E-DRUG: Experience in changing national health guidelines(5)
Back in 2000 before we changed our name to Healthy Skepticism I had a go at
influencing the Australian National Heart Foundation (NHF) Guidelines.
Can MaLAM make constructive contributions to improving guidelines?
MaLAM Int News. July/August 2000 Vol 18 No 7/8
The NHF responded to my criticisms of their hypertension guidelines by
inviting me to join the panel for their next guidelines: lipids.
It is my view that there should be one set of intergrated guidelines for
delaying cardiovascular disease so the decision they had already made to
write lipid guidelines was a major decision that could not be reversed.
They told me that I made a difference (probably by repeatedly writing
criticisms of evolving drafts) but they did not invite me back to the next
one. I expect they would if I had pushed for it.
I did achieve partial acceptance of the Rod Jackson's New Zealand
cardiovascular risk calculator which became popular with many GPs.
One of the main issues is that often people who research biological
mechanisms and/or have clinical experience believe that their expertise is
the most appropriate for deciding public health issues. This is because
they don't know that they don't know enough about epidemiology and economics
to make good decisions.
My conclusion is that it is possible to influence guidelines if you can find
the time to push persistently.
Dr Peter R Mansfield
Research Fellow, Department of General Practice, University of Adelaide
NHMRC Public Health Postgraduate Scholarship 250465
Flinders University Convocation Medal 2003
Director, Healthy Skepticism Inc
Improving health by reducing harm from misleading drug promotion.
34 Methodist St, Willunga SA 5172 Australia
ph/fax +61 8 8557 1040
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