How did the process go awry? Many of the current concerns stem from a process lacking openness and transparency, as recommended by the IOM. The Prevention Guidelines were originally commissioned in 2008 by the National Institutes of Health (NIH), the supervising authority for all previous lipid guidelines. Writing efforts lasted more than 5 years from initiation to completion. During the development process, several committee members resigned, although the exact reasons for their withdrawal have never been revealed. An adequate explanation for the long period of development also has not been provided. Although 4 separate guidelines were issued, despite years in development, the guidelines are narrow, not comprehensive. The main drug therapy recommendations address only 3 "critical questions," primarily describing which patients should receive statins.
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