Wednesday, April 8, 2015

Has the National Library of Medicine been recommending an experimental medical treatment for at least 15 years? I've requested an investigation


The National Library of Medicine (NLM), on the campus of the National Institutes of Health in Bethesda, Maryland, has been a center of information innovation since its founding in 1836. The world’s largest biomedical library, NLM maintains and makes available a vast print collection and produces electronic information resources on a wide range of topics that are searched billions of times each year by millions of people around the globe. (source)

For at least 15 years, the NLM has recommended performing the Heimlich maneuver on unconscious choking victims based on information provided health information provider A.D.A.M. Inc.

A.D.A.M. was among the first group of companies to receive URAC accreditation for health information, and has maintained its accreditation since that time. The URAC accreditation seal indicates that A.D.A.M.'s consumer health products are in compliance with 49 rigorous standards of quality and accountability, verified in an independent audit by URAC ( URAC performs this audit every 2 years.

A.D.A.M.'s goal is to present evidence-based health information. Therefore, content in A.D.A.M. products is created by identifying the best available evidence from national guidelines, government agencies, and peer-reviewed literature, and then asking our writers and reviewers to create content based both on the quality of the evidence and its applicability to everyday practice.

The use of the Heimlich maneuver to revive unconscious choking victims is reportedly not recommended by the American Heart Association or the American Red Cross, and I'm unaware of any research in which the treatment has been tested, so in recent months I've attempted to learn the basis for the NLM's recommendation.

In years 2000, 2005, and 2007 the information was reviewed and approved by this series of physicians who presumably were hired by A.D.A.M.

When I recently asked Dr. Perez to provide me with supporting information, he replied:
To my knowledge, there is no definitive evidence for or against performing abdominal thrusts (on an) unconscious patient.
So on what evidence did he -- and the other doctors -- approve the treatment recommendation?

Isla Ogilvie PhD (source)

After receiving Dr. Perez's reply, I received a January 16 e-mail from Isla Ogilvie PhD, A.D.A.M.'s Strategic Content Director, informing me the information was being reviewed.

Since then, in several e-mails, I've asked her this question:
Did A.D.A.M. research the literature on the subject of "the Heimlich" for unconscious choking victims? If so, would you please send me citations to any relevant articles or studies?  
I haven't received a reply so a couple days ago I sent an investigation request letter with supporting documents to the directors of NLM and NIH. (Click here to download a copy.)

Via my letter:
1) This is to respectfully request that your offices review the following information and provide me with a determination whether or not the treatment recommendation meets the standards of your agencies.

2) If the treatment recommendation does not meet those standards, this is to respectfully request that your offices investigate how the information came to be published on the NLM website; the basis for A.D.A.M.'s recommendation of the treatment for at least 15 years; all details regarding URAC's review of the information; and that I be provided with the results of those findings.
I'm also looking into how much the NIH pays A.D.A.M. and will report the results.