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Comment & Response
July 2019

Evidence-Based Medicine and the American Thoracic Society Guidelines

Author Affiliations
  • 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital, Boston
  • 2Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, Massachusetts
JAMA Intern Med. 2019;179(7):1002-1003. doi:10.1001/jamainternmed.2019.1864

To the Editor In a recently published Research Letter, Schumacher and colleagues1 argue that clinical guideline committees that make recommendations with only low-quality evidence do not promote the practice of evidence-based medicine. We feel that the authors misconstrued the role of clinical guidelines. According to the prevailing standards by the Institute of Medicine,2 committees should synthesize and rate the quality of evidence and then make recommendations using both the evidence and expert consensus. Individual frontline clinicians must then interpret the guidelines in the context of their individual patients. Guidelines are intended for the aggregate and cannot address every clinical nuance and exception.

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