James Sowers

Cardiovascular risk modification in participants with coronary disease screened by the Kidney Early Evaluation Program

Background: Coronary artery disease (CAD) identifies the need for intensive treatment of risk factors among individuals with chronic kidney disease (CKD), a high‐risk, complex cardiovascular risk state.

Expertise: No Longer a Sine Qua Non for Guideline Authors?

See Related Editorial, pp 238–239 nn> Quis custodiet ipsos custodes?—Who will guard the guards themselves? n> n> —Decimus Iunius Iuvenalis (Juvenal), 1st–2nd century AD, Satire VI, lines 347–348nnGuidelines are traditionally scripted by a panel of experts who are intimately familiar with the topic in question. Practicing physicians inherently trust guideline authors and rarely ever question their expertise, especially when guidelines are endorsed by such venerable societies as the American College of Physicians (ACP) and the American Academy of Family Practitioners (AAFP) and are published in high-impact journals, such as the Annals of Internal Medicine . The >250u2009000 members of the ACP and AAFP have come to expect that any set of clinically meaningful guidelines has been put together by authors who were selected because of their outstanding skills and expertise pertaining to the topic in question. Thus, there is little if any reason to voice doubt as to the validity of published guidelinesnnThe Free Dictionary defines expertise as special skills or knowledge acquired by a person through education, training, or experience. For a physician unfamiliar with the experts, there are several simple ways to get a grasp on the quality and quantity of expertise:nn1. One can scrutinize the publication list of the experts to assess how often they have been involved with the guideline topic. Any expert is expected to be well published in the specific area of the expertise.nn2. One may take into account an expert’s membership in professional organizations pertaining to the subject matter. Obviously, membership and participation in annual meetings demonstrates an ongoing interest in the guideline topic.nn3. One may examine whether the physician/scientist has been invited to serve on editorial boards of journals dealing with the topic in question. Being a member of an editorial board and peer reviewing submissions attest to some expertise pertaining to the …