Title:
Hyperbaric oxygen for sudden sensorineural deafness: when guideline develop- ment goes astray
Authors:
J.A. de Ru, A. Koole, R.D. Bol Raap, D.N. Teguh, R.A. van Hulst
Institutions:
Central Military Hospital, Utrecht, The Netherlands; Hyperbaar Geneeskundig Centrum Rijswijk, Rijswijk, The Netherlands; Department of Surgery/Hyperbaric Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
Keywords:
Guideline; evidence-based medicine; hyperbaric oxygen; therapy; sensorineural deafness
Pages:
97 - 104
Abstract:
Hyperbaric oxygen for sudden sensorineural deafness: when guideline development goes astray. Problem: This article uses a clinical example to describe the need, when formulating a guideline, to include all evidence levels in the deliberations leading to the recommendations. Methodology: A narrative review, in which the different viewpoints on a recent guideline from the Dutch Society of Otorhinolaryngology and Head & Neck Surgery are described. Results: The guideline committee on sensorineural hearing loss is not abiding by its own rules in respect of formulating their guideline. Furthermore, a narrow evaluation of the literature is not useful for practice guidelines. A restrictive interpretation of evidence-based medicine (EBM), as well as the formulation of overly directive recommendations, has adverse implications for maintaining the range of treatment options, which could be important in the context of shared decision-making. Conclusion: For a practice guideline, a broad approach to the presentation of evidence and practice-based recommendations is required.
Issue:
Vol. 13, 2017, 2nd trimester


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Hyperbaric oxygen for sudden sensorineural deafness: when guideline develop- ment goes astray