, Volume 17, Issue 6, pp 1478-1480

Do Practice Patterns Reflect Practice Guidelines?

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The emergence of clinical practice guidelines and consensus statements has stimulated a critical review of the literature and healthy debate among experts regarding how and when to treat patients with various diseases, especially cancer. An article in this issue of Annals of Surgical Oncology by Panigrahi and colleagues comments on the recent medullary thyroid cancer (MTC) guidelines published by the American Thyroid Association.1,2 In using the Surveillance, Epidemiology, and End Results Program (SEER) database, these investigators found that a high number of patients with MTC, treated from 1988 to 2006, received treatment viewed as out of line with the 2009 American Thyroid Association guidelines. Although this may well be true, there are limitations to the conclusions which one can draw from an analysis of such large data repositories. The SEER database and other tumor registries are intended primarily as sources of cancer incidence and mortality rates.3 Information regarding initia