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To the Editor: The Connecticut attorney general's antitrust investigation and settlement with the Infectious Diseases Society of America (IDSA) regarding its development of clinical practice guidelines for Lyme disease offers important guidance for strengthening the integrity of clinical practice guideline development and preserving clinical discretion. I believe that in their Commentary, Mr Kraemer and Mr Gostin¹ mischaracterized fact and misread the relevant law in criticizing the attorney general's intervention as political and purporting to defend the supposed positive, scientific character of clinical practice guidelines against the imposition of normative goals. Contrary to their argument, the attorney general's intervention can in fact advance evidence-based medicine.

First, the authors misleadingly likened guideline development—which only faintly resembles the scientific method—to bench science.² Guideline development has also proved vulnerable to due-process irregularities, through conduct and conflicts of interest, just as the attorney general found here.

Second, Kraemer and Gostin erroneously asserted that the attorney . . . [Full Text of this Article]

Richard Wolfram, JD
rwolfram@rwolframlex.com
New York, New York

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