Clinical Guidelines II

Clinical guidelines. They’re useful tools that can be used by physicians as a guide for treating their patients. They provide suggestions for and evaluations of treatments, diagnostic techniques, and cover a variety of other areas that stand to improve physician care. An example of a clinical guideline could be one that evaluates the effectiveness of screening tests for cervical cancer. Another type of clinical guideline could be the treatment process for an individual suffering with symptoms of colorectal cancer.

A main criticism of clinical guidelines is that they have the characteristics of ‘cookbook medicine.’ Critics argue that guidelines encompass broad scenarios, and generalize treatment(s). Consequences of this would be physicians not paying attention to specific complexities of their patients’ cases, or following the guidelines in situations that wouldn’t necessarily be appropriate. While there is reasonable merit in this argument, these are not sufficient arguments to stop using and producing clinical guidelines. Although certainly not always the case, physicians should possess the proper discretion when following guidelines. Physicians who are able to think critically and sensibly should be able to discern when a guideline is appropriate for their patients.

Clinical guidelines are created through academic institutions, health care institutions, as well as organizations such as the American Lung Association, cancer associations, etc. Guidelines may be critically appraised by evaluating bodies or other institutions. Guidelines that have been critically reviewed with good results are generally the best to follow.

How does the patient stand to benefit from these guidelines? There are a few places where guidelines are made available to the public. The National Guideline Clearinghouse, for example, contains thousands of clinical guidelines – all available to the general public. Anyone can browse through the guidelines; it’s fairly easy to find anything specific that you may be looking for. In an age where patients are second-guessing physician opinions, clinical guidelines may provide a background on what a doctor ‘should be doing.’ Patients, or ‘consumers’ as they are sometimes referred to, should be made aware that a clinical guideline is not a black and white outline for treatment/diagnosis/whatever the case may be. Guidelines can provide a reputable source of background information for patients, as opposed to some unreliable internet sources.

How is a guideline beneficial for a physician? I once worked with a physician who told me that everything he learned in medical school was outdated the very minute he had graduated. Of course, this is a slight exaggeration, but he had a very good point. There is a plethora of new information available for clinicians each day. It would be impossible for any human being to stay on top of all the new information, let alone be able to sift through and weed out the ‘bad’ research. Clinical guidelines provide a means to handle the information overload. Proper judgment, paired with a good, solid clinical guideline, a clinician should be well equipped to provide good patient care. Alternatively, if patients bring their own guideline research to their physicians, this also stands to improve patient care.

Its wishful thinking to hope that all clinicians keep abreast of the latest clinical guidelines, but one can assume that the research put into the guidelines is not going to waste. Clinical guidelines are valuable tools for knowledge translation among researchers and physicians, even among patients.

Viral Music

Kenny has tagged me in a game of internet-music-tag!

The setup: 1) three albums that I recommend you buy if you don’t already have them and; 2) three bloggers I’m tagging so that they’ll blog what three albums they recommend and the three bloggers they’ll tag and so forth.

Albums:

1. Caught By The Window, Pilate

2. A Collision, David Crowder Band

3. Funeral, Arcade Fire

Hmm, I have 2 friends have blogs, so I can’t tag 3. I really do have more than 2 friends…

My Friends:

1. Sid

2. Ken

Flickr Friday

Lake Louise, Alberta, 2007

Ridiculous

Even more reason to forbid Ann Coulter from opening her mouth. Harsh comments? Well, see for yourself what she has to say about a woman’s right to vote in this interview with the New York Observer.

Has she forgotten that she, herself, is a woman? If she was denied the right to vote, does she not realize that she probably wouldn’t be able to write her radically conservative books, or voice her absurd opinions? Does she think before she talks?

I don’t know what’s more disturbing, this woman spewing out these ridiculous ideas, or people actually believing her.

Clinical Guidelines

I’m now in the Population Risk Assessment and Management graduate program at the University of Ottawa, and taking a course in Health Technology Assessment. Although doing 2 years, and having an undergraduate degree in Health Sciences, I realized that I didn’t have a full understanding of what ‘health technology’ was. Broadly defined, health technology includes ‘anything’ that may improve clinical practice. Terrible definition, I know. This could include surgical procedures, MRI machines, research methods, and even clinical guidelines. Clinical guidelines are “systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances” (Field et. al, 1992).

I’ll be posting something a bit more detailed in the near future about these clinical guidelines. Prior to my seminar on the guidelines, I had no knowledge that they existed. I was also unaware that thousands of these guidelines are available free to the public. There is at least one set of clinical guidelines for virtually every single health ailment. Some ‘popular’ topics, such as breast cancer, has 210 guidelines at the National Guideline Clearinghouse alone.

Clinical guidelines are very useful tools, and from my understanding, not very well publicized.