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HHS Plans To Delete 20 Years of Critical Medical Guidelines Next Week (thedailybeast.com) 414

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 Not even an archived version of the site will remain, according to an official at AHRQ.

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HHS Plans To Delete 20 Years of Critical Medical Guidelines Next Week

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  • by NEDHead ( 1651195 ) on Friday July 13, 2018 @10:36PM (#56945398)

    They just can't stop themselves. Sad.

    • by rsilvergun ( 571051 ) on Friday July 13, 2018 @10:53PM (#56945466)
      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.
      • by Anonymous Coward on Friday July 13, 2018 @11:13PM (#56945558)

        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.

        • by Anonymous Coward on Saturday July 14, 2018 @01:53AM (#56945968)

          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.

          • by Joce640k ( 829181 ) on Saturday July 14, 2018 @04:50AM (#56946296) Homepage

            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.

            • by Agripa ( 139780 )

              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.

              How should it work? Puree the candidates and feed them to Congress.

          • by sjames ( 1099 )

            Not voting is just a way to say the election is between "turd sandwich" and "giant douche".

            To top it off, the current president didn't even turn out to be the least unpopular choice in the election, but won anyway.

            Only an egomanic fool would consider that an endorsement.

      • by GerryGilmore ( 663905 ) on Friday July 13, 2018 @11:16PM (#56945578)
        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.
        • by rsilvergun ( 571051 ) on Friday July 13, 2018 @11:41PM (#56945658)
          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.
          • by Solandri ( 704621 ) on Saturday July 14, 2018 @03:40AM (#56946166)
            2016 was different from 2000. In 2000 [wikipedia.org], 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 [wikipedia.org], 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 [nytimes.com]). We really need to switch to instant run-off voting [wikipedia.org], which is designed so that a candidate always gets a majority of votes before being declared the winner.
            • by CanadianMacFan ( 1900244 ) on Saturday July 14, 2018 @07:53AM (#56946624)

              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.

              • by currently_awake ( 1248758 ) on Saturday July 14, 2018 @08:33AM (#56946714)
                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.
              • by mpercy ( 1085347 ) on Saturday July 14, 2018 @02:39PM (#56948208)

                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...

                • 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 [motherjones.com]. 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 [jsonline.com], 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?

            • by fafalone ( 633739 ) on Saturday July 14, 2018 @01:51PM (#56947982)
              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".
        • As an old-school American patriot, it greatly saddens me to say that we deserve our declining fate.

          1) This was done to us deliberately by politicians who desire low-information voters. Like, all of them.
          2) Not all of us are like that, and the people who are don't listen to us. We're victims, and you're blaming us. That's abusive.

    • by nyet ( 19118 )

      What prevented the database from being copied/archived in the first place?

  • by SuperKendall ( 25149 ) on Friday July 13, 2018 @10:40PM (#56945420)

    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?

    • by fyzikapan ( 1223238 ) on Friday July 13, 2018 @11:04PM (#56945520)
      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.
    • by Anonymous Coward on Friday July 13, 2018 @11:18PM (#56945588)

      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.

      • Why? If wikipedia can host a much larger database, serve it to far more users per month, and fund the whole thing with donations from the public, why in the world does a smaller more specialised database geared towards doctors need government funding?

        Are all those poor MDs so empoverished that they can't afford a $3 donation every now and then?

        • by meglon ( 1001833 )
          You are still a fucking idiot. Government IS funded by the public, and it should be in the "business" of actually helping the citizens.... are you literally too fucking stupid to realize that?
    • Just HOW in da fuck can a medical database be "heavily politicized"?!?
      You "conservative"s (in quotes for a reason) make me sick!
    • by rsilvergun ( 571051 ) on Friday July 13, 2018 @11:47PM (#56945684)
      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.
    • What fucking moron moded you 'insightful'?

    • by q_e_t ( 5104099 )

      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?

      These things take time to organise, even assuming the database is allowed to be hosted elsewhere.

  • If it is too big for a single group or site to pull, then coordinate, distribute the slice load, and differentially pull the needed slices.

    Then, once the data is secured, see about establishing a trust or group to maintain it free of tiny orange hands.

  • by bugs2squash ( 1132591 ) on Friday July 13, 2018 @10:48PM (#56945448)
    This sounds like just the kind of content a private company would love to host. Lots of influential, wealthy eyeballs on it each day. Hell, they could probably sell a backup of the site to someone to get them a quick start.
    • At the bottom of the linked article, the agency says it would cost them "hundreds of thousands of dollars" each year to host even a static archive of the site - some text..

      If the agency is telling the truth, they don't know how to have a static site hosted for less than hundreds of thousands of dollars, somebody else should be doing it rather than them. That statement indicates they are either incompetent, dishonest, or both.

      • One hundred thousand dollars a year is enough to fund roughly one full-time senior engineer with the the broad skills to automate heavily and keep a bulky site with critical data alive. Anohter hundred thousand for one broadly skilled developer to keep the front end working and compatible with new browsers and new standards is also conservative. If we assume servers in AWS, at roughly $1/hour to support the necessary storage, backups, and web traffic for such a bulky system, hat is roughly $17,500/server p

    • by dryeo ( 100693 )

      If they try to monetize it through advertising, then they have to worry about the advertisers being happy with the content. Considering the target audience, the advertisers would probably be drug companies, companies that, for example, want the Doctor to start the insulin course as early as possible instead of when needed as it is more profitable.

  • It's going to take the next administration (if there is one) years to fix all the things that the trumpies have laid to waste, if they can be fixed at all.

  • Test anyone who wants to become a doctor.
    Have anyone interesting in entering medicine in the USA pass exams before getting accepted into starting any US medical education.
    Accept only the very best. Cant pass an exam on merit and be in the top percentage? Consider further university education outside medicine.
    Keep the testing and standards up until the medical professional has gradated.
    The person now allowed to practice medicine in the USA should be able to understand, learn and study at a very advan
    • That's the way it works in most countries. In the US, the MCAT is no cakewalk and serves as an entrance exam into med school, with a few other things like undergrad grades. Getting into medical school isn't easy, more difficult than it maybe even should be.

      In France, entrance into the first two years of medical school is open-admission, but then the exam required to continue on to the third to sixth year is brutal. Only the top 10% pass and the exam can only be re-taken once in a lifetime.

      • by AHuxley ( 892839 )
        Once any advance nation has that level of experts then they write their own books.
        Every doctor has their results peer reviewed. Not getting what all the other doctors can do on average? Time for a look at that doctor and their results.
        All kinds of issues per doctor quickly show up as all the other staff work to the best standards and their results are better.
        When doctors need stop and use a computer when they should know that to do something in the level of education has to be considered.
        • When doctors need stop and use a computer when they should know that to do something in the level of education has to be considered.

          What we have here is clear proof of Dunning-Kruger at work!

  • This was announced officially back in April.

    Back in February the HHS, which runs the office which runs this, released its budget request for the upcoming year. In it, they identified this as being duplicated in other governmental agencies and requested money to transfer the duties and money to different offices or agencies.
    The office than in April decided to kill this database even before any of that request to kill it off was approved by Congress and divert the money they were spending on it to someth
  • Is there any chance they will let the public sector copy this database before they just burn it along with all the books?

  • TFS says they're dropping the URL. Nothing about the database being deleted.

    And then there's TFA, which says that the group that maintains the database are looking for someone else to host it. Again, no suggestion that the database is being deleted.

    So, chill, people. It's not the end of the world. It's not even the end of medical science....

  • ... guess people are backing it up.
  • ... Be rich and/or don't get sick.

    Multiple Choice Quiz
    With regard to healthcare, the current Administration and Majority Party (not to name any names) doesn't really care about anyone: [select all that apply]

    (A) poor
    (B) sick
    (C) both A and B
    (D) all of the above

  • by reanjr ( 588767 ) on Saturday July 14, 2018 @03:05PM (#56948336) Homepage

    Is there anything stopping somebody from just downloading everything and hosting a mirror?

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