HHS Plans To Delete 20 Years of Critical Medical Guidelines Next Week (thedailybeast.com)

An anonymous reader quotes a report from The Daily Beast: The Trump Administration is planning to eliminate a vast trove of medical guidelines that for nearly 20 years has been a critical resource for doctors, researchers and others in the medical community. Maintained by the Agency for Healthcare Research and Quality [AHRQ], part of the Department of Health and Human Services, the database is known as the National Guideline Clearinghouse [NGC], and it's scheduled to "go dark," in the words of an official there, on July 16. "Guideline.gov was our go-to source, and there is nothing else like it in the world," King said, referring to the URL at which the database is hosted, which the agency says receives about 200,000 visitors per month. "It is a singular resource," Valerie King, a professor in the Department of Family Medicine and Director of Research at the Center for Evidence-based Policy at Oregon Health & Science University, added. [She] said the NGC is perhaps the most important repository of evidence-based research available.

Medical guidelines are best thought of as cheatsheets for the medical field, compiling the latest research in an easy-to use format. When doctors want to know when they should start insulin treatments, or how best to manage an HIV patient in unstable housing -- even something as mundane as when to start an older patient on a vitamin D supplement -- they look for the relevant guidelines. The documents are published by a myriad of professional and other organizations, and NGC has long been considered among the most comprehensive and reliable repositories in the world. AHRQ said it's looking for a partner that can carry on the work of NGC, but that effort hasn't panned out yet. Not even an archived version of the site will remain, according to an official at AHRQ.

Comments

The Administration that Keeps On Taking

[NEDHead]

They just can't stop themselves. Sad.

Re: The Administration that Keeps On Taking

[Hognoxious]

They had a meeting about it, but afterwards nobody could read the notes they took.

So actually no value then

[SuperKendall]

Nix has been helping coordinate an effort to get some outside stakeholder to take over the site's operations. She said she's still hopeful, and even days before the siteâ(TM)s scheduled demise, AHRQ spokesperson Hunt told the Daily Beast that the search continued.

So if it were truly a valuable resource where are the charities or groups of large insurance firms or hospitals willing to pay for this to be kept up?

The article mentioned how the database had been heavily politicized in the past, is it possible the value of this database is less than we are being told by the article writer?

Re:So actually no value then

[fyzikapan]

Actually the article makes clear that this source is particularly good because it makes a serious effort to vet articles and weed out the ones that are just pushing a company's agenda.

The administration really has no good argument for getting rid of it. The budget problem is entirely self-inflicted. Claims that it is politicized aren't particularly convincing considering that people who wound up in the Trump administration are the ones who tried to politicize it in the first place.

Re: So actually no value then

[fyzikapan]

Far better to be ignorant and have people die needlessly than to suffer the horror of a government-provided collection of medical best practices.

The private sector isn't magic. Hand this to the private sector and you'll wind up with something that's just drug pimping.

America elected an anti-government

[rsilvergun]

and anti-science administration. I'm not saying this to troll. We (or the 45% who voter for him) knew exactly what they were getting. Americans have been kicked around non stop for 40 years and unfortunately instead of blaming the billionaires that outsourced their jobs and brought in cheap labor to replace what they couldn't outsource they blamed "elites"; e.g. scientists and college professors. You know, nerds. And, well, this is the result.

Re: America elected an anti-government

[TheMiddleRoad]

The article is about deleting a valuable health database. Your response is to blame the unions. You're a moron. An abject shithead. For goodness sake, don't have children.

Re:America elected an anti-government

[Anonymous Coward]

Point of fact: ~20% voted for him, not 45%. ~21% voted Clinton, another ~1% wasted their votes on throwaway protest "message" which effectively let Trump eke out an electoral victory. The others, nearly 60% of the US population, did not vote at all.

Re:America elected an anti-government

[GerryGilmore]

I've got mod points, but I'm gonna burn them here to support you more fully.
Specifically, we collectively - as Americans - have allowed ourselves to become incredibly stupid and brain-washed to the point that we prioritize who kneels at a sports game over who will guarantee a civilized level of medical coverage for all citizens.
As an old-school American patriot, it greatly saddens me to say that we deserve our declining fate.
When the President and Vice-President regularly appear on idiot shows (Fox and Friends, Hannity and Limbaugh, the epitome of "irritable mental gestures which seek to resemble ideas") to get their political blowjiobs and the broad electorate elects them...again, we deserve our fate of decline. Jesus wept.

Re: America elected an anti-government

[Anonymous Coward]

Anytime someone blames unions you can bet they consider themselves "fiscally conservative" and they vote R almost exclusively. But in this case I'm guessing they probably call themselves "libertarian" which means they want to do away with all taxes and regulations. They claim that they really believe that the general public will step forward and take care of everything the government currently does through private donations and private businesses will get the money and not government employees and red tape. The problem is that nobody who suddenly has an extra 25% or more income is going to immediately turn around and give that money out to people to do what the government did with our taxes.

My older brother is a good example of a modern American libertarian. He doesn't want to pay property taxes because he doesn't have kids and is 50. He doesn't think he should be paying taxes for public schools on his property. I asked him who should and he said people with children. When I pointed out to him that not very many parent could afford to send their children to what would basically become private schools he said that wasn't his problem they shouldn't have kids. I asked him if he would set aside the same % of his income he pays in taxes to support the programs and infrastructure that money currently goes to. He said he would take a look at what he wanted to support and put some of his income into that. He wouldn't say that he would give what he currently pays in taxes.

He is just another person who wants to keep more for themselves. He would not give a penny to anything because he thinks his income is his and poor people should just stop being poor. He thinks the roads and bridges will just build and maintain themselves and people will volunteer to serve in the military for free and that business will build all the weapons they need at no cost out of the goodness of their hearts. Conservative and Libertarian voters are basically one in the same. They simply don't care about what happens to everyone else as long as they get a bigger piece of the pie.

Both parties blame everything on the government and unions because it's an easy target and gives voters something to focus their anger on. I generally just ignore them because they never have any evidence to back up their claims. They can never post any peer reviewed studies to back their claims or any statistics from any official sources. It's all from websites that cater to that voter base and the only links those articles will have go to another similar website with what is basically the same article worded a little differently. They are full of solutions but every solution they offer always benefits them at the expense of others. They are not willing to make any sacrifices for the good of the country or the good of humanity as a whole. The only thing they care about is adding to what they already have. In most cases they already have more than most people but they want to get a new $250,000 RV to park at the lake where they have their $90,000 boat docked. So they blame unions and the government and vote for people who make bad laws that hurt the most vulnerable citizens of the nation and who embarrass the country in front of the rest of the world. Just so they can keep an extra few % of their income so they can add another toy to their collection.

Re: America elected an anti-government

[Anonymous Coward]

Not voting is effectively endorsing the winner. You don't care who wins.
When people quote these figures they are implying that the non-voters oppose the winner, but that is not the case.
If you don't vote, you are equally responsible for the result as those who vote for the winner.

Re: America elected an anti-government

[Joce640k]

Not voting is effectively endorsing the winner. You don't care who wins.
When people quote these figures they are implying that the non-voters oppose the winner, but that is not the case.
If you don't vote, you are equally responsible for the result as those who vote for the winner.

Either that or you didn't want to vote for any of them.

What "democracy" really needs is a meaningful "none of the above" box on the voting papers.

How should it work? If the number of people who vote "none of the above" is greater than the difference between the top two candidates then it should force a new election with new candidates.

Re: America elected an anti-government

[Anonymous Coward]

"I've never met anyone who cares more about kneeling than healthcare; only a blowhard would claim that "Americans collectively" do."

This statement is so demonstrably false as to be downright silly. There are a *lot* of people that care more about football players kneeling than about healthcare policy. Further, the general American focus is undeniably more on kneeling athletes than healthcare.

How can you tell? Because the people upset about the athletes learn their names. They know exactly who has betrayed their concept of "patriotism" in their favorite hobby. Meanwhile, the people who are "more or less fine with the way things are" don't even bother learning *anything* about healthcare policy. These people say "The government needs to keep its hands off my medicare" while opposing medicare. They believe outright ludicrous lies like "government death panels that decide to kill grandma" without putting forth the slightest effort to learn why that's so patently fictional.

Sounds more like you're either out of touch with what Americans actually care about, or you're just absorbed in your own bullshit cognitive biases that cause you to reactively defend your "team" regardless of the available facts. Probably both.

Re: America elected an anti-government

[apoc.famine]

Absolutely correct.

The GP has tried to work around the problem rather than finding a solution for it. The solution is preferential or ranked voting.

As an example of how this works, see what Maine just did for their primaries. And that's what will happen there in November too.

Yes, it's more complicated, but it's far less complicated than the "solution" that the GP describes. Imagine that happening twice in a row!

It has lots of value

[Anonymous Coward]

It may have no commercial value, so no-one can make a profit from it.
But it can still have huge social value as general knowledge for medicine.

This is just the kind of thing the government should do.

I don't think we deserve our fate

[rsilvergun]

for one thing less than 50% of us choose that fate. It's only because of a messed up political system designed specifically to favor wealthy land owners (seriously, look it up, the electoral college, senate and even the SCOTUS were all checks not on the president but on the voters).

There's a lot out of folks hands. Hell, I'm stuck in a red state with a ton of problems I wouldn't have healthcare wise if I lived back east or even California. Why am I stuck here? Mom moved me here when I was 6 and by the time I was old enough to know better I couldn't afford to move. This country crushes people, and when it does you can't just go where life doesn't suck. You've got to make due with what you got.

Re:I don't think we deserve our fate

[Solandri]

2016 was different from 2000. In 2000, Gore won a plurality of the popular vote (but not a majority), and liberal parties (Gore + Nader) won a majority of the popular vote. The Electoral college did not reflect a majority of the popular vote in 2000.

In 2016, Clinton won a plurality (but not a majority) of the popular vote. However, Conservative parties combined won more popular votes than liberal parties combined (49.88% vs 49.13%, with the rest being cast for candidates without a party affiliation). So in 2016, the Electoral College awarded the election to the candidate whose ideology came closest to winning a majority of votes, rather than the individual who came closest to winning a majority. I didn't vote for Trump, but he was probably the correct winner in 2016.

People like to criticize the Electoral College. But IMHO the plurality-wins system they propose be used instead is nearly as bad (consider the California primaries where some candidates won one of two slots in the general election with barely 20% of the vote). We really need to switch to instant run-off voting, which is designed so that a candidate always gets a majority of votes before being declared the winner.

Re:I don't think we deserve our fate

[CanadianMacFan]

Probably the best thing to do would be to stop the gerrymandering of the districts. In Canada there is an independent third-party organization that sets the ridings (districts) according to a strict set of rules.

Re:I don't think we deserve our fate

[currently_awake]

Or Proportional Representation where you add up the votes nation wide and you get a percent of the seats equal to your percent of the votes.

Re:I don't think we deserve our fate

[fafalone]

Sorry, conservative parties? Libertarians might have supported Trump slightly more than Clinton as I just posted about above; but it's hardly unanimous, and it's absurd to call them a conservative party and chalk their votes up to the right. If you break it down point-by-point by ideology, Trumps didn't even come close to winning, because Libertarians diverge in majority percentages in just about every area outside domestic economics and regulatory issues (some; for instance NN has majority support among (L)). Trumps social conservatism, criminal justice policies, international trade policies, foreign intervention policies, and more, are all deeply offensive to most libertarians.
I've heard some ridiculous spin before to try to get past the fact you lost the popular, but claiming libertarians are conservatives and count towards conservative ideology is one of the great manipulations that sounds intelligent to people who have no idea what libertarians actually stand for. And the bottom line, the electoral college is a system that says "you live in a rural area, so your vote counts for more".

Bernie Sanders

[rsilvergun]

or hell, even Hilary Clinton. Yeah, she's a right wing corporatists bitch, but at least she isn't openly anti-science. As terrible as she was/is it's always better to pick the lesser of two evils.

Re: Bernie Sanders

[giggleloop]

At least some of those were policy/opinion changes she made over the course of several decades. If she held the same views in 2016 as she held in 1986, she'd be an idiot. Trump's lucky if his policy opinions are the same at the end of a sentence as they were when he started it.

Re:Compared to what?

[GerryGilmore]

I wrote-in Bernie. Living in North Georgia, I knew that Trump would win Georgia anyway so I voted for the guy who would have wiped the floor with Trump.
I say that knowing that 90%+ of Trump's vote was actually ABC (Anybody But Clinton).

Um... there utterly and completely overwhelmed

[rsilvergun]

you do know we just spent the last 40 years systematically dismantling the social safety net so we could make way for tax cuts for billionaires, right?

In the entire history of humankind charity has never once solved any problem long term. It's always been civilization in the form of government that did. A few nice people at the middle can't make up for the bad done by folks up at the top. Complex, widespread problems (like public health) need comprehensive solutions done an a society wide scale. You and me dropping change into a plastic bucket twice a year is not a viable solution to the world's problems.

Re:So what? not really needed and this was well kn

[lastman71]

Not really needed by some pharmaceuticals lobby, maybe?

https://www.propublica.org/art...

Also you should remember:

"Price was the first director of HHS, AHRQ's parent agency, under the Trump Administration, before resigning under pressure last year over his spending on chartered flights."

And of course people appointed by Trump Administration think it's a duplicate. How convenient... Less money spent in research, more budget available for chartered flights!

Re:Perhaps you should read the entire article

[Cinnamon Beige]

What I see on Slashdot is an awful lot of non-doctors (myself included) pontificating on this move. Is it really widely used? I don't know. All *I* (and the rest of you) have to go on is the demonstrated value which currently is zero as there are no takers to carry on this data.

Not a doctor yet, but I am a biomedical nerd and aware of how useful those in the research area tend to consider best practices guidelines--and my first question about this actually was "Why is this not at NIH?"

The general rule of thumb is that the lag time is too long between where the research says are the medical best practices and what any published list anywhere will say--part of this is because, to put it bluntly, most doctors aren't particularly into research and don't keep up with it. Those best practices databases aren't going to be getting kept up-to-date and current, and I honestly don't think there's a solution for this short of starting from scratch--if nothing else, because each and every entry should have a date on it saying when it was last checked on and it should be routinely gone into to add data. There is no such thing as too much data if you're trying to figure out what works in which populations; the more you have, the more certain you can be...and the more likely you are to be able to pin down which populations that have strange responses, which is pretty much a basic requirement if you want to do anything more than shrug and move on...and it's also a requirement for improving and fine-tuning the evidence.

Re:Compared to what?

[serviscope_minor]

I say that knowing that 90%+ of Trump's vote was actually ABC (Anybody But Clinton).

I really don't get the attitude of "we hate clinton so much we'll vote for someone far worse!".

I also don't get the hate for Clinton (actually I do). I mean she's basically another poltician and has the same sort of patina that people grudgingly accept on most other politicians. And yet she gets far, far more hate for it. I wonder why...

Re:Compared to what?

[phantomfive]

I really don't get the attitude of "we hate clinton so much we'll vote for [anyone else]!".

I'm not sure very many people have that attitude. The Trump supporters I know actively like him (that's why they're supporters). Everyone I've talked to who voted for him can articulate some reason why they think he is better than Hillary. It's not always a fact-based reason, but they feel like they voted for the best candidate.

Re:Compared to what?

[Hognoxious]

I don't think it's because she's a woman, if that's what you mean. Remember Sarah Palin? And Obama was, well, you know...

There were a few iffy things in her past - nothing proven, but mud sticks. She has the charisma of a tepid lettuce. And the whole dynasty thing, though I suspect we ain't seen nothin' yet on that front.

The survivors in 2050 or so might speak of 1776 as being the First American Revolution.

Re:Compared to what?

[serviscope_minor]

Everyone I've talked to who voted for him can articulate some reason why they think he is better than Hillary. It's not always a fact-based reason,

Well, that's part of the problem. Lots of people here seem to be willing to believe outright lies in order to justify the thought that Trump was less bad than Hillary. The thing is they have an irrational hatred for Hillary and won't vote for her no matter what.

Re:Compared to what?

[serviscope_minor]

Very true:

Hillary told lies so I voted for an much bigger liar. My point exactly.

Gerrymandering has almost ZERO impact

[mpercy]

Gerrymandering has almost ZERO impact on US Presidential elections.

Unless one considers state borders to be gerrymandered. Because 48 states use a winner-takes-all method for allocating electoral college votes. That is, the person receiving the most presidential votes within a state gets all the EC votes from the state. Maine and Nebraska have different rules that are impacted somewhat by district lines, but they have so few districts that its hard to figured gerrymandering has much impact. Maine has all of two districts, with Augusta and Portland and the section of the state between them comprising one district, and the rest of Maine the other, and Nebraska has 3 and their map is hardly what I'd consider gerrymandered, with the tow countries comprising Omaha in one, the suburbs of Omaha in another, and the rest of the state comprising the 3rd.

Further, gerrymandering does not impact Senate seats either. Senate seats are at-large within each state (no districts, only state borders).

Gerrymandering does impact the House of Representatives. It also impacts State legislature seats.

But please stop throwing gerrymandering around as a problem for Presidential elections...

Re:Gerrymandering has almost ZERO impact

[apoc.famine]

You are absolutely incorrect. I can understand why it doesn't seem like it could impact national elections, but it absolutely does.

Gerrymandering has allowed mostly republicans to hold onto state legislative majorities while receiving far less than half the vote. In 2012 in Wisconsin, Democrats won 52% of the aggregate vote but only 39% of the seats in the Assembly.

That majority in state legislature has allowed republicans to install laws designed to prevent voting, which disproportionately impacts democratic voters. If likely democratic voters aren't allowed to vote at all, national elections are absolutely impacted by gerrymandering.

As a great example, look at Wisconsin. While I know Mother Jones isn't necessarily a great source, feel free to click through and listen to the interview where Wisconsin Attorney General Brad Schimel says:

How many of your listeners really honestly are sure that Sen. Johnson was going to win reelection or President Trump was going to win Wisconsin if we didn’t have voter ID to keep Wisconsin’s elections clean and honest and have integrity?

It should be noted that you can count the voter fraud convictions in WI over the last decade on one hand. "if we didn’t have voter ID to keep Wisconsin’s elections clean and honest" is absolutely saying, "if we didn't have Voter ID to keep democrats, especially blacks, from voting".

23k-45k voters are estimated to have not been able to vote due to the voter ID law. Trump won the state by 22k votes.

If the state wasn't gerrymandered, that law wouldn't have passed, and those people would have voted. The supreme court has decided to pass on this lawsuit, because apparently the democrats didn't have standing? Apparently it will take someone losing a gerrymandered district to sue, and then proving that it was the gerrymandering that caused it. I.E., gerrymandering by political parties is fine according to the supreme court. That's fucked up, and pretty undemocratic.

But we got a supreme court that thinks this way in part due to gerrymandering. How's that for full circle?

False dichotomy

[rsilvergun]

You're suggesting a strong social safety net with guarantees of healthcare, food and shelter would result in miserable and isolated people. As if people can only make friends if they're in a constant state of desperation. No matter what you saw in a jug band once poverty does not bring people together. Money is the #1 cause of divorce you know? People can be economically secure and happy.

San Fransicso's problem is that it's stuffed with people who don't want to live there but do so because that's where the work is. They're unhappy because the city is a bad fit for them, but when you've got no social safety you can't take risks like moving to a smaller city with less job opportunities and worse schools for your kids. So you suck it down. For the people who _want_ to live in San Fransisco it's a paradise and they'd never leave.

Basic income's a great way to solve this. People could live where they want to instead of where they have to to find work. Also, it would be a nice way to distribute the productivity gains from the last 40 years (which have doubled).

Or we could do your way and keep giving all the gains to the rich plus a huge chunk of what the working class already has. That's what we've been doing for 40 years. How's that turning out for you, Mr takes time out of their day to post a bitter rant on /.?