Abstract
For a long time, the guidelines of medical conduct represented a useful, but not binding, model for adapting in order to avoid professional liability. In this sense, the idea of relying solely on these guidelines raises serious concerns, as very often there is no real “evidence” to scientifically support the recommendations. The authors have conducted a review of the literature to draw the attention of the scientific community to the highlights and shadows of this dangerous Italian prospect.
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References
Aristotele, Metafisica (1978) Italian traduction of Reale G. Rusconi, Milano
Provera A (2013) Residuo di colpa’ nell’ipotesi di condotta del medico tenuta in ossequio alle linee-guida. Il “paradosso” dellaculpa in actione perita. Riv It Med Leg 3:1420–1435
L’art Vallini A (2013) 3 del “Decreto Balduzzi” tra retaggi dottrinali, esigenze concrete, approssimazioni testuali, dubbi di costituzionalità. Riv It Med Leg 2:736–750
Rotolo G (2013) Guidelines e leges artis in ambito medico. Riv It Med Leg 1:269–297
Marino PA (2013) Dalle linee guida e dai protocolli all’individualizzazione della colpa penale nel settore sanitario. Misura oggettiva e soggettiva della malpractice. Riv It Med Leg 1:502–506
Lytras T, Bonovas S, Chronis C, Konstantinidis AK, Kopsachilis F, Papamichail DP, Dounias G (2013) Occupational asthma guidelines: a systematic quality appraisal using the AGREE II instrument. Occup Environ Med. doi:10.1136/oemed-2013-101656
Sanclemente G, Acosta JL, Tamayo ME, Bonfill X, Alonso-Coello P (2013) Clinical practice guidelines for treatment of acne vulgaris: a critical appraisal using the AGREE II instrument. Arch Dermatol Res PMID:23925586
Hoomans T, Evers SM, Ament AJ, Hübben MW, van der Weijden T, Grimshaw JM, Severens JL (2007) The methodological quality of economic evaluations of guideline implementation into clinical practice: a systematic review of empiric studies. Value Health 10:305–316
Niessen LW, Grijseels E, Koopmanschap M, Rutten F (2007) Health DMo economic analysis for clinical practice—the case of 31 national consensus guidelines in the Netherlands. J Eval Clin Pract 13:68–78
Vale L, Thomas R, MacLennan G, Grimshaw J (2007) Systematic review of economic evaluations and cost analyses of guideline implementation strategies. Eur J Health Econ 8:111–121
Alonso-Coello P, Irfan A, Solà I, Gich I, Delgado-Noguera M, Rigau D, Tort S, Bonfill X, Burgers J, Schunemann H (2010) The quality of clinical practice guidelines over the last two decades: a systematic review of guideline appraisal studies. Qual Saf Health Care 19:e58
Tan JK, Wolfe BJ, Bulatovic R, Jones EB, Lo AY (2010) Critical appraisal of quality of clinical practice guidelines for treatment of psoriasis vulgaris, 2006–2009. J Invest Dermatol 130:2389–2395
Wimpenny P, van Zelm R (2007) Appraising and comparing pressure ulcer guidelines. Worldviews Evid Based Nurs 4:40–50
Sabharwal S, Patel V, Nijjer SS, Kirresh A, Darzi A, Chambers JC, Malik I, Kooner JS, Athanasiou T (2013) Guidelines in cardiac clinical practice: evaluation of their methodological quality using the AGREE II instrument. J R Soc Med 106(8):315–322
Jo MW, Lee JY, Kim NS, Kim SY, Sheen S, Kim SH, Lee SI (2013) Assessment of the quality of clinical practice guidelines in Korea using the AGREE Instrument. J Korean Med Sci 28(3):357–365
Simone B, De Feo E, Nicolotti N, Ricciardi W, Boccia S (2012) Methodological quality of English-language genetic guidelines on hereditary breast-cancer screening and management: an evaluation using the AGREE instrument. BMC Med 10:143
Don-Wauchope AC, Sievenpiper JL, Hill SA, Iorio A (2012) Applicability of the AGREE II instrument in evaluating the development process and quality of current National Academy of Clinical Biochemistry guidelines. Clin Chem 58(10):1426–1437
Forsberg JS, Hansson MG, Evers K (2013) International guidelines on biobank research leave researchers in ambiguity: why is this so? Eur J Epidemiol 28(6):449–451
Council for International Organizations of Medical Sciences (2002) International ethical guidelines for biomedical research involving human subjects. CIOMS, Geneva
Hansson MG, Dillner J, Bartram CR et al (2006) Should donors be allowed to give broad consent to future biobank research? Lancet Oncol 7(3):266–269
Lunshof J, Chadwick R, Vorhaus D et al (2008) From genetic privacy to open consent? Nat Rev Genet 9:406–411
Arnason V (2004) Coding and consent: moral challenges of the database project in Iceland. Bioethics 18:27–49
Council for International Organizations of Medical Sciences (2008) International ethical guidelines for epidemiological studies. CIOMS, Geneva
United Nations Educational, Scientific and Cultural Organization (2002) Human genetic data: preliminary study by the IBC on its collection, processing, storage and use. UNESCO, IBC, Paris
Council of Europe recommendation Rec 2006 (2005) 4 of the committee of ministers to member states on research on biological materials of human origin. Council of Europe, Paris
European Society of Human Genetics (2003) Data storage and DNA banking for biomedical research: technical, social and ethical issues. Recommendations of the European society of human genetics. Eur J Hum Genet 11(suppl 2):S8–S10
Gurses AP, Seidl KL, Vaidya V, Bochicchio G, Harris AD, Hebden J et al (2008) Systems ambiguity and guideline compliance: a qualitative study of how intensive care units follow evidence-based guidelines to reduce healthcare-associated infections. Qual Saf Health Care 17:351–359
Ali FS, Harris PA, Butler PE (2002) Ambiguity in the UK guidelines for the management of cutaneous melanoma. Br J Plast Surg 55(5):452
Tudiver F, Guibert R, Haggerty J, Ciampi A, Medved W, Brown JB, Herbert C, Katz A, Ritvo P, Grant B, Goel V, Smith P, O’Beirne M, Williams JI, Moliner P (2002) What influences family physicians’ cancer screening decisions when practice guidelines are unclear or conflicting? J Fam Pract 51(9):760
Tudiver F, Brown JB, Medved W, Herbert C, Ritvo P, Guibert R, Haggerty J, Goel V, Smith P, O’Beirne M, Katz A, Moliner P, Ciampi A, Williams JI (2001) Making decisions about cancer screening when the guidelines are unclear or conflicting. J Fam Pract 50(8):682–687
Jo MW, Lee JY, Kim NS, Kim SY, Sheen S, Kim SH, Lee SI (2013) Assessment of the quality of clinical practice guidelines in Korea using the AGREE instrument. J Korean Med Sci 28(3):357–365
Farr BM (2013) Unclear study methods still confusing readers despite CONSORT guidelines (e.g., lidocaine patch does relieve pain of covered rib fractures). J Clin Epidemiol. doi:10.1016/j.jclinepi.2013.07.010
Moher D, Schultz KF, Altman DG (2001) The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomized trials. Ann Intern Med 134:657–662
Boutron I, Dutton S, Ravaud P, Altman DG (2010) Reporting and interpretation of randomized controlled trials with statistically nonsignificant results for primary outcomes. JAMA 303:2058–2064
Glasziou P, Meats E, Heneghan C, Shepperd S (2008) What is missing from descriptions of treatment in trials and reviews? BMJ 14:1472–1474
Ruiz MA (2013) Reviews and guidelines: evidence of progress and a starting point for standardization and changes. Rev Bras Hematol Hemoter 35(2):75–76
Ollenschläger G (2013) Clinical practice guidelines and knowledge management in healthcare. Recent Prog Med 104(10):515–521
Marino PA (2013) Dalle linee guida e dai protocolli all’individualizzazione della colpa penale nel settore sanitario. Misura oggettiva e soggettiva della malpractice. Riv It Med Leg 1:502–506
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Massoni, F., Ricci, P. & Ricci, S. Does the patient or pathology exist?. J Med Pers 12, 5–8 (2014). https://doi.org/10.1007/s12682-014-0165-6
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DOI: https://doi.org/10.1007/s12682-014-0165-6