The day’s mail was typical: an alert from a pharmaceutical company warning me not to use its antidepressant in children; the latest journals competing for my attention; a handful of offers for real estate and surefire investment schemes; the local business newspaper; and an “exclusive” invitation to dine with the President for the price of a small car (undoubtedly explained by the fact we live in an area known for its generous presidential campaign contributions). And, of course, 3 new guidelines—1 on asthma and 2 on diabetes.
Being an aficionado of guidelines, I was relieved to see my care for children with asthma was not too out of date and that the 2 diabetes guidelines even agreed on some points. Of course, I have almost given up trying to remember which guidelines say what, let alone assess their credibility. Too many guidelines, too little time.
The newest feature in The journal of family practice—Guideline Update—aims to help clear guideline gridlock. Keith Holten, MD, director of the University of Cincinnati–affiliated residency program at Clinton Memorial Hospital, Wilmington, Ohio, will coordinate this feature.
Dr Holten will regularly choose a guideline of broad interest in family medicine, summarize its recommendations, and provide a brief critique that answers important questions. Who are the authors of the guideline and are they impartial? How might the guideline be biased? What “competing” guidelines exist? How can we incorporate the guideline’s recommendations into practice? While he may not be able to advise you on how best to keep up with your mail, Dr Holten, we trust, will enhance your ability to translate best evidence into practice.
If you come across a guideline that interests you, let us know (jfp@fammed.uc.edu). We plan to review many different types—recently published guidelines, old reliables that can greatly improve practice, and a few we believe are controversial or even misguided. Send us your ideas on how to make this feature more useful. Who knows, by culling a few of those tomes from your mail, you may even make progress on thinning the pile.
