This week, in response to the approval of Boehringer-Ingelheim's dabigatran (Pradaxa®) by the FDA, guideline writers were relatively quick to issue a 'focused update' (pdf) to the recently-released 2011 guidelines for the management of atrial fibrillation to include the new medication.
With this "focused update" came a new era for doctors.
Now, instead of guidelines for care of a malady being published in a single publication, we are finding guidelines can morph across multiple articles. As such, the size and breadth of guidelines that are increasingly used for mandates for clinical care can stretch over a virtually limitless publication domain.
In this era of electronic, near instantaneous publication with the now-apparently limitless potential to expand to unlimited size, doctors should insist that electronic hyperlinks be established between published guidelines, their addenda, and their associated references.