Judge guidelines by the company they keep and not by the evidence. That seems to be the conclusion of the authors of a NEJM Perspective piece this year which was anything but evidence based. I blogged about it here and here.
There have been other responses to the Perspective article. Dr. Mitchell Levy, FCCM, responding to the criticisms in a recent interview which can be accessed from the Society of Critical Care Medicine podcast page, welcomes the Perspective piece as a starting point for discussion, but believes the authors’ criticisms of the sepsis guidelines are based on innuendo more than evidence. He also cites factual error in the article and wonders if the Perspective authors, whose publishing record seems to be slanted toward criticism of industry, have biases of their own.
He points out that the interests of Eli Lilly actually “dovetail” with the interests of patients because the use of their product activated protein C is supported by high level evidence. “Conflict of interest” is the knee jerk mantra invoked any time industry collaborates with science. But where is the conflict when industry’s role is in line with evidence and facilitates the adoption of best practice?
In another response entitled “Surviving Skeptics” Sean Townsend, M.D. addresses some FAQs about the Perspective piece.