Guidelines always the right lines?

Over the past years, it has become mandatory for composers of Clinical Practice Guidelines to disclose industrial relationships. This is based on the premise that disclosure of these relationships ensures the independence and scientific integrity of those involved in guidelines. Clinical practice guidelines serve as standards of care in practice, quality improvement, and reimbursement. Individual physicians use clinical practice guidelines to establish which diagnostic tests and therapeutic strategies are most appropriate in patient care. Government and third-party payers use clinical practice guidelines to determine which procedures and drugs should receive reimbursement. Hospitals use these guidelines to decide when therapies justify a major investment. The government, the public and the media use these guidelines as reference standards in the evaluation of the quality of medical practice for both hospitals and individual physicians. Accordingly, maintaining the integrity and reliability of clinical practice guidelines is crucial to society and fundamental to the practice of evidence-based medicine. …