Disclaimer
The clinical scenario featured in this article is a hypothetical one, used to illustrate the type of clinical dilemmas gastroenterologists may face in daily practice with respect to clinical practice guidelines. Furthermore, the earlier discussion is intended as general commentary, and does not constitute legal advice in individual cases. Do not act or rely on information contained in this article without first seeking the advice of a personal attorney.
References
1. Institute of Medicine. Clinical practice guidelines we can trust. National Academies Press, Washington, D.C.; 2011.
2. Yapali, S., Talaat, N., Lok, A.S. Management of hepatitis B: our practice and how it relates to the guidelines. Clin Gastroenterol Hepatol. 2014;12:16-26.
3. ASGE Standards of Practice Committee. Management of ingested foreign bodies and food impactions. Gastrointest Endosc. 2011;73:1085-91.
4. Restatement (Second) of torts: liability for physical & emotional harm § 283 (1965). Mello MM. Of swords and shields: the role of clinical practice guidelines in medical malpractice litigation. 149 U. Pa. L. Rev. 645 2000-2001.
6. Ransohoff, D.F., Pignone, M., Sox, H.C. How to decide whether a clinical practice guideline is trustworthy. JAMA. 2013;309:139-40.
7. Ubel, P.A. Medical facts versus value judgments – toward preference-sensitive guidelines. N Engl J Med. 2015;26:2475-6.
8. Kachalia, A., Little, A., Isavoran, M., et al. Greatest impact of safe harbor rules may be to improve patient safety, not reduce liability claims paid by physicians. Health Aff (Millwood). 2014;33:59-66.
9. Rex, D.K. Avoiding and defending malpractice suits for postcolonoscopy cancer: advice from an expert witness. Clin Gastroenterol Hepatol. 2013;11:768-73.
Dr. Oza is in the division of gastroenterology and liver diseases, Yale New Haven Medical Center, New Haven, Conn; Dr. El-Dika is in the division of gastroenterology, hepatology and nutrition, Ohio State University–Wexner Medical Center, Columbus; Dr. Adams is in the division of gastroenterology, department of medicine, University of Michigan Medical School, and Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor.
