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Blažek M, Vrbacký F, Fátorová I, Mirská K, Žák P. Sysmex-derived COVID-19 prognostic score as an early prognostic marker for severity of the COVID-19 disease. Int J Lab Hematol 2024; 46:243-249. [PMID: 37921205 DOI: 10.1111/ijlh.14197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/15/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is a life-threatening disease with a heterogeneous course. Even some young patients are at increased risk of severe course or death, as they can face severe complications. It would be very useful to have a cheap and easily available marker to predict COVID-19 course in the early stages of the disease. The COVID-19 prognostic score could be a very useful clinical indicator available at the time of primary contact with the patient. METHODS The COVID-19 prognostic score and the clinical condition together with selected laboratory parameters were evaluated in patients with respiratory tract infection and a positive PCR test for the SARS-CoV-2 during the first contact with the patient. Prognostic significance was evaluated using receiver operating characteristic curves (ROC) and area under the curve (AUC). Selected parameters of the blood count and hemostasis, as well as selected biochemical indicators, were examined too. RESULTS Thirty-seven of 164 patients developed serious symptoms. The COVID-19 score had one of the highest AUC values (0.855) of all markers. The highest combination of sensitivity (91.9%) and specificity (71.7%) for identifying patients with a subsequent moderate and severe course of the disease was achieved at the threshold 1.5. The predictive value of a negative test is beneficial too (0.968). CONCLUSIONS The COVID-19 prognostic score is a promising indicator stratifying patients with COVID-19 into prognostic groups at the time of the first contact, thus allowing the timely provision of increased care in patients at high risk of severe development.
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Affiliation(s)
- Martin Blažek
- Pulmonary Clinic, University Hospital Hradec Králové, Hradec Králové, Czech Republic
- Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czech Republic
| | - Filip Vrbacký
- 4th Department of Internal Medicine - Hematology, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Ilona Fátorová
- 4th Department of Internal Medicine - Hematology, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Klára Mirská
- Department of Biological and Medical Sciences, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Pavel Žák
- Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czech Republic
- 4th Department of Internal Medicine - Hematology, University Hospital Hradec Králové, Hradec Králové, Czech Republic
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Zhao FY, Kennedy GA, Xu P, Conduit R, Wang YM, Zhang WJ, Wang HR, Yue LP, Huang YL, Wang Y, Xu Y, Fu QQ, Zheng Z. Identifying complementary and alternative medicine recommendations for anxiety treatment and care: a systematic review and critical assessment of comprehensive clinical practice guidelines. Front Psychiatry 2023; 14:1290580. [PMID: 38152358 PMCID: PMC10751921 DOI: 10.3389/fpsyt.2023.1290580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/08/2023] [Indexed: 12/29/2023] Open
Abstract
Background Clinical practice guidelines (CPGs) are used to guide decision-making, especially regarding complementary and alternative medicine (CAM) therapies that are unfamiliar to orthodox healthcare providers. This systematic review aimed to critically review and summarise CAM recommendations associated with anxiety management included in the existing CPGs. Methods Seven databases, websites of six international guidelines developing institutions, and the National Centre for Complementary and Integrative Health website were systematically searched. Their reporting and methodological quality were evaluated using the Reporting Items for practice Guidelines in Healthcare checklist and the Appraisal of Guidelines for Research and Evaluation (2nd version) instrument, respectively. Results Ten CPGs were included, with reporting rates between 51.4 and 88.6%. Seven of these were of moderate to high methodological quality. Seventeen CAM modalities were implicated, involving phytotherapeutics, mind-body practice, art therapy, and homeopathy. Applied relaxation was included in 70% CPGs, which varied in degree of support for its use in the treatment of generalised anxiety disorder. There were few recommendations for other therapies/products. Light therapy was not recommended for use in generalised anxiety disorder, and St John's wort and mindfulness were not recommended for use in social anxiety disorder in individual guidelines. Recommendations for the applicability of other therapies/products for treating a specific anxiety disorder were commonly graded as "unclear, unambiguous, or uncertain". No CAM recommendations were provided for separation anxiety disorder, specific phobia or selective mutism. Conclusion Available guidelines are limited in providing logically explained graded CAM recommendations for anxiety treatment and care. A lack of high-quality evidence and multidisciplinary consultation during the guideline development are two major reasons. High quality and reliable clinical evidence and the engagement of a range of interdisciplinary stakeholders are needed for future CPG development and updating. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022373694, identifier CRD42022373694.
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Affiliation(s)
- Fei-Yi Zhao
- Department of Nursing, School of International Medical Technology, Shanghai Sanda University, Shanghai, China
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Gerard A. Kennedy
- Institute of Health and Wellbeing, Federation University, Mount Helen, VIC, Australia
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC, Australia
| | - Peijie Xu
- School of Computing Technologies, RMIT University, Melbourne, VIC, Australia
| | - Russell Conduit
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
| | - Yan-Mei Wang
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wen-Jing Zhang
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hui-Ru Wang
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Li-Ping Yue
- Department of Nursing, School of International Medical Technology, Shanghai Sanda University, Shanghai, China
| | - Yu-Ling Huang
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yin Wang
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yan Xu
- Department of Nursing, School of International Medical Technology, Shanghai Sanda University, Shanghai, China
| | - Qiang-Qiang Fu
- Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zhen Zheng
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
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Gazezova S, Nabirova D, Detmar A, Smagul M, Kasabekova L, Zikriyarova S, Horth R. Therapies for people hospitalized with COVID-19 and alignment with national clinical guidelines in a large hospital, Almaty, Kazakhstan, 2020-2021. Front Med (Lausanne) 2023; 10:1248959. [PMID: 37828941 PMCID: PMC10566366 DOI: 10.3389/fmed.2023.1248959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 08/21/2023] [Indexed: 10/14/2023] Open
Abstract
Background Clinical practice guidelines were continually changing during the COVID-19 pandemic to reflect the best available evidence for a novel virus. In Kazakhstan, the national clinical guidelines for COVID-19 patient care were regularly modified and it was not known if and to what extent these guidelines were being followed in practice. Methods We conducted a sub-analysis of data collected from an observational study among people hospitalized with COVID-19 in a large infectious disease hospital in Almaty in four cross-sections of increased COVID-19 incidence: T1 (1 June-30 August 2020); T2 (1 October-31 December 2020); T3 (1 April-31 May 2021); and T4 (1 July-26 October 2021). Modifications to the national COVID-19 treatment guidelines were identified and clinical data were abstracted from electronic medical records. We assessed frequency of antibiotic, glucocorticoid, anticoagulant, and antiviral administered in each period and determined if these aligned with national clinical guidelines. We used multivariable logistic regression to compare practices across periods. Results Six modifications were made to national COVID-19 treatment guidelines during this study. Of 1,146 people hospitalized with COVID-19, 14% were in T1, 14% in T2, 22% in T3, and 50% in T4. Anticoagulant treatment was administered to 87% (range: 56%-95%), antibiotic treatment to 60% (range: 58%-64%), glucocorticoid to 55% (range: 43%-64%) and antiviral therapy 15% (range: 7%-22%). Majority of treatments were not aligned with national guidelines, including 98% of anticoagulant use, 95% of antibiotic use, 56% of glucocorticoid use, and 56% of antiviral use. There were no significant changes in practice following changes in guidelines for antibiotic use (64% in T1 to 58% in T2, p = 0.30). There was significant increase in use of anticoagulant (84% in T2 vs. 95% in T3, p < 0.01), glucocorticoid (43% in T2 vs. 64% in T3, p < 0.01), and antiviral treatment (7% in T3 vs. 15% in T4, p < 0.01) after guidelines updates. Conclusion The majority of treatments administered to people hospitalized with COVID-19 in four periods of high incidence in Almaty were not aligned with updated clinical guidelines. Antibiotic misuse was markedly high throughout. Increased awareness and training on clinical practice guidelines as updates are released may help improve adoption of evidence-based practices.
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Affiliation(s)
- Saya Gazezova
- Central Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
- Scientific and Practical Center for Sanitary and Epidemiological Expertise and Monitoring, Almaty, Kazakhstan
| | - Dilyara Nabirova
- Central Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
- Division of Global Health Protection in Central Asia, United States Centers for Disease Control and Prevention, Almaty, Kazakhstan
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Ariana Detmar
- Division of Global Health Protection, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Manar Smagul
- Central Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
- Scientific and Practical Center for Sanitary and Epidemiological Expertise and Monitoring, Almaty, Kazakhstan
| | - Lena Kasabekova
- Central Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
- Scientific and Practical Center for Sanitary and Epidemiological Expertise and Monitoring, Almaty, Kazakhstan
| | - Sanam Zikriyarova
- Central Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Roberta Horth
- Central Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
- Division of Global Health Protection in Central Asia, United States Centers for Disease Control and Prevention, Almaty, Kazakhstan
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Yang N, Liu H, Zhao W, Pan Y, Lyu X, Hao X, Liu X, Qi W, Chen T, Wang X, Zhang B, Zhang W, Li Q, Xu D, Gao X, Jin Y, Sun F, Meng W, Li G, Wu Q, Chen Z, Wang X, Estill J, Norris SL, Du L, Chen Y, Wei J. Development of the Scientific, Transparent and Applicable Rankings (STAR) tool for clinical practice guidelines. Chin Med J (Engl) 2023; 136:1430-1438. [PMID: 37192012 PMCID: PMC10278700 DOI: 10.1097/cm9.0000000000002713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND This study aimed to develop a comprehensive instrument for evaluating and ranking clinical practice guidelines, named Scientific, Transparent and Applicable Rankings tool (STAR), and test its reliability, validity, and usability. METHODS This study set up a multidisciplinary working group including guideline methodologists, statisticians, journal editors, clinicians, and other experts. Scoping review, Delphi methods, and hierarchical analysis were used to develop the STAR tool. We evaluated the instrument's intrinsic and interrater reliability, content and criterion validity, and usability. RESULTS STAR contained 39 items grouped into 11 domains. The mean intrinsic reliability of the domains, indicated by Cronbach's α coefficient, was 0.588 (95% confidence interval [CI]: 0.414, 0.762). Interrater reliability as assessed with Cohen's kappa coefficient was 0.774 (95% CI: 0.740, 0.807) for methodological evaluators and 0.618 (95% CI: 0.587, 0.648) for clinical evaluators. The overall content validity index was 0.905. Pearson's r correlation for criterion validity was 0.885 (95% CI: 0.804, 0.932). The mean usability score of the items was 4.6 and the median time spent to evaluate each guideline was 20 min. CONCLUSION The instrument performed well in terms of reliability, validity, and efficiency, and can be used for comprehensively evaluating and ranking guidelines.
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Affiliation(s)
- Nan Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu 730000, China
- Institute of Global Health, University of Geneva, Geneva 1202, Switzerland
| | - Hui Liu
- Institute of Global Health, University of Geneva, Geneva 1202, Switzerland
- School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Wei Zhao
- Editor-in-Chief Office, Chinese Medical Association Publishing House, Beijing 100052, China
| | - Yang Pan
- Marketing Department, Chinese Medical Association Publishing House, Beijing 100052, China
| | - Xiangzheng Lyu
- Editorial Department, National Medical Journal of China, Chinese Medical Association Publishing House, Beijing 100052, China
| | - Xiuyuan Hao
- Editorial Department, Chinese Medical Journal, Chinese Medical Association Publishing House, Beijing 100052, China
| | - Xiaoqing Liu
- Division of Infectious Diseases, Department of Internal Medicine, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Wen’an Qi
- Editorial office of Digital Medicine and Health, Chinese Medical Association Publishing House, Beijing 100052, China
| | - Tong Chen
- Department of Hematology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Xiaoqin Wang
- Evidence-based Medicine Center, Fudan University, Shanghai 200032, China
| | - Boheng Zhang
- Department of Hepatic Oncology, Xiamen Clinical Research Center for Cancer Therapy, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian 361015, China
| | - Weishe Zhang
- Department of Obstetrics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Qiu Li
- Department of Nephrology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Dong Xu
- SMU Institute for Global Health (SIGHT), School of Health Management and Dermatology Hospital, Southern Medical University (SMU), Guangzhou, Guangdong 510515, China
| | - Xinghua Gao
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Yinghui Jin
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
| | - Feng Sun
- School of Public Health, Peking University, Beijing 100191, China
| | - Wenbo Meng
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, China
| | - Guobao Li
- Department of Lung Disease, Shenzhen Third People's Hospital, The Second Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong 518112, China
| | - Qijun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Ze Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Xu Wang
- Chevidence Lab of Child and Adolescent Health, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - Janne Estill
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu 730000, China
- Institute of Global Health, University of Geneva, Geneva 1202, Switzerland
| | - Susan L. Norris
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon 97239, USA
| | - Liang Du
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yaolong Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu 730000, China
- Research Unit of Evidence-Based Evaluation and Guidelines (2021RU017), Chinese Academy of Medical Sciences, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu 730000, China
- Guidelines and Standards Research Center, Chinese Medical Association Publishing House, Beijing 100052, China
| | - Junmin Wei
- Chinese Medical Association Publishing House, Beijing 100052, China
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O'Shaughnessy SM, Dimagli A, Kachulis B, Rahouma M, Demetres M, Govea N, Rong LQ. Evaluation of the Quality of COVID-19 Guidance Documents in Anaesthesia using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) Instrument. Br J Anaesth 2022; 129:851-860. [PMID: 36273932 PMCID: PMC9485431 DOI: 10.1016/j.bja.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/31/2022] [Accepted: 09/03/2022] [Indexed: 11/30/2022] Open
Abstract
Background Methods Results Conclusions
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Affiliation(s)
| | | | | | | | - Michelle Demetres
- Information, Technology and Services, Weill Cornell Medicine, New York, NY, USA
| | | | - Lisa Q Rong
- Department of Anesthesiology, New York, NY, USA
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