Tag: clinical practice guidelines
Vaginal Birth After C-Section: How Safe Is It?
Doctors used to insist “once a C-section, always a C-section.” Today it is standard practice to allow vaginal births after C-section (VBAC) for appropriately selected patients. The American Congress of Obstetricians and Gynecologists (ACOG) has issued a Practice Bulletin to guide obstetricians in determining which patients are appropriate candidates for VBAC. We frequently hear criticisms of practice guidelines like these. The doctors...
Hospitals Slow to Adopt Pediatric Pneumonia Guidelines
While it is both easy and fun to point out the inadequacies of unscientific modalities such as chiropractic and homeopathy, our goal at Science-Based Medicine is the application of a single standard to all medical practice, even if it stings a bit. We are far from perfect. While I firmly believe that most conventional healthcare professionals are good people who strive to...
Clinical Practice Guidelines: Cholesterol Tests for Children?
The American Academy of Family Physicians journal American Family Physician (AFP) has a feature called Journal Club that I’ve mentioned before. Three physicians examine a published article, critique it, discuss whether to believe it or not, and put it into perspective. In the September 15 issue the journal club analyzed an article that critiqued the process for developing clinical practice guidelines. It discussed...
“Patient-Centered Care” and the Society for Integrative Oncology
Should Medical Journals Inform Readers if a Book Reviewer can’t be Objective? At the end of last week’s post I suggested that book reviewer Donald Abrams and the New England Journal of Medicine had withheld information useful for evaluating Abrams’ review: that he is the Secretary/Treasurer of the Society for Integrative Oncology (SIO), the organization of which Lorenzo Cohen, the first editor of the...
Should Evidence-Based Medicine Be Replaced by Interpersonal Medicine?
An opinion piece in the New England Journal of Medicine complains about the limitations of evidence-based medicine (EBM) and recommends a new approach they call "interpersonal medicine." In my opinion, good clinical medicine is already interpersonal medicine; there is no need for something new.