From authority recommendations to fact-sheets--a future for guidelines.
ADA/EASD recommendations and diabetes expert consensus statements are not evidence-based. Reform of guideline development is urgently needed. Overriding governance and composition of the guideline committee is a key problem. Methodologists without important conflicts of interest should lead the development process and have primary responsibility. The rating of the quality of evidence should be separated from making the recommendations, transparency has to be increased and conflicts of interest must be tackled. Patient needs are not yet met in guidelines. Patients increasingly demand concise, easy-to-read summaries of the benefits and risks of medicines together with more comprehensive scientific data. However, patient participation in individual decision making is not considered in guidelines. Guidelines do not provide the information necessary for informed or shared decision making. Study fact-sheets and drug facts boxes should be included in practice guidelines. It is timely to consider patient needs from the outset of the development of future guidelines.
Mühlhauser
I
I
Unit of Health Sciences and Education, University of Hamburg, Martin-Luther-King Platz 6, 20146, Hamburg, Germany. Ingrid_Muehlhauser@uni-hamburg.de
D000465:Algorithms; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D005060:Europe; D019317:Evidence-Based Medicine / Q000592:standards; D017408:Guidelines as Topic; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy / Q000517:prevention & control / Q000523:psychology; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D007258:Informed Consent / Q000592:standards; D008019:Life Style; D012307:Risk Factors; D012955:Societies, Medical / Q000592:standards; D014481:United States
D007004:Hypoglycemic Agents
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