Analysis of Overall Level of Evidence Behind Infectious Diseases Society of America Practice Guidelines

Lee, Dong Heun; Vielemeyer, Ole

doi:10.1001/archinternmed.2010.482

Cited by 147 publications

(116 citation statements)

References 24 publications

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“…5 That is, the most skeptical decision makers may be the best informed about the limitations of available evidence. A growing body of work suggests that even widely used standards, such as ambulatory care metrics that are endorsed by key quality measurement organizations 6 and infectious disease treatment guidelines promulgated by the Infectious Diseases Society of America, 7 are commonly supported primarily by expert opinion or a methodologically suboptimal evidence base. Moreover, guidelines supported solely by observational evidence and/or expert opinion are commonly refuted and replaced when subjected to the more rigorous test of a randomized controlled trial.…”

mentioning

confidence: 99%

What Do We Really Know About VBID? Quality of the Evidence and Ethical Considerations for Health Plan Sponsors

Fairman¹,

Curtiss²

2011

JMCP

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mentioning

confidence: 99%

What Do We Really Know About VBID? Quality of the Evidence and Ethical Considerations for Health Plan Sponsors

Fairman¹,

Curtiss²

2011

JMCP

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“…In neurosurgery, 24.4% of the guidelines are based mainly on Level I recommendations; with neurosurgical vascular guidelines, this percentage is significantly higher: 51.9%. Some other specialties have Level I recommendations similar to neurosurgery, including endocrinology [20], infectious diseases [21] and hepatology [22]. Vascular neurosurgery is also the subspecialty with the highest publication rate in neurosurgery [5] and is the third most used in clinical practice (according to Table 3).…”

Section: Discussionmentioning

confidence: 99%

Neurosurgery - More Eminence than Evidence: Results of an International Survey (Preprint)

Martens¹

2017

Preprint

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BACKGROUND:The publication rate of neurosurgical guidelines has increased tremendously over the past decade. However, only a small proportion of clinical decisions appears to be based on highquality evidence. OBJECTIVE: To evaluate the available evidence within neurosurgery and its value within clinical practice according to neurosurgeons. METHODS: A web-based survey was sent to 2552 neurosurgeons, who were members of the European Association of Neurosurgical Societies. RESULTS:The response rate to the survey was 7% (173 respondents). According to 49% of the respondents, neurosurgery is based on less evidence compared with other medical specialties, and not enough high-quality evidence is available on which to base clinical practice. However, 84% of the respondents believed neurosurgery is amenable to evidence. Of the respondents, 59% considered the neurosurgical guidelines in their hospital to be based on high-quality evidence. Responders that did consider the neurosurgical guidelines in their hospital to be based on high-quality evidence did consider their own treatments more often as based on Level I and/or Level II (84% resp. 55%) (P < . 001). Also, neurosurgeons with formal training believed they could understand, criticize and interpret statistical outcomes presented in journals better than those without formal training (93% resp. 68%) (P < .001). CONCLUSION: According to the respondents, neurosurgery is based less often on high-quality evidence than other medical specialties. When looking at the results of the survey, formal training in EBM is desirable, so neurosurgeons can better understand, criticize and interpret statistical outcomes presented in journals.

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“…However, several evaluations of guidelines for long-term conditions have shown that only 6-16% of guidelines are based on level a evidence. [8][9][10] Guidelines do not address patient beliefs and values.…”

Section: Disorder Zonementioning

confidence: 99%

The Cynefin framework: applying an understanding of complexity to medicine

Gray¹

2017

J Prim Health Care

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Analysis of Overall Level of Evidence Behind Infectious Diseases Society of America Practice Guidelines

Abstract: More than half of the current recommendations of the IDSA are based on level III evidence only. Until more data from well-designed controlled clinical trials become available, physicians should remain cautious when using current guidelines as the sole source guiding patient care decisions.

Cited by 147 publications

References 24 publications

What Do We Really Know About VBID? Quality of the Evidence and Ethical Considerations for Health Plan Sponsors

What Do We Really Know About VBID? Quality of the Evidence and Ethical Considerations for Health Plan Sponsors

Neurosurgery - More Eminence than Evidence: Results of an International Survey (Preprint)

The Cynefin framework: applying an understanding of complexity to medicine

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