Department of Emergency Medicine, Medstar Washington Hospital Center, 110 Irving St, Washington, DC 20010, USA; Department of Critical Care Medicine, Medstar Washington Hospital Center, Washington, DC 20010, USA.
Department of Emergency Medicine, Medstar Washington Hospital Center, 110 Irving St, Washington, DC 20010, USA; Department of Critical Care Medicine, Medstar Washington Hospital Center, Washington, DC 20010, USA.
Med Clin North Am. 2022 Nov;106(6):1109-1117. doi: 10.1016/j.mcna.2022.08.006.
Even well-intentioned policies have great potential to cause harm. This statement is vividly illustrated by the influential, yet controversial, Surviving Sepsis Campaign guidelines and subsequent CMS benchmarks. Despite low-quality evidence, tendentious industry ties, and rebuke from the Infectious Disease Society of America (IDSA), these benchmarks continue to eschew therapy driven by clinician expertise and individual patient needs in favor of mandating an arbitrary, one-size-fits-all approach that suspends clinical judgment and promotes indiscriminate use of treatments that have the potential to cause great harm.
即使是出于善意的政策也有很大的潜在危害。这一说法被具有影响力但颇具争议的“拯救脓毒症运动指南”和随后的 CMS 基准生动地证明了。尽管证据质量低、行业关系有倾向性,而且受到传染病学会(IDSA)的谴责,但这些基准仍然回避了由临床医生专业知识和个体患者需求驱动的治疗方法,而倾向于强制实施一种一刀切的、一刀切的方法,暂停临床判断,并促进不加区别地使用可能造成巨大伤害的治疗方法。