NEJM Weighs in on Guidelines

Robert Steinbrook, national correspondent for the New England Journal of Medicine, writes a "Guidance on Guidelines" that echoes the NIH protest last week that led to cancellation of the neonatal herpes meeting (for more on that story, click here). He concludes:

Clinical practice guidelines would serve patients and physicians best if they were prepared with the necessary financial and methodologic support to ensure their quality; the guidelines would inspire the most confidence if independent experts developed them without funding from industry or others with self-interest in the outcome. One approach would be to expand the NIH Consensus Development Program so that it could take on more subjects. Or Congress might require that the AHRQ once again support guideline development. Alternatively, the United States could create its own version of NICE, or a new agency to oversee and publish comparisons of the clinical effectiveness of different treatments and interventions. To succeed, however, any entity would need independence and financial security: when powerful interests take issue with guidelines, challenges will be inevitable.