Mitigating intersubjective variability in clinical guidelines

In this (rejected) response to a JAMA Editorial, coo-authored by one of JAMA's editors on subjectivity in the construction of Clinical Practice Guidelines, we point out that intersubjectivity cannot be avoided therein. However, we show how through stricter rules for guideline committee entry, conflicts of interest can largely be avoided. In addition, transparent application of sensitivity analysis in benefit harm analysis (BHA) helps to steer clear of the problems around subjectivity addressed in the Editorial.