NIH: Office of Disease Prevention

Medicine: Mind the Gap

3-Part Series on Disease Prevention Screening

Series Topic #1:
Making Guidelines for Colon Cancer Screening: Evidence, Policy, and Politics

September 27, 2016
This Mind the Gap lecture was presented as a webinar.

David Ransohoff, M.D.

David F. Ransohoff, M.D. External Website Policy
Professor of Medicine and Epidemiology
University of North Carolina-Chapel Hill


NIH VideoCast of This Seminar

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About the Seminar

A major goal of clinical practice guidelines is to maximize benefit and minimize harm for patients. Yet many guidelines are made by many organizations and often they conflict on the same topic, so that Congress commissioned the Institute of Medicine to write a report about how to identify "guidelines you can trust." This seminar illustrated challenges and practical realities in guidelines-making by describing the evolution of evidence and of guidelines for colon cancer screening. The lecture described the relationship between evidence, policy, and politics and identified current challenges in making high-quality guidelines.

About David Ransohoff, M.D.

David F. Ransohoff, M.D., is professor of medicine (gastroenterology) and epidemiology at the University of North Carolina (UNC) at Chapel Hill. As one of the first clinical epidemiologists trained at Yale with Alvan Feinstein, he has written extensively about how to improve research methods used to evaluate diagnostic tests, with seminal publications in major journals. Trained additionally in gastroenterology at the University of Chicago, he was one of the first clinical epidemiologists in a subspecialty field and has published extensively on colon cancer screening, about colonoscopy, fecal occult blood testing, sigmoidoscopy, and virtual colonoscopy, and about clinical practice guidelines and policy. Extending his work 15 years ago to include molecular markers, with a sabbatical sponsored by UNC and the National Cancer Institute, he has published papers about methods to evaluate molecular markers for cancer screening in Science, Nature Reviews Cancer, and the Journal of the National Cancer Institute, and about stool-based DNA testing in the New England Journal of Medicine as well as about blood-based DNA and proteomics tests. He has served on Food and Drug Administration and Institute of Medicine committees. One of his overarching concerns is the quality of guidelines-making and the relationships between evidence, guidelines, and patient outcome, about which he published in the Journal of the American Medical Association. In training programs at UNC, he has directed the Robert Wood Johnson Clinical Scholars Program and the NIH-funded K30 faculty development program to help junior faculty develop careers in clinical and translational research.

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