The challenge of “ evidence based ” sore throat guidelines

CONCLUSION Although the evidence for the management of acute sore throat is easily available, national guidelines are different with regard to the choice of evidence and the interpretation for clinical practice. Also a transparent and standardized guideline development method is lacking. These findings are important in the context of appropriate antibiotic use, the problem of growing antimicrobial resistance, and costs for the community. We assume that the word “evidence” is all inclusive.  How can 9 guidelines on one subject differ significantly?  The first problem occurs in selecting the evidence.  Like defense and prosecution lawyers, guideline committees judge the potential evidence and decide which evidence meets their standards. This leads to the problem of confirmation bias.  These committees have biases.  What is confirmation bias?  Shane Parrish of the Farnam Street Blog has a wonderful article on confirmation bias.  His definition: Confirmation bias is our tendency to cherry pick information which confirms pre-existing beliefs or ideas. This is also known as myside bias or confirmatory bias. Two people with opposing views on a topic can see the same evidence, and still come away both validated by it. Confirmation bias is pronounced in the case of ingrained, ideological, or emotionally charged views. One does not have to impute bad intentions to the committees when considering confirmation bias. As Nietzsche famously said, There are no facts, onl...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs