About recommendations, guidelines and those who ultimately generate them

Progress always involves risks. You can’t steal second base and keep your foot on first base.

– Frederick B. Wilcox

Coming back from attending a major meeting in our field. I find it interesting to notice that the words “recommendation” and “guidelines” were some of the most used. Most of the time this is good and provides a common languages. However, once in a while someone use these words to shutdown an otherwise very interesting work.

Recommendations and guidelines comes about by the needs to summarize the current state-of-the-art based on the bulk of current evidence (generally from peer-reviewed scientific publications) and provide some guidance so that others do not repeat the trials and errors necessary to get there. In the medical field, this comes from phase I-III trials and metadata analyses. So this is actually very useful.

However, recommendations and guidelines are just that. There are not absolute truth nor law. They are certainly not a box preventing someone to think beyond its boundary. I see too many at meetings, by their intervention or comment, be clearly enclosed in deep and dark boxes. While I concede that most of the time one should follow recommendations and guidelines (in particular in medicine), never do so blindly and once in a while, at least scientifically speaking, going beyond the guidelines or recommendations may lead you to major leaps forward.

Remember that those who only follow recommendations and guidelines (the play it really safe type) never develop the next generation ones.

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