Holiday reading – we just published our analysis of how 225 medical NGOs approach common skin diseases when working in low resource international settings. Then we discussed how these clinical protocols compare to World Health Organization guidelines. Check out the article in the International Journal of Dermatology.

Clinical protocols: First, the good

The protocols we reviewed frequently tackled the most common skin diseases that clinicians encounter on short-term volunteer brigades to developing world settings. Pyoderma, fungal infections, and scabies were all well represented in the guidelines.

This is important, since doctors are notoriously bad at correctly identifying rashes and skin conditions. Since short-term volunteers are often unfamiliar with local diseases, and struggle with cultural challenges and resource limitations, these types of protocols are important to ensure that patients receive appropriate care. As we discuss below, however, they remain an imperfect solution.

Clinical protocols: The bad

Shockingly few organizations had protocols of any kind. In the end, less than 15% of the organizations had any protocols for review. Those that existed were often of poor quality. They frequently did not specify their authors, target audience, or source of evidence. They were also generally not endorsed by local health authorities in host countries.

What’s next for guidelines development?

Nothing erodes confidence in doctors quite like inconsistent care. Protocols are a key first step to addressing this problem, and signal a commitment by NGOs to quality improvement. But they are not enough. We’re working toward comprehensive clinical practice guidelines that integrate international guidelines with locally relevant research and consensus between local health authorities and NGOs.

Read our published methods paper, or visit The 53rd Week (our partner on this guidelines development initiative).

As usual, we also added a brief summary of our findings to the growing decision support menu of our free QuickChart EMR app for Android. Beta test it here and contact us to tell us how we can improve.