According to the authors, these guidelines are intended to be a “resource to share, discuss and disseminate across specialties and patient groups.”1 As such, they are a perfect RheumMadness team and will be a strong contender in the tournament.
Implications
It may be bold to say that no other paper in this tournament will have as much of a clinical impact and use as these guidelines. Before you dismiss this claim, remember rheumatic diseases disproportionately affect women. We are not just autoimmune specialists. We are de facto women’s health providers. This guideline acknowledges this fact and facilitates excellent care for women with rheumatic disease when they are most vulnerable.
This team has the basics down, with clear and concise recommendations on effective contraception and pregnancy-compatible medications. But it also has that special something, taking the combined knowledge of experts in rheumatology reproductive health and putting it at the fingertips of every rheumatologist. No more frantically searching for aspirin recommendations, what to do with that pesky anti-Ro antibodies or even trying to PubMed search whether a medication is safe for men trying to father a child. Heck, if you don’t know how to start the conversation, it has guidance on that too.
You must squint to identify any weaknesses with this team. However, one weak spot is the absence of recommendations on vaccination in pregnancy and management of vasculitis in pregnancy. Regardless of those drawbacks, ask yourself: Is dog osteoarthritis or women’s health more important?
Chances in the Tournament
Reproductive Health Guide will definitely win its first-round matchup against TNFi in Cord Blood and stands a fair chance to win the entire People Region.
Unlike many other teams in the bracket, the reproductive health guide is practical and highly likely to influence all tournament participants, especially considering how much improvement we, as a field, could make in this area. Only half of rheumatologists currently ask their patients about reproductive health!2
We think the chances for Reproductive Health Guide to advance to the final rounds of the tournament hinge primarily on how the Blue Ribbon Panel views the evidence informing the recommendations because many are based on low-quality evidence or expert opinion. Although this fact could be seen as a weakness, it also sets a clear research agenda for moving forward.
Overall, Reproductive Health Guide is a powerhouse that affects the lives of every patient and rheumatologist around the world. Clearly, it could win it all.