Response to: Is the new ASNM intraoperative neuromonitoring supervision “guideline” a trustworthy guideline? A commentary

Excerpt

On behalf of the membership of the American Society of Neurophysiological Monitoring (ASNM), we welcome our esteemed colleagues’ comments on this new supervision guideline for Intraoperative Neurophysiological Monitoring (IONM) [1, 2]. As with the previous version of this living document, thoughtful comment and criticism assisted the society in crafting this revision and will guide future iterations as well. We applaud Skinner et al.’s pursuit of important concepts such as teambuilding, collaboration, and effective communication. Many of these arguments and aspirations resonate for the authors, even if we do not arrive at the same conclusions. Indeed, revision of the guideline in this instance was triggered by substantive criticism of the previous version’s overreaching aspirational approach to IONM untethered from practical application. The reasonable application of evidence-based outcome data would appear to be an excellent arbiter for most areas of controversy in medicine, if only there were enough material to shed light on some of the more controversial issues (a topic we will return to later). …