Abstract
Since Japan Society for Lipid Nutrition (JSLN) published their cholesterol guideline in 2010, controversy and confusion occurred between patients and general physicians.
In this guideline, JSLN criticized several clinical studies which were reffered in guideline of Japan Atherosclerosis Society and JSLN denied the conclusion of guideline of Japan Atherosclerosis Society. Although JSLN claimed that they made their guideline emphasizing all-cause mortality, their guideline did not refer any prospective randomized intervention trial. They made their conclusion without exclusion of confounders. Furthermore, their process was informal consensus development which is called black-box method.
In general, human can understand the fact, but not the truth. When investigators accumulate the mountains of the facts, they can look into one aspect of the truth.
JSLN must not consider they have got the truth. They just built their hypothesis. They must prove their hypothesis performing randomized interventional trial and basic research. Until these data would be published, general physicians do not have to read or obey JSLN guideline.