{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T07:07:10Z","timestamp":1773299230226,"version":"3.50.1"},"reference-count":17,"publisher":"BMJ","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Ethics"],"published-print":{"date-parts":[[2009,5]]},"abstract":"<jats:p>Lyme disease is one of the most controversial illnesses in the history of medicine. In 2006 the Connecticut Attorney General launched an antitrust investigation into the Lyme guidelines development process of the Infectious Diseases Society of America (IDSA). In a recent settlement with IDSA, the Attorney General noted important commercial conflicts of interest and suppression of scientific evidence that had tainted the guidelines process. This paper explores two broad ethical themes that influenced the IDSA investigation. The first is the growing problem of conflicts of interest among guidelines developers, and the second is the increasing centralisation of medical decisions by insurance companies, which use treatment guidelines as a means of controlling the practices of individual doctors and denying treatment for patients. The implications of the first-ever antitrust investigation of medical guidelines and the proposed model to remediate the tainted IDSA guidelines process are also discussed.<\/jats:p>","DOI":"10.1136\/jme.2008.026526","type":"journal-article","created":{"date-parts":[[2009,4,30]],"date-time":"2009-04-30T17:23:58Z","timestamp":1241112238000},"page":"283-288","source":"Crossref","is-referenced-by-count":35,"title":["Attorney General forces Infectious Diseases Society of America to redo Lyme guidelines due to flawed development process: Table 1"],"prefix":"10.1136","volume":"35","author":[{"given":"L","family":"Johnson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R B","family":"Stricker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2009,4,30]]},"reference":[{"key":"2024052300471419000_35.5.283.1","doi-asserted-by":"publisher","DOI":"10.1586\/14787210.2.4.533"},{"key":"2024052300471419000_35.5.283.2","unstructured":"Stolberg S . 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BMJ rapid response 30 Nov 2007. www.bmj.com\/cgi\/eletters\/335\/7628\/1008 (accessed 9 Mar 2009). (See appendix A for details of competing interests.)"},{"key":"2024052300471419000_35.5.283.8","unstructured":"Center for Biotechnology. Companies developed. Brook Biotechnologies. http:\/\/www.biotech.sunysb.edu\/industDev\/comp-dev.html (accessed 9 Mar 2009). (See appendix A for details of competing interests.)"},{"key":"2024052300471419000_35.5.283.9","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000265517.66976.28"},{"key":"2024052300471419000_35.5.283.10","doi-asserted-by":"publisher","DOI":"10.1038\/439524a"},{"key":"2024052300471419000_35.5.283.11","unstructured":"Saul S . Unease on industry\u2019s role in hypertension debate. New York Times. 20 May 2006. www.nytimes.com\/2006\/05\/20\/business\/20hyper.html?ex\u200a=\u200a1148788800&en\u200a=\u200ac743a665286103ef&ei\u200a=\u200a5070&emc\u200a=\u200aeta1 (accessed 9 Mar 2009)."},{"key":"2024052300471419000_35.5.283.12","unstructured":"Ferrette C . Lyme disease expert defends research. Journal News. 6 May 2008. http:\/\/m.lohud.com\/news.jsp?key\u200a=\u200a76504 (accessed 14 Mar 2009)."},{"key":"2024052300471419000_35.5.283.13","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1993.03510040124050"},{"key":"2024052300471419000_35.5.283.14","doi-asserted-by":"publisher","DOI":"10.1001\/jama.263.6.877"},{"key":"2024052300471419000_35.5.283.15","unstructured":"Connecticut Attorney General\u2019s Office. Attorney General\u2019s investigation reveals flawed Lyme disease guideline process, IDSA agrees to reassess guidelines, install independent arbiter. 1 May 2008. http:\/\/www.ct.gov\/ag\/cwp\/view.asp?a\u200a=\u200a2795&q\u200a=\u200a414284 (accessed 9 Mar 2009)."},{"key":"2024052300471419000_35.5.283.16","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000313811.07154.89"},{"key":"2024052300471419000_35.5.283.17","unstructured":"Landers SJ . Lyme treatment accord ends antitrust probe. 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