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.     

A preliminary analysis of instructional control in the maintenance of appropriate behavior

This bridge study evaluated the effects of contingency-specifying instructions (CSIs) and incomplete instructions (IIs) in terms of establishing instructional control of appropriate behavior. Results suggested that instructional control and maintenance were achieved with CSIs but not with IIs. Results are discussed in terms of the potential use of instructional control in the maintenance of appropriate behavior for children with attention deficit hyperactivity disorder.     

Stereotype Threat in Applied Settings Re‐Examined: A Reply1

This is a rebuttal to Danaher & Crandall's (2008 ) rejoinder to Stricker & Ward's (2004 ) article. The article reports 2 field experiments concerning the effects of inquiring about gender and ethnicity on the performance of women and Black students taking operational tests. The rejoinder's conclusion (after reanalyzing our data) that several thousand more young women would pass the AP calculus test if they were not asked about their gender, thereby reducing stereotype threat, is unwarranted because of flawed estimates and extrapolations. Our findings are selectively described, distorting their overall thrust. Criticisms of our statistical analyses are debatable or incorrect. Our original conclusion appears justified: Inquiring about gender and ethnicity did not affect test performance of women or Black students.     

When Small Means Comfortable: Relations Between Product Attributes in Two‐Sided Advertising

The processes that mediate the effectiveness of 2‐sided advertising were studied. We predicted that (a) 2‐sided (vs. 1‐sided) advertisements increase perceived source credibility and that (b) the logical relation between the negative and positive product attributes mentioned in the 2‐sided ad (e.g., little space, implying a cozy atmosphere) facilitates favorable inferences about the positive attributes, especially when recipients have sufficient time to process the message content. Results supported these predictions. However, the effects of message type and processing time on attitudes were mediated by inferences about positive attributes but not by perceived source credibility. Implications of these findings for consumer judgment and decision making are discussed.     

Language asymmetry and auditory attention in young adulthood after being born small-for-gestational age or with cardio-pulmonary resuscitation at birth.

A dichotic listening test with consonant-vowel syllables was used to assess language asymmetry and shift of attention in 42 young adults who had been in need of cardio-pulmonary resuscitation at birth, with a mild or moderate clinical course during the neonatal period (n = 31), or were born small-for-gestational age (SGA; n = 11) and compared with healthy controls (n = 17). All the participants were followed up prospectively and displayed no neurological or developmental deficits at 18 months of age. All the groups had an expected right-ear advantage during a baseline condition with no instructions to shift attention. The SGA group and the moderate resuscitated group displayed clear signs of an attenuation of the right-ear advantage and they were also less able to modify the ear preference in forced-attention conditions, compared with the control group. The main finding was that the groups with the most severe pre- and perinatal complications were also most affected on the dichotic listening test at adult age.     

Weber and Weimar: A response to Factor and Turner

In their critique, Factor and Turner attempt to substitute one commonplace for another by merely supplying long lists of publications that mention Max Weber. While accepting their reproof that I applied the concept of „influence”︁ too narrowly, my response endeavors to map out the directions that further research in this area will need to follow if the controversy is ever to move beyond jejune polemics.