Editorial
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jul 14, 2012; 18(26): 3331-3335
Published online Jul 14, 2012. doi: 10.3748/wjg.v18.i26.3331
Time to detoxify medical literature from guideline overdose
Dinesh Vyas, Arpita K Vyas
Dinesh Vyas, Department of Surgery, Nanomedical OncoSepsis Lab, Institute of International Health, College of Human Medicine, Michigan State University, East Lansing, MI 48824, United States
Arpita K Vyas, Pediatric Endocrinology, Department of Pediatrics and Human Development, Michigan State University, East Lansing, MI 48824, United States
Author contributions: Vyas D and Vyas AK both co-wrote the article and involved in conception and design, acquisition of data, analysis and interpretation of data, drafting the article and revising it critically for important intellectual content.
Correspondence to: Dinesh Vyas, MD, MS, FICS, Assistant Professor, Department of Surgery, Nanomedical OncoSepsis Lab, Institute of International Health, College of Human Medicine, Michigan State University, 1200 East Michigan Avenue, Suite 655, East Lansing, MI 48824, United States. dinesh.vyas@hc.msu.edu
Telephone: +1-517-2672491  Fax: +1-517-2672488
Received: September 23, 2011
Revised: April 5, 2012
Accepted: April 12, 2012
Published online: July 14, 2012
Abstract

The current financial turmoil in the United States has been attributed to multiple reasons including healthcare expenditure. Health care spending has increased from 5.7 percent of the gross domestic product (GDP) in 1965 to 16 percent of the GDP in 2004. Healthcare is driven with a goal to provide best possible care available at that period of time. Guidelines are generally assumed to have the high level of certainty and security as conclusions generated by the conventional scientific method leading many clinicians to use guidelines as the final arbiters of care. To provide the standard of care, physicians follow guidelines, proposed by either groups of physicians or various medical societies or government organizations like National Comprehensive Cancer Network. This has lead to multiple tests for the patient and has not survived the test of time. This independence leads to lacunae in the standardization of guidelines, hence flooding of literature with multiple guidelines and confusion to patients and physicians and eventually overtreatment, inefficiency, and patient inconvenience. There is an urgent need to restrict articles with Guidelines and develop some strategy like have an intermediate stage of pre-guidelines and after 5-10 years of trials, a systematic launch of the Guidelines. There can be better ways than this for putting together guidelines as has been suggested by multiple authors and researchers.

Keywords: Guidelines, Controversies in medicine, Conflict of interest, Health economics, Standard of care