting and Disseminationmentioning

confidence: 99%

A manifesto for reproducible science

et al. 2017

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Improving the reliability and efficiency of scientific research will increase the credibility of the published scientific literature and accelerate discovery. Here we argue for the adoption of measures to optimize key elements of the scientific process: methods, reporting and dissemination, reproducibility, evaluation and incentives. There is some evidence from both simulations and empirical studies supporting the likely effectiveness of these measures, but their broad adoption by researchers, institutions, funders and journals will require iterative evaluation and improvement. We discuss the goals of these measures, and how they can be implemented, in the hope that this will facilitate action toward improving the transparency, reproducibility and efficiency of scientific research.

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Section: Reporting and Disseminationmentioning

confidence: 99%

A manifesto for reproducible science

et al. 2017

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“…1,2 Global expert collaboratives are increasingly producing evidence-informed consensus guidelines; examples can be found in cardiac resuscitation, initial sepsis management, and acute stroke care. 3 The 2010 International Liaison Committee on Resuscitation (ILCOR) Consensus on Science and Treatment Recommendations included solid EBM recommendations for both EM and EMS. 4,5 …”

Section: Ebm In Emmentioning

confidence: 99%

Applying Hospital Evidence to Paramedicine: Issues of Indirectness, Validity and Knowledge Translation

Bigham

Welsford

2015

CJEM

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The practice of emergency medicine (EM) has been intertwined with emergency medical services (EMS) for more than 40 years. In this commentary, we explore the practice of translating hospital based evidence into the prehospital setting. We will challenge both EMS and EM dogmabringing hospital care to patients in the field is not always better. In providing examples of therapies championed in hospitals that have failed to translate into the field, we will discuss the unique prehospital environment, and why evidence from the hospital setting cannot necessarily be translated to the prehospital field. Paramedicine is maturing so that the capability now exists to conduct practice-specific research that can inform best practices. Before translation from the hospital environment is implemented, evidence must be evaluated by people with expertise in three domains: critical appraisal, EM, and EMS. Scientific evidence should be assessed for: quality and bias; directness, generalizability, and validity to the EMS population; effect size and anticipated benefit from prehospital application; feasibility (including economic evaluation, human resource availability in the mobile environment); and patient and provider safety. RÉSUMÉLa pratique de la médecine d'urgence (MU) est étroitement liée aux services médicaux d'urgence (SMU) depuis plus d'une quarantaine d'années. Aussi les auteurs traitent-ils, dans le présent article, du transfert des données probantes, du milieu hospitalier au milieu préhospitalier. Sera remis en question un dogme admis tant par la MU que par les SMU; en effet, le transfert, sur le terrain, des pratiques en milieu hospitalier n'est pas toujours la meilleure solution. Il sera question, à l'aide d'exemples de traitements préconisés dans les hôpitaux qui se sont soldés par des échecs sur le terrain, du caractère propre du milieu préhospitalier et des raisons pour lesquelles l'application directe des données probantes, recueillies en milieu hospitalier ne convient pas nécessairement au milieu préhospitalier. Les secours paramédicaux sont une discipline en évolution, si bien que la capacité de recherche sur la pratique est suffisamment importante pour jeter une lumière nouvelle sur les pratiques exemplaires. Avant d'envisager l'application des connaissances recueillies en milieu hospitalier, il faut que les données probantes à l'appui soient évaluées par des experts dans trois domaines: l'évaluation critique, la MU et les SMU. Les données probantes de scientifiques devrait faire l'objet d'examen à l'égard: de la qualité et des biais; de l'application directe des données dans la population visée par les SMU ainsi que de leur généralisabilité et de leur validité; de l'ampleur de l'effet et des avantages prévisibles de l'application préhospitalière de ces pratiques; de la faisabilité (y compris l'évaluation économique et la suffisance des ressources humaines dans un environnement mobile); et finalement de la sécurité tant des patients que des fournisseurs de soins.

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“…Though the Guideline Panel Review working group indicates that lacking any of these elements is a "red flag" in clinical guideline generation [8], holding the Choosing Wisely campaign to such standards may be too stringent; the ABIM Foundation frames the campaign's lists as opportunities for conversation, rather than explicit guidelines for clinical practice. and laboratory testing are also common.…”

Section: How Were the Choosing Wisely Lists Developed?mentioning

confidence: 99%

Limiting Low-Value Care by “Choosing Wisely”

Schpero

2014

Virtual Mentor

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Ensuring the integrity of clinical practice guidelines: a tool for protecting patients

Cited by 172 publications

References 41 publications

A manifesto for reproducible science

A manifesto for reproducible science

Applying Hospital Evidence to Paramedicine: Issues of Indirectness, Validity and Knowledge Translation

Limiting Low-Value Care by “Choosing Wisely”

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