An interesting e-mail landed on my desk asking me to remove a guideline from the TRIP Database. The guideline in question being Infectious Diseases Society of America practice guidelines for clinical assessment, treatment and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis. We link to this guideline via the American government’s National Guideline Clearinghouse. The reason for this request:

“I feel it is wholly inappropriate that this document is still on this website and being used as reference guide. The authors of this document have been subpoeaned by Conneticut Attorney General in the US over the likelihood of the breaking antitrust laws because of biased and warped content of this document, furthermore the document does not take into account of any other medical practises for the treatment of Lyme Disease and is not peer reviewed, please remove this document immediately as their could be legal consequences ensuing by practioners following this protocol.”

It caused me some concern as this is the first time someone has asked for material to be removed. So I did a bit of digging round:

1) It does appear that the Connecticut DA is looking into this.
2) There appears to be a great deal of controversy around Lyme disease (see, for instance The Dirty Truth About Lyme Disease Research or wikipedia entry The Lyme controversy).
3) The person contacting me stated that the guideline had not been peer-reviewed, yet I found that the peer-reviewed journal ‘Clinical Infectious Diseases’ published the guideline in 2006 (click here).

Some final thoughts:

  • Ultimately, we (at TRIP) are not in a position to arbitrate on this one, the Connecticut DA appears to be.
  • The statement “innocent until proven guilty” springs to mind.
  • Unless anything substantial appears as long as the National Guidelines Clearinghouse contain the guideline, so shall we.