This week, we are introducing a new feature to the CSA website: CSA Editors’ Picks. Dr. Linda Hertzberg and I, CSA editors of electronic and print media, will select articles that we think CSA members will find interesting or helpful, and that you might not come across on your own. We’ll post the links on the CSA website for easy access, and explain why we think the articles are worth your time.
The articles won’t necessarily be from the journals that anesthesiologists most often read, such as Anesthesiology or Anesthesia & Analgesia. They may be from other journals, from the popular press, or from healthcare blogs. All the articles we post will have a theme in common. This week’s theme is evidence-based medicine and clinical guidelines.
If you read an article that you think would make a good Editor’s Pick, by all means send the link to email@example.com. We look forward to hearing from you, and welcome your comments.
This week’s first article appeared recently in the British Medical Journal, and is called "Evidence based medicine: a movement in crisis?" The authors make a compelling argument that although evidence based medicine has had many benefits it has also had some negative unintended consequences. They offer a preliminary agenda for improvement by combining evidence with context and professional expertise to individualize patient care.
Dr. Mark Neuman, from the Department of Anesthesiology and Critical Care at the University of Pennsylvania, and his colleagues decided to take a look at the durability of clinical practice guideline recommendations over time. They reviewed Class I guidelines from the American Heart Association and the American College of Cardiology, and found that a surprising number were eventually downgraded, reversed, or omitted. Their original article appeared in JAMA, along with an accompanying editorial. (Editor’s note: to read the full versions of both articles, download the free JAMA Reader. You have to create an account, but are not required to join the AMA in order to do so.)
Many physician blogs address evidence-based guidelines and clinician frustration. Check out these recent posts from a cardiologist, writing about his love-hate relationship with guidelines in KevinMD, and two internists who discuss how guidelines are failing both patients and physicians in The Health Care Blog.
In internal news, for those who missed our HOD meeting in June, we've uploaded the speeches by now Past President Dr. Peter Sybert and President Dr. Paul Yost, including a presentation by President Yost, on our website under Practice Resources/HOD Reports.
Read Past President Dr. Peter Sybert's Speech
Read President Dr. Paul Yost's Speech
Check out President Yost's Presentation