The Infectious Diseases Society of America Lyme guidelines: a cautionary tale about the development of clinical practice guidelines

Flawed clinical practice guidelines may compromise patient care. Commercial conflicts of interest on panels that write treatment guidelines are particularly problematic, because panelists may have conflicting agendas that influence guideline recommendations. Historically, there has been no legal remedy for conflicts of interest on guidelines panels. However, in May 2008, the Attorney General of Connecticut concluded a ground-breaking antitrust investigation into the development of Lyme disease treatment guidelines by one of the largest medical societies in the United States, the Infectious Diseases Society of America (IDSA). Although the investigation found significant flaws in the IDSA guidelines development process, the subsequent review of the guidelines mandated by the settlement was compromised by a lack of impartiality at various stages of the IDSA review process. This article will examine the interplay between the recent calls for guidelines reform, the ethical canons of medicine, and due process considerations under antitrust laws as they apply to the formulation of the IDSA Lyme disease treatment guidelines. The article will also discuss pitfalls in the implementation of the IDSA antitrust settlement that should be avoided in the future.     

ISSUES AND IMPLICATIONS OF ESTABLISHING GUIDELINES FOR THE USE OF BEHAVIORAL TECHNIQUES

Several guidelines surrounding the use of behavioral procedures have recently appeared, the best of which is that of the National Association of Retarded Citizens (NARC). Some issues and implications of the establishment of guidelines are briefly reviewed in the context of the NARC guidelines. Issues include the factual versus opinion bases for guidelines and the need to continue the development of explicit behavioral criteria for assessing staff competence. Implications for programs include the impact of guidelines on professional boundaries, administrative decision-making, and budgeting, together with the dangers of expanding the regulatory bureaucracy. Several miscellaneous impacts are noted, including a potential for curbing innovative behavioral technology.     

Ethical Issues and Guidelines for Conducting Data Analysis in Psychological Research

Psychologists are directed by ethical guidelines in most areas of their practice. However, there are very few guidelines for conducting data analysis in research. The aim of this article is to address the need for more extensive ethical guidelines for researchers who are post–data collection and beginning their data analyses. Improper data analysis is an ethical issue because it can result in publishing false or misleading conclusions. This article includes a review of ethical implications of improper data analysis and potential causes of unethical practices. In addition, current guidelines in psychology and other areas (e.g., American Psychological Association and American Statistical Association Ethics Codes) were used to inspire a list of recommendations for ethical conduct in data analysis that is appropriate for researchers in psychology.     

Prayer in psychotherapy: a model for its use, ethical considerations, and guidelines for practice

Although few guidelines exist, many therapists use prayer as a part of psychotherapy. The immense variance inherent in prayer behaviors and the paucity of literature on its use beckons the profession to develop a model for its use in therapy, examine the ethical implications for such use, and prepare guidelines for practice. A tripartite model for the conceptualization and localization of prayer in therapy is presented, ethical issues of therapist bias and competence and clients' right to autonomous decision making are considered, and guidelines for employing prayer in psychotherapy are developed.     

Guidelines for Writing Letters to Patients

Patient letters provide a permanent record of the genetic counseling that was provided and are unique in medical care; rarely do other health care providers send summaries written specifically to their patients and families. We surveyed genetic counseling training program directors and found that while the acquisition of patient letter-writing skills was considered important, there were no specific guidelines made available to students. To develop letter-writing guidelines, we evaluated patient letters, reviewed references on professional correspondence, surveyed the medical literature, and worked with a writing consultant. The guidelines we subsequently developed and present here include a format for writing patient letters, suggestions on presenting medical information in understandable terms, and wording considerations. These patient letter-writing guidelines are intended to serve as a guide for teaching students this important skill and as a resource for practicing health care professionals.     

不同高血压治疗指南的比较与分析

为了更好的控制高血压的发病率和死亡率,达到对高血压患者的最佳和规范化治疗,各国家和地区的医疗机构均制定了相应的治疗指南,并及时进行更新和修正。由于这些指南之间存在着不同程度的差异,导致医疗工作者在学习和实践中产生了一定的困惑,通过运用哲学的思维和方法论对四种主要的高血压治疗指南的异同点进行比较和分析,有利于我国临床医师更好地将其运用于临床,从而更好地控制高血压患者的病情。     

Effectiveness of research guidelines in prevention of scientific misconduct

In response to a series of allegations of scientific misconduct in the 1980’s, a number of scientific societies, national agencies, and academic institutions, including Harvard Medical School, devised guidelines to increase awareness of optimal scientific practices and to attempt to prevent as many episodes of misconduct as possible. The chief argument for adopting guidelines is to promote good science. There is no evidence that well-crafted guidelines have had any detrimental effect on creativity since they focus on design of research studies, documentation of research findings, assignment of credit through authorship, data management and supervision of trainees, not on the origin and evolution of ideas. This paper addresses a spectrum of causes of scientific misconduct or unacceptable scientific behavior and couples these with estimates of the potential for prevention if guidelines for scientific investigation are adopted. The conclusion is that clear and understandable guidelines should help to reduce the chance that flawed research will escape from our institutions. However, they cannot be relied upon alone to prevent all instances of scientific misconduct and should be regarded rather as one means of bolstering the integrity of the entire scientific enterprise.     

Design and Development of the ITC Guidelines on Computer-Based and Internet-Delivered Testing

This article describes the design and development of the International Test Commission's (ITC, this issue) Guidelines for Computer-Based and Internet-Delivered Testing. It examines some of the reasons why the ITC Council decided to invest in a program of research, consultation, and conferences designed to develop internationally agreed-on guidelines specifically aimed at computer- and Internet-based testing and describes the methodology involved in developing and disseminating the guidelines. Through a process of reviewing relevant literature and organizing conferences and wide consultations, a set of internationally recognized guidelines that highlighted good practice issues in computer/Internet testing were developed. The guidelines will raise awareness among all stakeholders in the testing process of what constitutes good practice in computer/Internet testing and can be used as a benchmark to set local standards and guidelines. Further issues are raised from the research, not least the need to ensure that with advances in technology and science comes the updating of training in tests and testing to keep up with such advances.     

Psychological management intervention guidelines for rape survivors with post-traumatic stress disorder (PTSD): A brief exploratory systematic literature review

This exploratory systematic literature review aimed to characterise the current evidence on psychological management intervention guidelines for use with rape survivors with post-traumatic stress disorder (PTSD) symptoms. For the data searches we accessed the following electronic databases: Google Scholar, Science Direct, EBSCOhost, and PsychInfo. We utilised search terms with variations of the following key words: psychological management guidelines of PTSD*, rape survivors*. Inclusion criteria were guidelines for rape survivors with PTSD that consider referral, treatment, and preventive and health promotion in an international setting. We excluded guidelines that did not address PTSD resulting from rape in an international setting. We employed a narrative synthesis data analysis approach to integrate the evidence from across studies. Findings suggest prevalent guidelines for rape survivors with PTSD focus on cognitive behavioural therapy and other psychological management interventions in highly specialised areas and Primary Health Care (PHC) settings in international countries, but not in other countries such as South Africa. Emerging guidelines are needed for PTSD psychological management interventions in rape care clinics situated in South Africa.     

Guidelines and Ethical Considerations for Assessment Center Operations1

This document is an update of several prior editions of guidelines and ethical considerations for assessment center operations dating back to 1975. Each set of guidelines was developed and endorsed by specialists in the research, development, and implementation of assessment centers. The guidelines are a statement of the considerations believed to be most important for all users of the assessment center method. For instance, the use of job‐related simulations is a core concept when using the method. Job simulation exercises allow individuals to demonstrate their abilities in situations that are important on the job. As stressed in these guidelines, a procedure should not be represented as an assessment center unless it includes at least one, and usually several, job‐related simulations that require the assessee to demonstrate a constructed behavioral response. Other important areas include assessor selection and training, using ‘competencies’ as dimensions to be assessed, validation, participants' rights, and the incorporation of technology into assessment center programs. The current guidelines discuss a number of considerations in developing and using assessment centers in diverse cultural settings.     

From the lab to the police station. A successful application of eyewitness research

The U.S. Department of Justice released the first national guide for collecting and preserving eyewitness evidence in October 1999. Scientific psychology played a large role in making a case for these procedural guidelines as well as in setting a scientific foundation for the guidelines, and eyewitness researchers directly participated in writing them. The authors describe how eyewitness researchers shaped understanding of eyewitness evidence issues over a long period of time through research and theory on system variables. Additional pressure for guidelines was applied by psychologists through expert testimony that focused on deficiencies in the procedures used to collect the eyewitness evidence. DNA exoneration cases were particularly important in leading U.S. Attorney General Janet Reno to notice the eyewitness literature in psychology and to order the National Institute of Justice to coordinate the development of national guidelines. The authors describe their experience as members of the working group, which included prosecutors, defense lawyers, and law enforcement officers from across the country.     

Writing About Clients: Developing Composite Case Material and Its Rationale

Ethical guidelines of the 4 major professional associations representing counselors and psychotherapists are reviewed. To help clarify thinking about writing up clinical cases, 3 kinds of cases are described. The author concludes that the current guidelines for clinician‐authors in writing about clients for publication or presentation are contradictory and conflicting. The use of composite clinical case material is discussed as having a number of advantages over disguise or consent when writing about clients. Presented are guidelines for developing composite clinical cases and an example of how to use them effectively.     

The American psychological Association's practice guidelines for men and boys: Are they hurting rather than helping male mental wellness?

Introduced in 2018, the American Psychological Association's (APA) Practice Guidelines for Men and Boys was intended to provide helpful direction for practitioners when seeing male patients. This followed in the tradition of other practice and clinical guidelines for clinical work with specific identity populations. However, the practice guidelines for men and boys quickly became controversial given concerns that the guidelines were disparaging of men and boys, particularly those with traditional values and sought to impose progressive or feminist gender norms and ideologies rather than remaining focused on clinical wellness and empathy. This review finds that, though the guidelines were offered in good faith, many of the critiques are likely valid. Specifically, the guidelines failed to acknowledge significant evidence for biological influences on gender (e.g., hormonal, and hypothalamic influences on gender identity and gendered behavior), were unintentionally disparaging of traditional men and families, and were too closely wedded to specific sociocultural narratives and incurious of data not supporting those narratives. It is concluded that there are reasonable concerns that the current guidelines may do more harm than good by dissuading traditional men and families from seeking counseling.     

Scaffolding the design of accessible eLearning content: a user-centered approach and cognitive perspective

There exist various guidelines for facilitating the design, preparation, and deployment of accessible eLearning applications and contents. However, such guidelines prevalently address accessibility in a rather technical sense, without giving sufficient consideration to the cognitive aspects and issues related to the use of eLearning materials by learners with disabilities. In this paper we describe how a user-centered design process was applied to develop a method and set of guidelines for didactical experts to scaffold their creation of accessible eLearning content, based on a more sound approach to accessibility. The paper also discusses possible design solutions for tools supporting eLearning content authors in the adoption and application of the proposed approach.     

Application of multiple baseline designs in behavior analytic research: Evidence for the influence of new guidelines

The multiple baseline (MBL) design is a single‐case experimental design that has both research and applied utility. Although the concurrent and nonconcurrent MBL variants are valid designs, each rules out different threats to internal validity. To help clarify these differences, studies have provided guidelines for graphically depicting and distinguishing between concurrent and nonconcurrent MBLs. This study assessed the extent to which data‐presentation guidelines have been adopted by examining single‐case experimental design studies published in 3 behavior‐analytic journals from 2000 to 2015. Results suggest that data‐depiction guidelines have increased correct identification of concurrent multiple baseline designs but also indicate that these guidelines have not been universally adopted.     

Umgang mit sexuellem Missbrauch Minderj?hriger durch Kleriker, Ordensleute und andere Mitarbeiter

The guidelines of the Catholic Church from 2010 have picked up on new findings and experiences which have arisen since the first guidelines from 2002. The necessity of a forensic psychiatric assessment of the prognosis or the credibility has been emphasized for the first time. The disjuncture of therapy and control will be considered as well as the basic obligation to report sexual abuse to the authorities if there are strong indications for a suspicion, except when there is a complete denial by the assumed victim. The history of guidelines in connection with the changing scientific, social and clerical judgement of pedosexual contacts will be discussed.     

The method of psychobiography: presenting a step-wise approach

Psychobiography as a qualitative research method in psychology has witnessed prolific growth in the last few decades. This growth has been accompanied by concerns regarding the veracity, rigour, quality, and trustworthiness of psychobiographical research. Current research has gone a long way toward addressing these concerns through the publication of excellent best practice guidelines as well as criteria for evaluating the quality of psychobiographical research. However, a gap remains regarding guidelines detailing the steps involved in conducting psychobiographical research. This article addresses this gap by relying on existing psychobiographical guidelines and general qualitative research strategies to advance a step-wise approach to the conducting of a psychobiography. The aim is to provide simple and clear guidelines that can be followed when undertaking psychobiographical research. Through so doing, this article contributes to the continuous growth and improvement of the field of psychobiographical research.     

Guidelines for Counsellors Working with People of African Ancestry in a Sport Context

The objective this article is to describe five practice guidelines for counsellors working with people of African ancestry in a sport context. The practice guidelines pertain to counsellor training, counsellor perspectives, counsellor services, counsellor ethics and counsellor research. These practice guidelines can assist counsellors working with people of African ancestry in a sport context to focus on both personal development through sport and performance enhancement in sport. This will enable athletes not just to view sport in terms of their win-lose record, but to also strive for excellence in sport by becoming better people. In becoming better people athletes can contribute to building up Africa and her people.     

ICD-11 guidelines for psychotic,mood, anxiety and stress-related disorders in Mexico: Clinical utility and reliability

Background/Objective: The World Health Organization's diagnostic guidelines for ICD-11 mental and behavioural disorders must be tested in clinical settings around the world to ensure that they are clinically useful and genuinely global. The objective is evaluate the inter-rater reliability and clinical utility of ICD-11 guidelines for psychotic, mood, anxiety- and stress-related disorders in Mexican patients. Method: Adult volunteers exhibiting the selected symptoms were referred from the pre-consultation unit of a public psychiatric hospital to an interview by a pair of clinicians, who subsequently assigned independent diagnoses and evaluated the clinical utility of the diagnostic guidelines as applied to each particular case, on the basis of a scale developed for this purpose. Results: 23 clinicians evaluated 153 patients. Kappa scores were strong for psychotic disorders (.83), moderate for stress-related (.77) and mood disorders (.60) and week for anxiety and fear-related disorders (.43). A high proportion of clinicians considered all diagnostic guidelines to be quite to extremely useful as applied to their patients. Conclusions: ICD-11 guidelines for psychotic, stress-related and mood disorders allow adequate inter-rater consistency among Mexican clinicians, who also considered them as clinical useful tools.