By: Joan Stewart, RT(T), BA HCA, Clinical Services Project Coordinator, TCCC
Today the email from a trusted source stated: “Mid-Year Report on Updated Guidelines.” The multi-page report to follow covered 16 advisory boards and professional associations with recommendations for everything from high-blood pressure management to recurrent vertigo (dizziness). Every known medical and dental professional organization or governing body puts forth guidelines on practice standards to assist physicians and clinicians in determining a course of action. In some cases, the guidelines come from task forces or patient advocacy groups. As a recipient of health care you might ask: why do we need these guidelines and how are they created? Should my family physician or oncologist use them?
First let’s look at how they are created. Professional guidelines and practice standards are synonymous terms. History and time have shown the best method to perform certain medical procedures such as setting a broken bone or curing an ear infection. Physicians are often faced with more complex situations and look for an indication on the best course of action. That is when guidelines developed by good clinical evidence assist the physician in making the best decision possible. We call this evidence-based medicine and it assures medical decisions are based on good clinical evidence with solid research and results. The opposite is anecdotal evidence; it seemed to work once, maybe it will work again!
What do we mean by good clinical evidence? That would be data driven information. Perhaps there was a clinical trial with stringent standards for enrollment and data collection. Or maybe the clinical evidence came from a retrospective meta-analysis of large numbers of people or a long running prospective study such as the Nurse’s Study (www.nurseshealthstudy.org). Any of these paths create strong bodies of evidence that allow clinicians to use a decision tool with the support of their peers.
Why do we need guidelines? The guidelines allow the physician to have a strong foundation from which to start. From this starting point the unique conditions of you, the patient, must be considered. Are you too weak and fragile to withstand the chemotherapy in the guidelines for sarcoma? Are you too young for mammography but you have a strong family history of breast cancer? Are you older than the recommendation for prostate cancer screening but have 10 or more good years left in you? These are all situations where your physician may decide the guidelines are good for most but they fit you like a cheap suit!
The Tri-Cities Cancer Center offers many free or low cost screenings during the year to help improve the health of our region and provide convenience for the communities we serve. All screenings are offered to those who fall within the guidelines for the screening as published by the United States Preventative Service Task Force, The National Comprehensive Cancer Network and the American Cancer Society. Our screenings do not replace the role of your primary care provider/family physician, who is instrumental in helping you determine what screenings are appropriate given your unique situation. If you don’t have a family physician, let us know. We can help!