are new directions coming forward that are expressing the view
that guidelines built upon evidence-based information are, in fact,
based only upon the physiology and process, but not on the characteristics that make us human. Current guidelines do not take into
account patient preferences. They do not recognize the variations in
value placed by people of different ethnic or cultural backgrounds.
Guidelines as they are written today only value the medical science
and not the choices our patients want.
In March of this year, the New York Academy of Medicine, hosted
the Guidelines International Network—North America (GIN-NA)
with the topic of “Evidence-Based Guidelines Affecting Policy,
Practice and Stakeholders.” There were some key elements that
came from this conference:
• Richard Rosenfeld MD (Chair of ENT at SUNY Downstate,
and chair of Cochrane ENT Disorders group) stressed that
guideline development is based upon evidence culled over the
years so is always a retrospective look at physiologic quality. His thesis is that clinical quality will always be ahead of
cli