[For those not familiar with ILADS (International Lyme and Associated Diseases Society), it is the main voluntary organization for medical personnel [and others] who take a focused view of Lyme disease and its co-infections such as babesia, bartonella, and others, providing serious analysis and commentary on research and advances about Lyme disease and its co-infections.
[ILADS is, in my view, the main counterweight to positions on Lyme diagnosis and treatment as taken by the Centers for Disease Control (CDC), an arm of the Federal government reaching into every aspect of health, disease, injury, safety, environmental isssues, and other aspects affecting all of us. The CDC means well, but in fast-moving areas of medicine like Lyme disease, the CDC moves slowly and tends to cling to previous views. Lyme ticks, however, move much faster than the CDC.]
Here is the text of today's ILADS news release, for those interested:
ILADS treatment guidelines are now listed on the National Guidelines Clearinghouse Website.
(Sept 21, 2015) — The Centers for Disease Control and Prevention (CDC) estimates that more than 300,000 new cases of Lyme disease occur annually in the US. ILADS guidelines, Evidence Assessments and Guideline Recommendations in Lyme disease: The Clinical Management of Known Tick Bites, Erythema Migrans Rashes and Persistent Disease” bring the latest scientific evidence to bear on the management of the illness. ILADS is proud to announce their guidelines are now available on the National Guidelines Clearinghouse (NGC) website.
The National Guidelines Clearinghouse (NGC) is an initiative of the Agency for Healthcare Research and Quality (AHRQ), under the umbrella of the U.S. Department of Health and Human Services. The NGC recently adopted the Institute of Medicine (IOM) standards for developing trustworthy guidelines, which define the highest level of excellence that a guideline can achieve. Guidelines posted on the NGC website must now satisfy these standards. Thus, the inclusion of ILADS’s peer reviewed guidelines on the NGC website demonstrates that they meet the level of excellence called for by the IOM.
ILADS is the first organization to issue guidelines on Lyme disease that were developed in accordance with the IOM standards. The document provides a detailed review of the pertinent medical literature and contains the first set recommendations for Lyme disease based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process. This rigorous review format is also used by many other well-respected medical organizations including the World Health Organization (WHO), the American College of Physicians, and the National Institute for Health and Clinical Excellence (NICE) in the UK. ILADS guidelines are the only Lyme disease guidelines that included a patient from the Lyme community as an author or as a member of the guidelines development panel.
ILADS’ GRADE-based analyses found the evidence was of very low quality and regimens based on randomized controlled trials often failed. “For this reason, we moved away from designating a fixed duration for antibiotic therapy and instead encourage clinicians to tailor therapy based on the patient’s response,” noted Cameron, author and president of ILADS.
“We not only recommend that clinicians perform a deliberate and individualized assessment of the potential risks and benefits of various treatment options before making their initial selection, we also recommend careful follow-up because this allows them to adjust therapy as circumstances evolve. This patient-centered approach should reduce the risk of chronic illness due to inadequate antibiotic therapy.” said Elizabeth Maloney, MD, a guidelines coauthor and provider of continuing medical education courses on tick-borne illnesses.
The guidelines include share medical decision making and take patient values into consideration. Lorraine Johnson, JD, MBA, a coauthor and Chief Executive Officer of LymeDisease.org, said “A lot of the treatment decisions in Lyme disease depend on trade-offs. How sick is the patient, how invasive is the treatment, what is valued by the patient? Patients need to understand the risks and benefits of treatment options to make informed medical choices. These guidelines provide that information.”
ILADS is a nonprofit, international, multidisciplinary medical society dedicated the appropriate diagnosis and treatment of Lyme and associated diseases. For more information, visit www.ILADS.org.