American Academy of Orthopaedic Surgeons Rotator Cuff Clinical Practice Guideline

The editorial in the May 2012 issue regarding the AAOS Rotator Cuff Clinical Practice Guideline deserves to be reprinted in every medical journal and read aloud in the halls of Congress.1Lubowitz J.H. McIntyre L.F. Provencher M.T. Poehling G.G. AAOS Rotator Cuff Clinical Practice Guideline misses the mark.Arthroscopy. 2012; 28: 589-592Abstract Full Text Full Text PDF PubMed Scopus (32) Google ScholarBecause “evidence-based medicine” (EBM) has become the singular guarantor of good medicine, it was with great relief that I read Arthroscopy's published editorial putting EBM into perspective.EBM is a goal; it is a methodology; it is an ideal for which to strive.EBM should be creating thoughtfulness and pathways, not constraints.Stating views with statistical reviews is one thing; placing them as immutable guidelines in cement is another.Years of experience still count. We should never let “facts” overrule common sense.Thank you Drs. Lubowitz, McIntyre, Provencher, and Poehling. And, thank you Dr. Pedowitz. The editorial in the May 2012 issue regarding the AAOS Rotator Cuff Clinical Practice Guideline deserves to be reprinted in every medical journal and read aloud in the halls of Congress.1Lubowitz J.H. McIntyre L.F. Provencher M.T. Poehling G.G. AAOS Rotator Cuff Clinical Practice Guideline misses the mark.Arthroscopy. 2012; 28: 589-592Abstract Full Text Full Text PDF PubMed Scopus (32) Google Scholar Because “evidence-based medicine” (EBM) has become the singular guarantor of good medicine, it was with great relief that I read Arthroscopy's published editorial putting EBM into perspective. EBM is a goal; it is a methodology; it is an ideal for which to strive. EBM should be creating thoughtfulness and pathways, not constraints. Stating views with statistical reviews is one thing; placing them as immutable guidelines in cement is another. Years of experience still count. We should never let “facts” overrule common sense. Thank you Drs. Lubowitz, McIntyre, Provencher, and Poehling. And, thank you Dr. Pedowitz. AAOS Rotator Cuff Clinical Practice Guideline Misses the MarkArthroscopyVol. 28Issue 5PreviewThe American Academy of Orthopaedic Surgeons Clinical Practice Guideline (CPG) on Optimizing the Management of Rotator Cuff Problem was developed using the best available evidence to improve treatment in keeping with current evidentiary practice standards.1 This is a laudable and necessary effort. Unfortunately, the CPG process produces inconclusive recommendations supported by relatively low-levels of evidence. The CPG “assessment of the current scientific and clinical information”1 does not result in an accurate description of “accepted approaches to treatment.”1 This is because accepted approaches to treatment, or guidelines, must be based on adequate evidence to set standards of practice.