title: Are standards and evidence sufficient?
abstract: The origins of standards and guidelines in medicine are traced from work in the 1970s showing that treatment variations could not be accounted for by objective differences in the disease or other conditions of patients. Guidelines based on evidence can be effective in reducing such variation and in reducing costs. However, population disparities in disease and access, as well as dramatically rising insurance costs, pose challenges. Standards based entirely on efficacy of procedures will leave unanswered important questions about diagnosis and effective allocation of resources throughout population groups.
authors.affiliation: Dental Service of Massachusetts, USA. koloughlin@deltadentalma.com
authors.forename: Kathleen T
authors.initials: KT
authors.lastname: O'Loughlin
authors.forename: Robert
authors.initials: R
authors.lastname: Compton
mesh_terms: D001294:Attitude to Health; D003363:Cost Control; D003729:Dental Care / Q000191:economics / Q000592:standards*; D003945:Diagnosis, Oral; D019317:Evidence-Based Medicine; D005102:Health Expenditures; D006295:Health Resources; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007347:Insurance, Dental / Q000191:economics; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care / Q000592:standards; D040841:Resource Allocation; D035862:Vulnerable Populations