Richard Bettigole, MD
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To the Editors: When they are good, practice guidelines issued by organizations like the American College of Physicians (ACP) may well be very, very good, but when they are bad, they will, like the little girl in the nursery rhyme, be horrid. The assertion that such guidelines "should become the preferred source for definitive advice" (1) ignores the fact that, because data accumulate continuously, any such guidelines would potentially be outdated before publication. The assertion is also based on a false premise: that the standard of care is based on medical textbooks, which may also be out of date by
Bettigole R. ACP Practice Guidelines. Ann Intern Med. ;117:268. doi: 10.7326/0003-4819-117-3-268_1
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Published: Ann Intern Med. 1992;117(3):268.
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