Abstract
PDF- 2001;4;14-23The Role of Guidelines in Interventional Pain Medicine:Let Us Separate Apples and Oranges
A Focused Review
Laxmaiah Manchikanti, M.D, David Kloth, M.D, and Vijay Singh, M.D.
Practice guidelines are not only an ancient tradition, but they are a fact of life. The first guidelines were developed in the 1840s, shortly after the use of anesthesia was first demonstrated. Even though practice guideline development has spawned an impressive and overaggressive literature of its own, many unanswered questions exist with regard not only to practice parameters and guidelines in general, but in particular with the application of interventional techniques in managing persistent pain. In spite of the great potential of clinical practice guidelines, and the involvement of numerous medical societies and physician groups, there is still a great debate within the profession not only about the pros and cons of the development and usage of the guidelines, but also conflicting and controversial opinions on both sides of the issue, ie, providers and patients vs payors. This article discusses the development, usage, advantages, disadvantages and the implications of practice guidelines to interventional pain medicine specialists. Keywords: Interventional techniques, persistent pain, chronic pain, practice guidelines