title: Guidelines for guidelines.
abstract: Practice guidelines are proliferating in medicine. In addition to methodological problems that cause guidelines to be outdated rapidly, they are plagued by conflicts of interest. They are largely consensus opinions of panels of experts, most of whom are supported by industry. Professional societies, health insurers, Centers for Medicare and Medicaid Services, and dialysis providers also benefit from guidelines. Little attention is paid to the potential for harm to patients, and to the profession of medicine, from the widespread use of guidelines.
authors.affiliation: Beth Israel Medical Center, 350 East 17th Street, New York, NY 10003, USA. ramerling@usa.net
authors.forename: Richard
authors.initials: R
authors.lastname: Amerling
authors.forename: James F
authors.initials: JF
authors.lastname: Winchester
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
mesh_terms: D014487:Centers for Medicare and Medicaid Services, U.S. / Q000592:standards*; D016265:Conflict of Interest; D006801:Humans; D007348:Insurance, Health / Q000592:standards*; D007676:Kidney Failure, Chronic / Q000628:therapy*; D017410:Practice Guidelines as Topic / Q000592:standards*; D006435:Renal Dialysis; D014481:United States