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June 24, 2009

Clinical Practice Guideline Development and Antitrust Law—Reply

JAMA. 2009;301(24):2548-2550. doi:10.1001/jama.2009.876

In Reply: Clinical practice guidelines play a central role in evidence-based medicine. By synthesizing available medical science, they can guide physicians and assist them to ensure that patients receive high-quality care while preventing the costs of treatment that provide uncertain benefit. These guidelines are, of course, only as good as the science that underlies them and the process by which they are created. Recent research shows that, when the science is disputable, practice guidelines often do not give enough attention to valid scientific dispute.1 But it is only against the best available science that clinical practice guidelines should be measured. The IDSA guidelines appropriately synthesize scientific data on diagnosis, prevention, and treatment of Lyme disease, and the antitrust investigation that resulted from their issuance was justified by neither fact nor law.

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