Lyme Disease Guideline Comparison
from
| GUIDELINE TITLE | Evidence-based guidelines for the management of Lyme disease. | Practice guidelines for the treatment of Lyme disease. |
| DATE RELEASED | 2004 | 2000 July (revised 2006 Jun) |
| ADAPTATION | Not applicable: The guideline was not adapted from another source. | Not applicable: The guideline was not adapted from another source. |
| GUIDELINE DEVELOPER(S) | International Lyme and Associated Diseases Society — Disease Specific Society | Infectious Diseases Society of America — Medical Specialty Society |
| SOURCE(S) OF FUNDING | International Lyme and Associated Diseases Society (ILADS) | Infectious Diseases Society of America (IDSA) |
| COMPOSITION OF GROUP THAT AUTHORED THE GUIDELINE | Daniel Cameron, MD, MPH, Internal Medicine and Epidemiology; Andrea Gaito, MD, Rheumatology; Nick Harris, PhD, Immunology; Gregory Bach, DO, Family and Integrative Medicine; Sabra Bellovin, MD, Family Practice; Kenneth Bock, MD, Family Practice; Steven Bock, MD, Family Practice; Joseph Burrascano, MD, Internal Medicine; Constance Dickey, RN, Registered Nurse; Richard Horowitz, MD, Internal Medicine; Steven Phillips, MD, Internal Medicine; Laurence Meer-Scherrer, MD, Internal Medicine; Bernard Raxlen, MD; Psychiatry; Virginia Sherr, MD, Psychiatry; Harold Smith, MD, Emergency Medicine; Pat Smith, President, Lyme Disease Association, Inc.; Raphael Stricker, MD, Hematology and Immunotherapy. | Gary P. Wormser, Robert B. Nadelman, Raymond J. Dattwyler, David T. Dennis, Eugene D. Shapiro, Allen C. Steere, Thomas J. Rush, Daniel W. Rahn, Patricia K. Coyle, David H. Persing, Durland Fish, and Benjamin J. Luft. |
| CONFLICTS OF INTEREST | Not stated | Not stated |
| DISEASE/CONDITION(S) | Lyme disease | Lyme disease |
| GUIDELINE CATEGORY | Diagnosis — Evaluation — Management — Treatment | Management — Prevention — Treatment |
| CLINICAL SPECIALTY | Emergency
Medicine Family Practice Infectious Diseases Internal Medicine Nursing Psychiatry Rheumatology |
Family
Practice Infectious Diseases Internal Medicine Neurology Rheumatology |
| INTENDED USERS | Advanced
Practice Nurses Nurses Physician Assistants Physicians Public Health Departments |
Allied
Health Personnel Physicians |
| GUIDELINE OBJECTIVE(S) |
|
To provide clinicians and other health care practitioners with recommendations for the management of patients diagnosed with Lyme disease, or patients bitten by an Ixodes tick in North America |
| TARGET POPULATION |
|
Patients with Lyme disease or patients bitten by an Ixodes tick in North America |
| MAJOR OUTCOMES CONSIDERED | In developing these treatment guidelines, the guideline developers considered factors such as incidence of Lyme disease; severity of disease in terms of morbidity; co-morbidities and determinants of when Lyme disease is most likely to become chronic; feasibility, efficacy, and cost of antibiotic treatment; impact of antibiotic therapy on quality of life, including adverse drug events; and the potential for drug resistance to develop. |
|
| COST ANALYSIS PERFORMED/REVIEWED? (YES/NO) | No | No |
| METHODS USED TO COLLECT/SELECT EVIDENCE |
Hand-searches
of Published Literature (Primary Sources) |
Searches of Electronic Databases |
| DESCRIPTION OF METHODS USED TO COLLECT/SELECT THE EVIDENCE | English-language articles published from 1975 to 2003 were selected. The selection panel synthesized the recommendations from published and expert opinion. Human studies of Lyme disease were identified from MEDLINE (1975 to 2003) and from references in pertinent articles and reviews. Also included were abstracts and material presented at professional meetings and the collective experiences of the International Lyme and Associated Diseases Society (ILADS) Working Group treating tens of thousands of Lyme disease patients. | Not stated |
| METHODS USED TO ASSESS THE QUALITY AND STRENGTH OF THE EVIDENCE | Weighting According to a Rating Scheme (Scheme Given) | Weighting According to a Rating Scheme (Scheme Given) |
| RATING SCHEME FOR THE STRENGTH OF THE EVIDENCE |
Quality of the Data I. At least one randomized controlled trial supports the recommendation II. Evidence from at least one well-designed clinical trial without randomization supports the recommendation III. “Expert opinion” |
I. Evidence from at least one properly randomized, controlled trial II. Evidence from at least one well-designed clinical trial without randomization, from cohort or case-controlled analytic studies (preferably from more than one center), from multiple time-series studies, or from dramatic results of uncontrolled experiments III. Evidence from opinions of respected authorities based on clinical experience, descriptive studies, or reports of expert committees |
| METHODS USED TO ANALYZE THE EVIDENCE | Review | Review of Published Meta-AnalysesSystematic Review |
| METHODS USED TO FORMULATE THE RECOMMENDATIONS | Expert Consensus | Not stated |
| DESCRIPTION OF METHODS USED TO FORMULATE THE RECOMMENDATIONS | Not stated | Not stated |
| RATING SCHEME FOR THE STRENGTH OF THE RECOMMENDATIONS |
Recommendations rated A.
Good evidence to support the recommendation. |
Strength of recommendation: A.
Good evidence to support a recommendation for use |
| METHOD OF GUIDELINE VALIDATION | Peer Review | Peer Review |
| DESCRIPTION OF METHOD OF GUIDELINE VALIDATION | Not stated | Not stated |
| CLINICAL ALGORITHM? (YES/NO) | No | No |
| IMPLEMENTATION PLAN DEVELOPED? (YES/NO) | No | No |
| HAS PATIENT INFO? (YES/NO) | No | No |
