The Infectious Diseases Society of America Lyme guidelines: Poster child for guidelines reform

摘要

Tn the era of managed healthcare, medical specialty societies Xhave gained tremendous power over the practice of medicine. Specialty societies exert their power through clinical practice guidelines that dictate the standard of care for diagnosis and treatment in a given field, and compliance with these guidelines is considered mandatory by insurers, medical boards, government agencies and courts of law. Recent commentaries have highlighted the poor evidence supporting most guideline recommendations and the problems caused by conflicts of interest and bias of guidelines panelists.1"3 The article by Susan Ronn4 in this issue of the SMJ shows how the Lyme disease guidelines published in 2006 by the powerful Infectious Diseases Society of America (IDSA)5 could serve as a poster child for these problems.