Abstract
The development of consensus and the issuing of consensus guidelines in medicine and in perioperative medicine in particular appear to be potentially useful activities whose impact on patient outcome, however, remains unclear. The current approach based on the creation of semi-arbitrary groups of so-called experts who meet for a period of time, issue statements, guidelines, suggestions, and recommendations has several potential flaws but has not, until recently, been challenged by another approach. The arrival of a Web-based consensus process provides the first challenge to the current model and overcomes some of its limitations while potentially creating others. Which one of the two models will prove empirically superior and will become the dominant paradigm in within a decade or two remains uncertain.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Grocott MP, Pearse RM (2012) Perioperative medicine: the future of anaesthesia? Br J Anaesth 108:723–726
Chen K, Cheung K, Sosa JA (2012) Surgeon volume trumps specialty: outcomes from 3596 pediatric cholecystectomies. J Pediatr Surg 47:673–680
Mann CD, Palser T, Briggs CD et al (2010) A review of factors predicting perioperative death and early outcome in hepatopancreaticobiliary cancer surgery. HPB (Oxford) 12:380–388
Bellomo R, Bagshaw SM (2006) Evidence-based medicine: classifying the evidence form clinical trials—the need to consider other dimensions. Crit Care 10:232–240
Guyatt G, Gutterman D, Baumann MH et al (2006) Grading strength of recommendations and quality of evidence in clinical guidelines: report from an American college of chest physicians task force. Chest 129:174–181
Dellinger RP, Levy MM, Carlet JM (2008) Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2008. Intensive Care Med 34:17–60
Hicks P, Cooper DJ, The Australian and New Zealand Intensive Care Society (ANIZCS) (2008) Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Resusc 10:6–8
The NICE-SUGAR Study Investigators (2009) Intensive versus conventional glucose control in critically ill patients. N Engl J Med 360:1283–1297
Ranieri VM, Thompson BT, Barie PS et al (2012) Drotrecogin alfa (activated) in adults with septic shock. N Engl J Med 366:2055–2064
Boone D, Halligan S, Mallett S et al (2012) Systematic review: bias in imaging studies—the effect of manipulating clinical context, recall bias and reporting intensity. Eur Radiol 22:495–505
Bellomo R, Warrillow SJ, Reade MC (2009) Why we should be wary of single center trials. Crit Care Med 37:3114–3119
Rosenberg EI, Bass PF 3rd, Davidson RA (2012) Arriving at correct conclusions: the importance of association, causality, and clinical significance. South Med J 105:161–166
Cleophas TJ, Zwinderman AH (2007) Clinical trials: how to assess confounding and why so. Curr Clin Pharmacol 2:129–133
Landoni G, Rodseth RN, Santini F et al (2012) Randomized evidence for reduction in perioperative mortality. J Cardiovasc Anesth 26:764–772
Bellomo R, Weinberg L (2012) Web-enabled democracy-based consensus in perioperative medicine: sedition or solution? J Cardiothorac Vasc Anesth 26:762–763
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Bellomo, R. (2014). The Risks and Benefits of the Consensus Process. In: Landoni, G., Ruggeri, L., Zangrillo, A. (eds) Reducing Mortality in the Perioperative Period. Springer, Cham. https://doi.org/10.1007/978-3-319-02186-7_1
Download citation
DOI: https://doi.org/10.1007/978-3-319-02186-7_1
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-02185-0
Online ISBN: 978-3-319-02186-7
eBook Packages: MedicineMedicine (R0)