Lyme disease: guidelines need update in Nova Scotia



Many Nova Scotian doctors have a reputation for excellence. One way in which this is achieved is through the availability and use of clinical guidelines.

However, there are so many that it can be hard, given the time constraints doctors face, to stay current with regular updates and editions.

There are government web portals that make this a little easier: with the click of a mouse, the latest, revised edition of any particular disease guideline is available.

One such web portal is the National Guidelines Clearinghouse (NGC), a federal agency of the United States Department of Health and Human Services responsible for providing the most up-to-date clinical guidelines to physicians.

The NGC also removes those clinical guidelines that are no longer relevant, do not meet the requirements and standards of the Institute of Medicine Grading of Recommendations Assessment, Development and Evaluation (GRADE) requirements, and/or have not been revised in the last five years.

One can be assured that NGC clinical guidelines are the most current, evidence-based, peer reviewed, and of the highest standards.

A good example of how well the NGC works can be found by reading the recent news regarding the removal, in January of this year, of the Infectious Disease Society of America Lyme disease guidelines.

These guidelines were removed for the reasons stated in the previous paragraph. This does not leave physicians without clinical support for Lyme disease. There are still guidelines available on the NGC web portal for the diagnosis and treatment of Lyme disease.

These guidelines were revised in 2014. They meet (and exceed) the requirement and standards of the IOM GRADE recommendations, are evidence-based and peer reviewed.

The only evidence-based, peer reviewed, guidelines now available on the U.S. government NGC web portal for Lyme disease are the International Lyme and Associated Diseases Society Lyme disease guidelines.

The Nova Scotia Department of Health and Wellness, Doctors Nova Scotia and the College of Physicians and Surgeons of Nova Scotia are aware of the above. However, for some unknown reason, these organizations continue to use and promote the aforementioned outdated Lyme disease guidelines.

Since Lyme disease can be a debilitating and disabling condition if not caught early enough and not treated until symptoms have abated, I have requested a collaborative message be sent to all doctors in Nova Scotia, notifying them of the above facts, in time for Lyme Disease Awareness month in May.

I believe it is important to have wide dissemination from public institutions of facts that have a bearing on our health and wellness.

Jane Bailey has a background in science research and public health. She served in both the Canadian and U.K. armed forces and is currently an educator. She lives in Wolfville.

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