1
|
Hashmi SA, Martins RS, Ishtiaq A, Rizvi NA, Mustafa MA, Pervez A, Siddiqui A, Shariq SF, Nadeem S, Haider AH, Waqar MA. Development of palliative care clinical practice guidelines and referral care pathways for primary care practitioners in Pakistan. BMC Palliat Care 2024; 23:112. [PMID: 38693518 PMCID: PMC11061908 DOI: 10.1186/s12904-024-01438-y] [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: 06/26/2023] [Accepted: 04/19/2024] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND Despite a large burden of life-limitingillness, there exists a dearth of services of palliative care in Pakistan. International guidelines have questionable applicability in Pakistan due to the socioeconomic differences. We generated a protocol describing the process of developing comprehensive palliative care guidelines and palliative care referral pathways for primary care practitioners to adopt in Pakistan. METHODS A GRADE-ADOLOPMENT approach with modification has been employed to create guidelines for a Pakistani context. The "National Comprehensive Cancer Network Guidelines Insights: Palliative Care, Version 2.2021" was used as the source guideline. Recommendations from the source guideline were reviewed by two local palliative care specialists to either "Adopt," "Adapt" or "Exclude". The finalized recommendations were incorporated into the local palliative care guideline. Clinical diagnosis and referral pathways were made from the finalized guideline. Any gaps in management found in the pathways were filled by taking existing recommendations from other credible guidelines. RESULTS Twenty-seven recommendations were adopted without modification. No recommendations were deemed to be adapted and 15 were excluded. The referral care pathways created were reflective of the local guideline and included elements of initial assessment, preliminary management, reassessment, and referral. 6 additional recommendations were made. CONCLUSION The described clinical practice guidelines and primary care clinical referral pathways will aid to standardize palliative care provision in Pakistan. These can be used by other resource constrained settings to develop guidelines within their own local context.
Collapse
Affiliation(s)
- Syeda Amrah Hashmi
- Center for Clinical Best Practices, Clinical and Translational Research Incubator (CITRIC), Aga Khan University Hospital, Karachi, 74800, Pakistan
| | - Russell Seth Martins
- Center for Clinical Best Practices, Clinical and Translational Research Incubator (CITRIC), Aga Khan University Hospital, Karachi, 74800, Pakistan
| | - Annum Ishtiaq
- Section of Palliative Medicine, Department of Oncology, Aga Khan University Hospital, Karachi, 74800, Pakistan
| | - Nashia Ali Rizvi
- Center for Clinical Best Practices, Clinical and Translational Research Incubator (CITRIC), Aga Khan University Hospital, Karachi, 74800, Pakistan
| | - Mohsin Ali Mustafa
- Center for Clinical Best Practices, Clinical and Translational Research Incubator (CITRIC), Aga Khan University Hospital, Karachi, 74800, Pakistan
| | - Alina Pervez
- Center for Clinical Best Practices, Clinical and Translational Research Incubator (CITRIC), Aga Khan University Hospital, Karachi, 74800, Pakistan
| | - Ayra Siddiqui
- Medical College, Aga Khan University, Karachi, 74800, Pakistan
| | | | - Sarah Nadeem
- Center for Clinical Best Practices, Clinical and Translational Research Incubator (CITRIC), Aga Khan University Hospital, Karachi, 74800, Pakistan
- Section of Endocrinology, Department of Medicine, Aga Khan University Hospital, Karachi, 74800, Pakistan
| | - Adil H Haider
- Medical College, Aga Khan University, Karachi, 74800, Pakistan
| | - Muhammad Atif Waqar
- Section of Palliative Medicine, Department of Oncology, Aga Khan University Hospital, Karachi, 74800, Pakistan.
| |
Collapse
|
2
|
Naqvi WM, Mishra G, Pashine AA, Arora SP, Gupta S, Goyal C, Varma AR, Quazi Z, Muthukrishnan R, Kumar Kandakurti P, Umate L. A protocol for the development of PhyCaRe: An extension of the CARE guideline for physiotherapy using the Delphi method. F1000Res 2024; 12:838. [PMID: 37655118 PMCID: PMC10465994 DOI: 10.12688/f1000research.138599.1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/12/2024] [Indexed: 09/02/2023] Open
Abstract
Background Case reports are one of the important forms of documentation and publication of clinical physiotherapy presenting the first line of evidence in scientific literature. In order to provide a systematic and precise structure for reporting and presenting cases, the CARE guidelines were established in 2013. However, these guidelines present limitations as while reporting require items of specific specialties following the checklist. Authors from different specialities have developed CARE extensions specifying the characteristic features of corresponding fields, however, an extension dealing with physiotherapy assessment and line of management in the CARE guidelines is proposed as PhyCaRe. Method After consulting with the advisors, a draft will be prepared of the specific elements that should be included in the PhyCaRe using web Delphi methodology considering CARE statement as the source and SurveyMonkey will be used to undertake the web Delphi questionnaire. The web Delphi methodology will be assumed for three rounds and will be open to physiotherapists and others with substantial experience in reviewing case reports. Subsequently, an online consensus meeting, pilot testing, and submission of the CARE extension for physiotherapy will be conducted for publication. Dissemination The 2010 "Guidance for Developers of Health Research Reporting" and instructions from the EQUATOR Network will be followed in the preparation of PhyCaRe guidelines. The guidelines will be propagated at different platforms and journals will be requested to adopt the guidelines. Registration The reporting guideline under development is prospectively registered on the EQUATOR Network website on PhyCaRe - Reporting guideline for physiotherapy case reports.
Collapse
Affiliation(s)
- Waqar M. Naqvi
- Physiotherapy, Gulf Medical University, Ajman, United Arab Emirates
- Datta Meghe Institute of Higher Education and Research, Wardha, India
| | - Gaurav Mishra
- Datta Meghe Institute of Higher Education and Research, Wardha, India
| | | | - Sakshi P. Arora
- Datta Meghe Institute of Higher Education and Research, Wardha, India
| | - Sonia Gupta
- VSPM College of Physiotherapy, Nagpur, India
| | | | - Ashish R. Varma
- Datta Meghe Institute of Higher Education and Research, Wardha, India
| | - Zahiruddin Quazi
- Datta Meghe Institute of Higher Education and Research, Wardha, India
| | | | | | - Laxmikant Umate
- Datta Meghe Institute of Higher Education and Research, Wardha, India
| |
Collapse
|
3
|
Seino M, Nagase S, Tokunaga H, Yamagami W, Kobayashi Y, Tabata T, Kaneuchi M, Hirashima Y, Niikura H, Yoshino K, Takehara K, Baba T, Katabuchi H, Mikami M. Japan Society of Gynecologic Oncology 2022 guidelines for uterine cervical neoplasm treatment. J Gynecol Oncol 2024; 35:e15. [PMID: 38037547 PMCID: PMC10792216 DOI: 10.3802/jgo.2024.35.e15] [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: 08/05/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 12/02/2023] Open
Abstract
The Japan Society of Gynecologic Oncology (JSGO) Guidelines 2022 for the Treatment of Uterine Cervical Cancer are revised from the 2017 guideline. This guideline aimed to provide standard care for cervical cancer, indicate appropriate current treatment methods for cervical cancer, minimize variances in treatment methods among institutions, improve disease prognosis and treatment safety, reduce the economic and psychosomatic burden of patients by promoting the performance of appropriate treatment, and enhance mutual understanding between patients and healthcare professionals. The guidelines were prepared through the consensus of the JSGO Guideline Committee, based on a careful review of evidence gathered through the literature searches and the medical health insurance system and actual clinical practice situations in Japan. The guidelines comprise seven chapters and 5 algorithms. The main features of the 2022 revision are as follows: 1) added discussed points at the final consensus meeting; 2) revised the treatment methods based on the International Federation of Gynecology and Obstetrics 2018 staging system; 3) examined minimally invasive surgery based on Laparoscopic Approach to Cervical Cancer trial; 4) added clinical question (CQ) for treatments of rare histological types, gastric type, and small-cell neuroendocrine carcinoma; 5) added CQ for intensity-modulated radiation therapy; 6) added CQ for cancer genomic profiling test; and 7) added CQ for cancer survivorship. Each recommendation is accompanied by a classification of recommendation categories based on the consensus reached by the Guideline Committee members. Here, we present the English version of the JSGO Guidelines 2022 for the Treatment of Uterine Cervical Cancer.
Collapse
Affiliation(s)
- Manabu Seino
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yamagata University, Yamagata, Japan.
| | - Satoru Nagase
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Hideki Tokunaga
- Department of Gynecology and Obstetrics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Wataru Yamagami
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Yoichi Kobayashi
- Department of Obstetrics and Gynecology, Kyorin University, Faculty of Medicine, Tokyo, Japan
| | - Tsutomu Tabata
- Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Tokyo, Japan
| | - Masanori Kaneuchi
- Department of Obstetrics and Gynecology, Otaru General Hospital, Hokkaido, Japan
| | - Yasuyuki Hirashima
- Department of Gynecologic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Hitoshi Niikura
- Department of Obstetrics and Gynecology, National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - Kiyoshi Yoshino
- Department of Obstetrics and Gynecology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kazuhiro Takehara
- Department of Gynecologic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Tsukasa Baba
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Shiwa, Japan
| | - Hidetaka Katabuchi
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Mikio Mikami
- Department of Obstetrics and Gynecology, Tokai University, Kanagawa, Japan
| |
Collapse
|
4
|
Stubbs DJ, Davies BM, Dixon-Woods M, Bashford TH, Braude P, Bulters D, Camp S, Carr G, Coles JP, Dhesi J, Dinsmore J, Edlmann E, Evans NR, Figaji A, Foster E, Lecky F, Kolias A, Joannides A, Moppett I, Nathanson M, Newcombe V, Owen N, Peterman L, Proffitt A, Skiterall C, Whitfield P, Wilson SR, Zolnourian A, Amarouche M, Ansari A, Borg N, Brennan PM, Brown C, Corbett C, Dammers R, Das T, Feilding E, Galea M, Gillespie C, Glancz L, Gooding F, Grange R, Gray N, Hartley P, Hassan T, Holl D, Jones J, Knight R, Luoma V, Mee H, Minett T, Novak S, Peck G, Ralhan S, Ramshaw J, Richardson D, Sadek AR, Sheehan K, Sheppard F, Shipway D, Singh N, Smith M, Sturley R, Swart M, Thomas W, Uprichard J, Yeardley V, Menon DK, Hutchinson PJ. Protocol for the development of a multidisciplinary clinical practice guideline for the care of patients with chronic subdural haematoma. Wellcome Open Res 2023; 8:390. [PMID: 38434734 PMCID: PMC10905132 DOI: 10.12688/wellcomeopenres.18478.1] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2023] [Indexed: 03/05/2024] Open
Abstract
Introduction: A common neurosurgical condition, chronic subdural haematoma (cSDH) typically affects older people with other underlying health conditions. The care of this potentially vulnerable cohort is often, however, fragmented and suboptimal. In other complex conditions, multidisciplinary guidelines have transformed patient experience and outcomes, but no such framework exists for cSDH. This paper outlines a protocol to develop the first comprehensive multidisciplinary guideline from diagnosis to long-term recovery with cSDH. Methods: The project will be guided by a steering group of key stakeholders and professional organisations and will feature patient and public involvement. Multidisciplinary thematic working groups will examine key aspects of care to formulate appropriate, patient-centered research questions, targeted with evidence review using the GRADE framework. The working groups will then formulate draft clinical recommendations to be used in a modified Delphi process to build consensus on guideline contents. Conclusions: We present a protocol for the development of a multidisciplinary guideline to inform the care of patients with a cSDH, developed by cross-disciplinary working groups and arrived at through a consensus-building process, including a modified online Delphi.
Collapse
Affiliation(s)
- Daniel J Stubbs
- Division of Perioperative, Acute, and Critical care, University of Cambridge Addenbrooke's Hospital Cambridge, Cambridge, UK
- Healthcare Design Group, Department of Engineering, University of Cambridge, Cambridge, UK
| | - Benjamin M Davies
- Department of Clinical Neurosurgery, University of Cambridge Addenbrooke's Hospital Cambridge, Cambridge, UK
| | - Mary Dixon-Woods
- The Healthcare Improvement Studies (THIS) Institute, University of Cambridge, Cambridge, UK
| | - Thomas H Bashford
- Division of Perioperative, Acute, and Critical care, University of Cambridge Addenbrooke's Hospital Cambridge, Cambridge, UK
- Healthcare Design Group, Department of Engineering, University of Cambridge, Cambridge, UK
| | - Philip Braude
- Department of Medicine for Older People, North Bristol NHS Trust, Bristol, UK
| | - Diedrik Bulters
- Department of Neurosurgery, University Hospital Southampton, Southampton, UK
| | - Sophie Camp
- Department of Neurosurgery, Imperial College Healthcare NHS Trust, London, UK
- Imperial College Healthcare NHS Trust, London, UK
| | | | - Jonathan P Coles
- Division of Perioperative, Acute, and Critical care, University of Cambridge Addenbrooke's Hospital Cambridge, Cambridge, UK
| | - Jugdeep Dhesi
- Department of Geriatric Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Judith Dinsmore
- Department of Anaesthesia, St George's University NHS Trust, London, UK
| | - Ellie Edlmann
- Department of Neurosurgery, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Nicholas R Evans
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Anthony Figaji
- Department of Neurosurgery, University of Cape Town, Cape Town, South Africa
| | - Emily Foster
- Department of Clinical Neurosciences, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Fiona Lecky
- Department of Emergency Medicine, University of Sheffield, Sheffield, UK
| | - Angelos Kolias
- Department of Clinical Neurosurgery, University of Cambridge Addenbrooke's Hospital Cambridge, Cambridge, UK
| | - Alexis Joannides
- Department of Clinical Neurosurgery, University of Cambridge Addenbrooke's Hospital Cambridge, Cambridge, UK
| | - Iain Moppett
- Department of Anaesthesia and Perioperative Medicine, University of Nottingham, Nottingham, UK
| | - Mike Nathanson
- Department of Anaesthesia, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Virginia Newcombe
- Division of Perioperative, Acute, and Critical care, University of Cambridge Addenbrooke's Hospital Cambridge, Cambridge, UK
| | - Nicola Owen
- Department of Neurosurgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Amy Proffitt
- Department of Palliative Medicine, Barts and The London NHS Trust, London, UK
| | - Charlotte Skiterall
- Pharmacy Department, Manchester University NHS Foundation Trust, Manchester, UK
| | - Peter Whitfield
- Department of Neurosurgery, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Sally R Wilson
- Department of Anaesthesia and Critical Care, National Hospital for Neurology and Neurosurgery, London, UK
| | - Ardalan Zolnourian
- Department of Neurosurgery, University Hospital Southampton, Southampton, UK
| | | | - Akbar Ansari
- The Healthcare Improvement Studies (THIS) Institute, University of Cambridge, Cambridge, UK
| | - Nick Borg
- Department of Neurosurgery, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Paul M Brennan
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Charlotte Brown
- Pharmacy Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Christopher Corbett
- ACP in Emergency Medicine, Norfolk & Norwich University Hospital, Norwich, UK
| | - Ruben Dammers
- Neurosurgeon, Erasmus MC Stroke Center, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Tilak Das
- Consultant Neuroradiologist, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Emily Feilding
- Consultant Geriatrician (Major Trauma), Salford Royal Hospital, Salford, UK
| | - Marilise Galea
- Department of Neurosurgery, University Hospital Southampton, Southampton, UK
| | - Conor Gillespie
- Department of Clinical Neurosurgery, University of Cambridge Addenbrooke's Hospital Cambridge, Cambridge, UK
| | - Laurence Glancz
- Department of Neurosurgery, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Felix Gooding
- Department of Emergency Medicine, St Thomas' Hospital, London, UK
| | - Robert Grange
- Department of Medicine for Older People, North Bristol NHS Trust, Bristol, UK
| | - Natalie Gray
- Department of Physiotherapy, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Peter Hartley
- Department of Physiotherapy, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Taj Hassan
- Department of Emergency Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Dana Holl
- Department of Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Julia Jones
- Department of Neurosurgery, St George's Hospital, London, UK
| | | | - Val Luoma
- Department of Anaesthesia and Critical Care, National Hospital for Neurology and Neurosurgery, London, UK
| | - Harry Mee
- Department of Rehabilitation Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Thais Minett
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Stephen Novak
- Department of Rehabilitation Medicine, North Bristol NHS Trust, Bristol, UK
| | - George Peck
- Department of Geriatric Medicine, Imperial College London, London, UK
| | - Shvaita Ralhan
- Department of Geriatric Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Jennifer Ramshaw
- Pharmacy Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Davina Richardson
- Department of Neurosciences, Imperial College Healthcare NHS Trust, London, UK
| | - Ahmed-Ramadan Sadek
- Department of Neurosurgery, Barking Havering Redbridge University Trust, Romford, UK
| | - Katie Sheehan
- Rehabilitation and Health Services Research, Kings College, London, UK
| | - Francoise Sheppard
- Department of Emergency Medicine, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - David Shipway
- Department of Medicine for Older People, North Bristol NHS Trust, Bristol, UK
| | - Navneet Singh
- Department of Neurosurgery, St George's Hospital, London, UK
| | - Martin Smith
- Department of Emergency Medicine, Salford Royal NHS Foundation Trust, Salford, UK
| | - Rhonda Sturley
- Department of Geriatric Medicine, St George's, University of London, London, UK
| | - Michael Swart
- Department of Anaesthesia, Torbay and South Devon NHS Foundation Trust, Torquay, UK
| | - William Thomas
- Department of Haematology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Vickie Yeardley
- Imperial College Healthcare NHS Trust, London, UK
- Central London Community Healthcare NHS Trust, London, UK
| | - David K Menon
- Division of Perioperative, Acute, and Critical care, University of Cambridge Addenbrooke's Hospital Cambridge, Cambridge, UK
| | - Peter J Hutchinson
- Department of Clinical Neurosurgery, University of Cambridge Addenbrooke's Hospital Cambridge, Cambridge, UK
| |
Collapse
|
5
|
Fizazi K, Gillessen S. Updated treatment recommendations for prostate cancer from the ESMO Clinical Practice Guideline considering treatment intensification and use of novel systemic agents. Ann Oncol 2023; 34:557-563. [PMID: 36958590 DOI: 10.1016/j.annonc.2023.02.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/25/2023] Open
Affiliation(s)
- K Fizazi
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, Villejuif, France
| | - S Gillessen
- Oncology Institute of Southern Switzerland (IOSI), EOC, Bellinzona, Switzerland
| |
Collapse
|
6
|
Bossi P, Chan AT, Even C, Machiels JP. ESMO-EURACAN Clinical Practice Guideline update for nasopharyngeal carcinoma: adjuvant therapy and first-line treatment of recurrent/metastatic disease. Ann Oncol 2023; 34:247-250. [PMID: 36529446 DOI: 10.1016/j.annonc.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 12/23/2022] Open
Affiliation(s)
- P Bossi
- Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, Brescia, Italy
| | - A T Chan
- State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Shatin, Hong Kong, Special Administrative Region, People's Republic of China
| | - C Even
- Head and Neck Department, Gustave Roussy, Paris
| | - J-P Machiels
- Institut Roi Albert II, Service d'Oncologie Médicale, Cliniques Universitaires Saint-Luc, Brussels; Institut de Recherche Clinique et Expérimentale (POLE MIRO), Université Catholique de Louvain, Brussels, Belgium
| |
Collapse
|
7
|
Kim SY. Recent Advance in Clinical Practice Guideline Development Methodology. Korean J Fam Med 2022; 43:347-352. [PMID: 36444118 PMCID: PMC9708852 DOI: 10.4082/kjfm.22.0178] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/08/2022] [Accepted: 11/15/2022] [Indexed: 01/14/2024] Open
Abstract
Clinical practice guidelines (CPG) can be defined as systematically developed recommendations and related content obtained by reviewing scientific evidence, which help healthcare providers make decisions. CPG is one of the most powerful tools that helps clinicians make evidence-based decisions in practice. Methodologies in areas essential for CPG development, such as for systematic review, risk of bias (ROB) assessment, adaptation, and the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations, are rapidly developing. Therefore, they must be well-understood and applied to evidence-based CPG development. In this regard, it is necessary to learn about the updates and changed in the methodologies for CPG development. This manuscript covers the following CPG development methodologies: (1) main principles of CPG, (2) managing conflict of interest, (3) considering patient value and preference, (4) determination of key questions, (5) ROB assessment, (6) adaptation, (7) rapid guideline development, (8) living guideline development, and (9) GIN-McMaster Guideline Development Checklist.
Collapse
Affiliation(s)
- Soo Young Kim
- Department of Family Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| |
Collapse
|
8
|
Beckmann CL, Lodde G, Livingstone E, Schadendorf D, Böckmann B. Guideline-Based Context-Sensitive Decision Modeling for Melanoma Patients. Stud Health Technol Inform 2022; 296:50-57. [PMID: 36073488 DOI: 10.3233/shti220803] [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] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The provision of knowledge through clinical practice guidelines and hospital-specific standard operating procedures (SOPs) is ubiquitous in the medical context and in the treatment of melanoma patients. However, these knowledge sources are only available in unstructured text form and without any contextual link to real patient data. The aim of our project is to give a modeled decision support for the next treatment step based on the actual data and position of a patient. METHODS First, we identified passages for qualified decision-making necessary at the point of care from the SOP for melanoma. Thereby, the patient-specific contextual reference data at decision points was considered in parallel and represented by FHIR (Fast Healthcare Interoperability Resource) resources. The decision algorithm was then formalized using BPMN modeling with FHIR annotations. Validation was provided by medical experts, dermatooncologists from University Hospital Essen. RESULTS The resulting BPMN model is presented here with the diagnostic procedure of sentinel lymph node excision as the example snippet from the whole algorithm. Each decision point is edited with FHIR resources covering the patient data and preparing the context sensitivity of the model. CONCLUSION Modeling guideline-based information into a decision algorithm that can be presented at the point of care with contextual reference, may have the potential to support patient-specific clinical decision-making. For patients from a certain status like in the metastatic setting modeling becomes highly tailored to specific patient cases, alternative and individualized treatment options.
Collapse
Affiliation(s)
- Catharina Lena Beckmann
- Department of Computer Science, University of Applied Sciences and Arts Dortmund (FH Dortmund), 44227 Dortmund, Germany
| | - Georg Lodde
- Department of Dermatology, Venereology and Allergology, University Hospital Essen, 45147 Essen, Germany
| | - Elisabeth Livingstone
- Department of Dermatology, Venereology and Allergology, University Hospital Essen, 45147 Essen, Germany
| | - Dirk Schadendorf
- Department of Dermatology, Venereology and Allergology, University Hospital Essen, 45147 Essen, Germany
| | - Britta Böckmann
- Department of Computer Science, University of Applied Sciences and Arts Dortmund (FH Dortmund), 44227 Dortmund, Germany
- Institute of Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital Essen, 45122 Essen, Germany
| |
Collapse
|
9
|
Peña AM, Ladd CC, Anderson JM, Torgerson T, Hartwell M, Johnson BS, McMurray M, Vassar M. An analysis of the evidence underpinning the American Urologic Association clinical practice guidelines. Urology 2022; 161:42-49. [PMID: 34986408 DOI: 10.1016/j.urology.2021.12.019] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 12/15/2021] [Accepted: 12/21/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the reporting quality of systematic reviews (SRs) underpinning the American Urologic Association (AUA) clinical practice guidelines (CPGs). METHODS We searched the AUA for CPGs from 2015-2021. We extracted all SRs from the reference sections and two independent investigators evaluated eligible SR/meta-analysis using the PRISMA (Preferred Reporting Instrument for Systematic Reviews and Meta-Analyses) and AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews 2) instruments. We compared SRs conducted by the Cochrane group to non-Cochrane SRs using a Mann-Whitney test. A multivariate regression was used to compare study characteristics. RESULTS Eighteen CPG's met inclusion criteria. We extracted 120 unique SRs, which accounted for 5.1% (n=120/2346) of all citations. Mean percent adherence to PRISMA and AMSTAR-2 was 65.4% and 55.2% respectively. SRs conducted by the Cochrane Collaboration scored higher on AMSTAR-2 compared to non-Cochrane (z = -4.41, p <0.01) and a positive correlation between PRISMA and AMSTAR-2 scores (r=0.56, p<0.001) was determined. CONCLUSION Our study indicated the quality of SRs used to develop AUA CPGs across both PRISMA and AMSTAR-2 was variable. Despite higher evaluations, Cochrane SRs accounted for less than 15% of SRs underpinning CPG recommendations. Given the importance placed on CPGs within clinical practice, we recommended a synergistic relationship between the AUA and the Cochrane Collaboration to increase the number of quality urologic SRs.
Collapse
Affiliation(s)
- Andriana M Peña
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma.
| | - Chase C Ladd
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - J Michael Anderson
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Trevor Torgerson
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Bradley S Johnson
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Megan McMurray
- Southern Illinois University, Department of Urology, Springfield, Illinois
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| |
Collapse
|
10
|
Gronchi A, Miah AB, Dei Tos AP, Abecassis N, Bajpai J, Bauer S, Biagini R, Bielack S, Blay JY, Bolle S, Bonvalot S, Boukovinas I, Bovee JVMG, Boye K, Brennan B, Brodowicz T, Buonadonna A, De Álava E, Del Muro XG, Dufresne A, Eriksson M, Fagioli F, Fedenko A, Ferraresi V, Ferrari A, Frezza AM, Gasperoni S, Gelderblom H, Gouin F, Grignani G, Haas R, Hassan AB, Hecker-Nolting S, Hindi N, Hohenberger P, Joensuu H, Jones RL, Jungels C, Jutte P, Kager L, Kasper B, Kawai A, Kopeckova K, Krákorová DA, Le Cesne A, Le Grange F, Legius E, Leithner A, Lopez-Pousa A, Martin-Broto J, Merimsky O, Messiou C, Mir O, Montemurro M, Morland B, Morosi C, Palmerini E, Pantaleo MA, Piana R, Piperno-Neumann S, Reichardt P, Rutkowski P, Safwat AA, Sangalli C, Sbaraglia M, Scheipl S, Schöffski P, Sleijfer S, Strauss D, Strauss S, Sundby Hall K, Trama A, Unk M, van de Sande MAJ, van der Graaf WTA, van Houdt WJ, Frebourg T, Casali PG, Stacchiotti S. Soft tissue and visceral sarcomas: ESMO-EURACAN-GENTURIS Clinical Practice Guidelines for diagnosis, treatment and follow-up ☆. Ann Oncol 2021; 32:1348-1365. [PMID: 34303806 DOI: 10.1016/j.annonc.2021.07.006] [Citation(s) in RCA: 345] [Impact Index Per Article: 115.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 02/08/2023] Open
Affiliation(s)
- A Gronchi
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori and University of Milan, Milan, Italy
| | - A B Miah
- Department of Oncology, Royal Marsden Hospital and Institute of Cancer Research, London, UK
| | - A P Dei Tos
- Department of Pathology, Azienda Ospedale Università Padova, Padua, Italy
| | - N Abecassis
- Instituto Portugues de Oncologia de Lisboa Francisco Gentil, EPE, Lisbon, Portugal
| | - J Bajpai
- Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - S Bauer
- Department of Medical Oncology, Interdisciplinary Sarcoma Center, West German Cancer Center, University of Duisburg-Essen, Essen, Germany
| | - R Biagini
- Department of Oncological Orthopedics, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - S Bielack
- Klinikum Stuttgart-Olgahospital, Stuttgart, Germany
| | - J Y Blay
- Centre Leon Berard and UCBL1, Lyon, France
| | - S Bolle
- Radiation Oncology Department, Gustave Roussy, Villejuif, France
| | - S Bonvalot
- Department of Surgery, Institut Curie, Paris, France
| | | | - J V M G Bovee
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - K Boye
- Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway
| | - B Brennan
- Paediatric Oncology, Royal Manchester Children's Hospital, Manchester, UK
| | - T Brodowicz
- Vienna General Hospital (AKH), Medizinische Universität Wien, Vienna, Austria
| | - A Buonadonna
- Centro di Riferimento Oncologico di Aviano, Aviano, Italy
| | - E De Álava
- Hospital Universitario Virgen del Rocio-CIBERONC, Seville, Spain; Department of Normal and Pathological Cytology and Histology, School of Medicine, University of Seville, Seville, Spain
| | - X G Del Muro
- Integrated Unit ICO Hospitalet, HUB, Barcelona, Spain
| | - A Dufresne
- Département d'Oncologie Médicale, Centre Leon Berard, Lyon, France
| | - M Eriksson
- Skane University Hospital-Lund, Lund, Sweden
| | - F Fagioli
- Paediatric Onco-Haematology Department, Regina Margherita Children's Hospital, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - A Fedenko
- P. A. Herzen Cancer Research Institute, Moscow, Russian Federation
| | - V Ferraresi
- Sarcomas and Rare Tumors Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - A Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A M Frezza
- Department of Cancer Medicine, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - S Gasperoni
- Azienda Ospedaliera Universitaria Careggi Firenze, Florence, Italy
| | - H Gelderblom
- Department of Medical Oncology, Leiden University Medical Centre, Leiden, The Netherlands
| | - F Gouin
- Centre Leon-Berard Lyon, Lyon, France
| | - G Grignani
- Candiolo Cancer Institute, FPO - IRCCS, Candiolo, Italy
| | - R Haas
- Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Radiotherapy, Leiden University Medical Centre, Leiden, The Netherlands
| | - A B Hassan
- Oxford University Hospitals NHS Foundation Trust and University of Oxford, Oxford, UK
| | | | - N Hindi
- Department of Medical Oncology, Fundación Jimenez Diaz University Hospital, Advanced Therapies in Sarcoma Lab, Madrid, Spain
| | - P Hohenberger
- Mannheim University Medical Center, Mannheim, Germany
| | - H Joensuu
- Helsinki University Hospital (HUH) and University of Helsinki, Helsinki, Finland
| | - R L Jones
- Sarcoma Unit, Royal Marsden Hospital and Institute of Cancer Research, London, UK
| | - C Jungels
- Medical Oncology Clinic, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - P Jutte
- University Medical Center Groningen, Groningen, The Netherlands
| | - L Kager
- St. Anna Children's Hospital, Department of Pediatrics and Medical University Vienna Children's Cancer Research Institute, Vienna, Austria
| | - B Kasper
- Mannheim University Medical Center, Mannheim, Germany
| | - A Kawai
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - K Kopeckova
- University Hospital Motol, Prague, Czech Republic
| | - D A Krákorová
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - A Le Cesne
- Department of Cancer Medicine, Gustave Roussy, Villejuif, France
| | - F Le Grange
- Department of Oncology, University College London Hospitals NHS Foundation Trust (UCLH), London, UK
| | - E Legius
- Department for Human Genetics, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - A Leithner
- Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria
| | - A Lopez-Pousa
- Medical Oncology Department, Hospital Universitario Santa Creu i Sant Pau, Barcelona, Spain
| | - J Martin-Broto
- Department of Medical Oncology, Fundación Jimenez Diaz University Hospital, Advanced Therapies in Sarcoma Lab, Madrid, Spain
| | - O Merimsky
- Tel Aviv Sourasky Medical Center (Ichilov), Tel Aviv, Israel
| | - C Messiou
- Department of Radiology, Royal Marsden Hospital and Institute of Cancer Research, London, UK
| | - O Mir
- Department of Ambulatory Cancer Care, Gustave Roussy, Villejuif, France
| | - M Montemurro
- Department of Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - B Morland
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - C Morosi
- Department of Radiology, IRCCS Foundation National Cancer Institute, Milan, Italy
| | - E Palmerini
- Department of Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - M A Pantaleo
- Division of Oncology, IRCCS Azienda Ospedaliero-Universitaria, di Bologna, Bologna, Italy
| | - R Piana
- Azienda Ospedaliero, Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | | | - P Reichardt
- Helios Klinikum Berlin Buch, Berlin, Germany
| | - P Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - A A Safwat
- Aarhus University Hospital, Aarhus, Denmark
| | - C Sangalli
- Department of Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Sbaraglia
- Department of Pathology, Azienda Ospedale Università Padova, Padua, Italy
| | - S Scheipl
- Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria
| | - P Schöffski
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - S Sleijfer
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - D Strauss
- Department of Surgery, Royal Marsden Hospital, London, UK
| | - S Strauss
- Department of Oncology, University College London Hospitals NHS Foundation Trust (UCLH), London, UK
| | - K Sundby Hall
- Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway
| | - A Trama
- Department of Research, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Unk
- Institute of Oncology of Ljubljana, Ljubljana, Slovenia
| | - M A J van de Sande
- Department of Orthopedic Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - W T A van der Graaf
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands; Department of Medical Oncology, the Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - W J van Houdt
- Department of Surgical Oncology, the Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - T Frebourg
- Department of Genetics, Normandy Center for Genomic and Personalized Medicine, Normandie Univ, UNIROUEN, Inserm U1245 and Rouen University Hospital, Rouen, France
| | - P G Casali
- Department of Cancer Medicine, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Department of Oncology and Hemato-oncology University of Milan, Milan, Italy
| | - S Stacchiotti
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| |
Collapse
|
11
|
Parish SJ, Simon JA, Davis SR, Giraldi A, Goldstein I, Goldstein SW, Kim NN, Kingsberg SA, Morgentaler A, Nappi RE, Park K, Stuenkel CA, Traish AM, Vignozzi L. International Society for the Study of Women's Sexual Health Clinical Practice Guideline for the Use of Systemic Testosterone for Hypoactive Sexual Desire Disorder in Women. J Sex Med 2021; 18:849-867. [PMID: 33814355 DOI: 10.1016/j.jsxm.2020.10.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/12/2020] [Accepted: 10/19/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The Global Consensus Position Statement on the Use of Testosterone Therapy for Women (Global Position Statement) recommended testosterone therapy for postmenopausal women with hypoactive sexual desire disorder (HSDD). AIM To provide a clinical practice guideline for the use of testosterone including identification of patients, laboratory testing, dosing, post-treatment monitoring, and follow-up care in women with HSDD. METHODS The International Society for the Study of Women's Sexual Health appointed a multidisciplinary panel of experts who performed a literature review of original research, meta-analyses, review papers, and consensus guidelines regarding testosterone use in women. Consensus was reached using a modified Delphi method. OUTCOMES A clinically useful guideline following a biopsychosocial assessment and treatment approach for the safe and efficacious use of testosterone in women with HSDD was developed including measurement, indications, formulations, prescribing, dosing, monitoring, and follow-up. RESULTS Although the Global Position Statement endorses testosterone therapy for only postmenopausal women, limited data also support the use in late reproductive age premenopausal women, consistent with the International Society for the Study of Women's Sexual Health Process of Care for the Management of HSDD. Systemic transdermal testosterone is recommended for women with HSDD not primarily related to modifiable factors or comorbidities such as relationship or mental health problems. Current available research supports a moderate therapeutic benefit. Safety data show no serious adverse events with physiologic testosterone use, but long-term safety has not been established. Before initiation of therapy, clinicians should provide an informed consent. Shared decision-making involves a comprehensive discussion of off-label use, as well as benefits and risks. A total testosterone level should not be used to diagnose HSDD, but as a baseline for monitoring. Government-approved transdermal male formulations can be used cautiously with dosing appropriate for women. Patients should be assessed for signs of androgen excess and total testosterone levels monitored to maintain concentrations in the physiologic premenopausal range. Compounded products cannot be recommended because of the lack of efficacy and safety data. CLINICAL IMPLICATIONS This clinical practice guideline provides standards for safely prescribing testosterone to women with HSDD, including identification of appropriate patients, dosing, and monitoring. STRENGTHS & LIMITATIONS This evidence-based guideline builds on a recently published comprehensive meta-analysis and the Global Position Statement endorsed by numerous societies. The limitation is that testosterone therapy is not approved for women by most regulatory agencies, thereby making prescribing and proper dosing challenging. CONCLUSION Despite substantial evidence regarding safety, efficacy, and clinical use, access to testosterone therapy for the treatment of HSDD in women remains a significant unmet need. Parish SJ, Simon JA, Davis SR, et al. International Society for the Study of Women's Sexual Health Clinical Practice Guideline for the Use of Systemic Testosterone for Hypoactive Sexual Desire Disorder in Women. J Sex Med 2021;18:849-867.
Collapse
Affiliation(s)
- Sharon J Parish
- Department of Psychiatry & Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
| | - James A Simon
- IntimMedicine Specialists, George Washington University School of Medicine, Washington, DC, USA
| | - Susan R Davis
- Women's Health Research Program, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Annamaria Giraldi
- Sexological Clinic, Psychiatric Center, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Irwin Goldstein
- Sexual Medicine, Alvarado Hospital, San Diego, CA, USA; San Diego Sexual Medicine, San Diego, CA, USA
| | | | - Noel N Kim
- Institute for Sexual Medicine, San Diego, CA, USA
| | - Sheryl A Kingsberg
- University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Abraham Morgentaler
- Men's Health Boston, Beth Israel Deaconess Medical Center, Harvard Medical School, Chestnut Hill, MA, USA
| | - Rossella E Nappi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, Obstetrics and Gynecology Unit, IRCCS S. Matteo Foundation, University of Pavia, Pavia, Italy
| | - Kwangsung Park
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Cynthia A Stuenkel
- Department of Medicine, UC San Diego School of Medicine, La Jolla, CA, USA
| | - Abdulmaged M Traish
- Departments of Biochemistry and Urology, Boston University School of Medicine, Boston, MA, USA
| | - Linda Vignozzi
- Andrology, Women's Endocrinology & Gender Incongruence Unit, Department of "Excellence" Experimental and Clinical Biomedical Sciences "Mario Serio"-Careggi Hospital-University of Florence, Florence, Italy; Consorzio Interuniversitario I.N.B.B., Rome, Italy
| |
Collapse
|
12
|
Verville L, Dc PC, Grondin D, Dc SM, Kay R. The development and evaluation of an online educational tool for the evidence-based management of neck pain by chiropractic teaching faculty. J Chiropr Educ 2021; 35:95-105. [PMID: 33175979 PMCID: PMC7958658 DOI: 10.7899/jce-19-18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 01/13/2020] [Accepted: 04/04/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To develop an online, interactive educational tool to deliver an evidence-based clinical practice guideline to faculty members at a Canadian chiropractic college. Second, to evaluate the learning, design, and engagement constructs of the tool in a sample of chiropractic faculty members. METHODS Using an integrated knowledge translation methodology and the Knowledge to Action Framework, we developed an evidence-based online learning tool. The context of the tool focused on a clinical practice guideline on the management of neck pain. We evaluated the learning, design, and engagement constructs in a sample of faculty members and residents using the Learning Object Evaluation Scale for Students. Participants were also asked to provide suggestions for improvement of the tool. RESULTS Sixteen participants completed the evaluation. Most (68.8%) participants were chiropractors, 75% were male and 56% were between the ages of 25 and 44 years. At least 75% of participants agreed that the learning, design, and engagement constructs of the learning tool were adequate. The open-ended suggestions unveiled 3 pedagogical themes, relating to multimedia, thinking skills, and learner control, within the tool that could benefit from further development. These themes informed recommendations to improve the tool. CONCLUSION Our online, interactive, module-based learning tool has sound pedagogical properties. Further research is needed to determine if its use is associated with a change in knowledge.
Collapse
|
13
|
Fonseca J, Taveira-Gomes T, Pereira AM, Branco-Ferreira M, Carreiro-Martins P, Alves-Correia M, Correia de Sousa J, Costa E, Lourenço O, Morais-Almeida M, Morête A, Regateiro F, Todo Bom A, Bachert C, Pfaar O, Wallace D, Bedbrook A, Czarlewski W, Bousquet J. [ARIA 2019: An Integrated Care Pathway for Allergic Rhinitis in Portugal]. ACTA MEDICA PORT 2021; 34:144-157. [PMID: 33275547 DOI: 10.20344/amp.13777] [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: 03/23/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 11/20/2022]
Abstract
The Allergic Rhinitis and Its Impact on Asthma (ARIA) initiative started more than 20 years ago and has developed and disseminated evidence-based guidelines and projects in the field of allergic rhinitis. This initiative is currently focused on providing patient-centred guidelines that contribute to an integrated care pathway between the various levels of care and take advantage of digital solutions, and the introduction of integrated care pathways in clinical practice has been recommended. In this article we describe the adaptation for Portugal of the ARIA Integrated Care Pathways document. After a brief review of the epidemiology and impact of allergic rhinitis in Portugal and the activities carried out in Portugal within the ARIA initiative, we describe the broad knowledge base used for the development of recommendations for the pharmacological treatment of allergic rhinitis, and these recommendations are based on the GRADE methodology, real world evidence acquired by mobile technology (mHealth) and resulting from allergenic exposure chamber studies. What follows is a summary of integrated care pathways for allergen immunotherapy produced in 2019. Allergen immunotherapy is considered an example of precision medicine where the use of mHealth technologies will improve stratification for patient selection and response monitoring. These recommendations were considered as best practices of integrated patient-centred care supported by digital systems from Directorate General for Health and Food Safety of the European Union (DG Santé) and represent the ARIA Phase 4 Change Management strategy.
Collapse
Affiliation(s)
- João Fonseca
- Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS). Faculdade de Medicina. Universidade do Porto. Porto; Departamento de Medicina da Comunidade, Informação e Decisão em Saúde (MEDCIDS). Faculdade de Medicina. Universidade do Porto. Porto. Portugal
| | - Tiago Taveira-Gomes
- Departamento de Medicina da Comunidade, Informação e Decisão em Saúde (MEDCIDS). Faculdade de Medicina. Universidade do Porto. Porto. Instituto Universitário de Ciências da Saúde. Cooperativa de Ensino Superior Politécnico Universitário. Gandra. Faculdade de Ciências da Saúde. Universidade Fernando Pessoa. Porto. Portugal
| | - Ana Margarida Pereira
- Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS). Faculdade de Medicina. Universidade do Porto. Porto. Departamento de Medicina da Comunidade, Informação e Decisão em Saúde (MEDCIDS). Faculdade de Medicina. Universidade do Porto. Porto. Serviço de Imunoalergologia. Hospital CUF. Porto. Portugal
| | - Manuel Branco-Ferreira
- Clínica Universitária Imunoalergologia. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Serviço de Imunoalergologia. Centro Hospitalar Universitário Lisboa Norte. Lisboa. Sociedade Portuguesa de Alergologia e Imunologia Clínica. Lisboa. Portugal
| | - Pedro Carreiro-Martins
- Comprehensive Health Research Center (CHRC). NOVA Medical School. Lisboa. Serviço de Imunoalergologia. Centro Hospitalar Universitário de Lisboa Central. Lisboa. Portugal
| | - Magna Alves-Correia
- Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS). Faculdade de Medicina. Universidade do Porto. Porto. Departamento de Medicina da Comunidade, Informação e Decisão em Saúde (MEDCIDS). Faculdade de Medicina. Universidade do Porto. Porto. Serviço de Imunoalergologia. Hospital CUF. Porto. Portugal
| | - Jaime Correia de Sousa
- Instituto de Investigação em Ciências da Vida e Saúde (ICVS). Escola de Medicina. Universidade do Minho. Braga. Laboratório Associado. Instituto de Investigação em Ciências da Vida e Saúde Braga/Guimarães. Braga. Unidade de Saúde Familiar Horizonte. Matosinhos. Portugal
| | - Elísio Costa
- UCIBIO/REQUIMTE. Porto4Ageing Reference Site. Faculdade de Farmácia. Universidade do Porto. Portugal
| | - Olga Lourenço
- Faculdade de Ciências da Saúde e Centro de Investigação em Ciências da Saúde. Universidade da Beira Interior. Covilhã. Portugal
| | | | - Ana Morête
- Serviço de Imunoalergologia. Hospital CUF. Porto. Unidade de Imunoalergologia. Centro Hospitalar Baixo Vouga. Aveiro. Portugal
| | - Frederico Regateiro
- Serviço de Imunoalergologia. Centro Hospitalar e Universitário de Coimbra. Coimbra. Instituto de Imunologia. Faculdade de Medicina. Universidade de Coimbra. Coimbra. Instituto de Investigação Clínica e Biomédica de Coimbra (ICBR). Faculdade de Medicina. Universidade de Coimbra. Coimbra. Portugal
| | - Ana Todo Bom
- Serviço de Imunoalergologia. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Claus Bachert
- Upper Airways Research Laboratory. ENT Department. Ghent University Hospital. Ghent. Bélgica
| | - Oliver Pfaar
- Department of Otorhinolaryngology. Head and Neck Surgery. Section of Rhinology and Allergy. University Hospital Marburg. Phillipps-Universität Marburg. Marburg. Alemanha
| | - Dana Wallace
- Nova Southeastern University. Fort Lauderdale. Florida. Estados Unidos da América do Norte
| | - Anna Bedbrook
- MACVIA-France. Fondation Partenariale FMC VIA-LR. Centre Hospitalier Arnaud de Villeneuve. Montpellier. França
| | | | - Jean Bousquet
- MACVIA-France. Fondation Partenariale FMC VIA-LR. Centre Hospitalier Arnaud de Villeneuve. Montpellier. INSERM U 1168. Université Versailles St-Quentin-en-Yvelines. Montigny le Bretonneux. France. Charité. Universitätsmedizin Berlin. Humboldt-Universität zu Berlin. Berlin. Alemanha
| |
Collapse
|
14
|
Tokunaga H, Mikami M, Nagase S, Kobayashi Y, Tabata T, Kaneuchi M, Satoh T, Hirashima Y, Matsumura N, Yokoyama Y, Kawana K, Kyo S, Aoki D, Katabuchi H. The 2020 Japan Society of Gynecologic Oncology guidelines for the treatment of ovarian cancer, fallopian tube cancer, and primary peritoneal cancer. J Gynecol Oncol 2021; 32:e49. [PMID: 33650343 PMCID: PMC7930451 DOI: 10.3802/jgo.2021.32.e49] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/01/2021] [Accepted: 01/16/2021] [Indexed: 12/20/2022] Open
Abstract
The fifth edition of the Japan Society of Gynecologic Oncology guidelines for the treatment of ovarian cancer, fallopian tube cancer, and primary peritoneal cancer was published in 2020. The guidelines contain 6 chapters—namely, (1) overview of the guidelines; (2) epithelial ovarian cancer, fallopian tube cancer, and primary peritoneal cancer; (3) recurrent epithelial ovarian cancer, fallopian tube cancer, and primary peritoneal cancer; (4) borderline epithelial tumors of the ovary; (5) malignant germ cell tumors of the ovary; and (6) malignant sex cord-stromal tumors. Furthermore, the guidelines comprise 5 algorithms—namely, (1) initial treatment for ovarian cancer, fallopian tube cancer, and primary peritoneal cancer; (2) treatment for recurrent ovarian cancer, fallopian tube cancer, and primary peritoneal cancer; (3) initial treatment for borderline epithelial ovarian tumor; (4) treatment for malignant germ cell tumor; and (5) treatment for sex cord-stromal tumor. Major changes in the new edition include the following: (1) revision of the title to “guidelines for the treatment of ovarian cancer, fallopian tube cancer, and primary peritoneal cancer”; (2) involvement of patients and general (male/female) participants in addition to physicians, pharmacists, and nurses; (3) clinical questions (CQs) in the PICO format; (4) change in the expression of grades of recommendation and level of evidence in accordance with the GRADE system; (5) introduction of the idea of a body of evidence; (6) categorization of references according to research design; (7) performance of systematic reviews and meta-analysis for three CQs; and (8) voting for each CQ/recommendation and description of the consensus.
Collapse
Affiliation(s)
- Hideki Tokunaga
- Department of Gynecology, Tohoku University Hospital, Miyagi, Japan.
| | - Mikio Mikami
- Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan
| | - Satoru Nagase
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Yoichi Kobayashi
- Department of Obstetrics and Gynecology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Tsutomu Tabata
- Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Tokyo, Japan
| | | | - Toyomi Satoh
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | | | - Noriomi Matsumura
- Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yoshihito Yokoyama
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Kei Kawana
- Department of Obstetrics and Gynecology, Nihon University School of Medicine, Tokyo, Japan
| | - Satoru Kyo
- Department of Obstetrics and Gynecology, Shimane University School of Medicine, Shimane, Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Hidetaka Katabuchi
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| |
Collapse
|
15
|
Folguera-Arnau M, Gutiérrez-Vilaplana JM, González-María E, Moreno-Casbas MT, Obarrio-Fernández S, Lorente-Granados G, Viñoly Torres E, Rodríguez-Soberado MP. Implementation of best practice guidelines for ostomy care and management: Care outcomes. Enferm Clin (Engl Ed) 2020; 30:176-184. [PMID: 32359975 DOI: 10.1016/j.enfcli.2019.10.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 08/05/2019] [Revised: 10/03/2019] [Accepted: 10/25/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Care provided to ostomized people is crucial in their progress and rehabilitation. The Registered Nurses' Association of Ontario clinical practice guidelines include greatest evidence nursing interventions for ostomized patient care. The aim of the study is to analyze the impact on patients' care and health outcomes after Care and management of ostomy guideline implementation. METHOD Pre-post quasi-experimental study, carried out in all patients who underwent a digestive or urological ostomy in 8 centres of Best Practices Spotlight Organization® where the ostomy care and management guideline was implanted from 2012 to 2018. Clinical, process and health outcome variables were analyzed and compared in 3 periods of time. Descriptive analysis and comparison of proportions between the periods was performed, using Chi square, applying Yates correction, considering a 95% confidence interval. RESULTS Preoperative education went from 36.7 to 47.3% (P<.05); stoma site marking from 25.2 to 33.8% (P<.05); postoperative evaluation from 94.8 to 59% (P<.05); postoperative education from 75.5 to 91.9% (P<.05); peristomal skin complications from 16.6 to 10.9% (P<.05), and ostomy complications from 21.8 to 27.9% (P<.05). CONCLUSIONS The implementation of the ostomy care and management improved preoperative care, stoma site marking and peristomal skin complications.
Collapse
Affiliation(s)
| | | | - Esther González-María
- Unidad de Investigación en Cuidados y Servicios de Salud (Investén-isciii), Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, España
| | - María Teresa Moreno-Casbas
- Unidad de Investigación en Cuidados y Servicios de Salud (Investén-isciii), Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, España
| | | | - Gloria Lorente-Granados
- Gerencia de Atención Integrada de Alcázar de San Juan, Alcázar de San Juan, Ciudad Real, España
| | | | | |
Collapse
|
16
|
Yamagami W, Mikami M, Nagase S, Tabata T, Kobayashi Y, Kaneuchi M, Kobayashi H, Yamada H, Hasegawa K, Fujiwara H, Katabuchi H, Aoki D. Japan Society of Gynecologic Oncology 2018 guidelines for treatment of uterine body neoplasms. J Gynecol Oncol 2019; 31:e18. [PMID: 31789001 PMCID: PMC6918887 DOI: 10.3802/jgo.2020.31.e18] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 09/05/2019] [Indexed: 11/30/2022] Open
Abstract
The Fourth Edition of the Guidelines for Treatment of Uterine Body Neoplasm was published in 2018. These guidelines include 9 chapters: 1. Overview of the guidelines, 2. Initial treatment for endometrial cancer, 3. Postoperative adjuvant therapy for endometrial cancer, 4. Post-treatment surveillance for endometrial cancer, 5. Treatment for advanced or recurrent endometrial cancer, 6. Fertility-sparing therapy, 7. Treatment of uterine carcinosarcoma and uterine sarcoma, 8. Treatment of trophoblastic disease, 9. Document collection; and nine algorithms: 1-3. Initial treatment of endometrial cancer, 4. Postoperative adjuvant treatment for endometrial cancer, 5. Treatment of recurrent endometrial cancer, 6. Fertility-sparing therapy, 7. Treatment for uterine carcinosarcoma, 8. Treatment for uterine sarcoma, 9. Treatment for choriocarcinoma. Each chapter includes overviews and clinical questions, and recommendations, objectives, explanation, and references are provided for each clinical question. This revision has no major changes compared to the 3rd edition, but does have some differences: 1) an explanation of the recommendation decision process and conflict of interest considerations have been added in the overview, 2) nurses, pharmacists and patients participated in creation of the guidelines, in addition to physicians, 3) the approach to evidence collection is listed at the end of the guidelines, and 4) for clinical questions that lack evidence or clinical validation, the opinion of the Guidelines Committee is given as a “Recommendations for tomorrow”.
Collapse
Affiliation(s)
- Wataru Yamagami
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
| | - Mikio Mikami
- Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan
| | - Satoru Nagase
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Tsutomu Tabata
- Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yoichi Kobayashi
- Department of Obstetrics and Gynecology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | | | - Hiroaki Kobayashi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Hidekazu Yamada
- Department of Gynecology, Miyagi Cancer Center, Miyagi, Japan
| | - Kiyoshi Hasegawa
- Department of Obstetrics and Gynecology, Dokkyo Medical University, Tochigi, Japan
| | - Hiroyuki Fujiwara
- Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan
| | - Hidetaka Katabuchi
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
| |
Collapse
|
17
|
Fortmann J, Spreckelsen C. Separating Procedures and Criteria in Computerized Clinical Guidelines - A 3-Layer Approach. Stud Health Technol Inform 2019; 267:118-125. [PMID: 31483263 DOI: 10.3233/shti190815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Computerized guidelines have been utilized for several decades by now. Systems based on computerized-guidelines often intertwine (1) medical knowledge representation, (2) guideline procedures and (3) hospital workflows. This induces several drawbacks. Most prominent problems include non-shareability of the computerized guideline between hospitals, limited accessibility of the computerized guideline for humans, and an unclear, often confusing combination of hospital-specific workflow and guideline-induced control flows. This article proposes a 3-layer modelling approach strictly distinguishing the aforementioned three aspects to overcome the respective problems. We applied the 3-layer approach to the implementation of a guideline-interpreting software module in the context of the Medical Informatics Initiative Germany (here: SMITH Project) and comment on the resulting implications for the software design of that module.
Collapse
Affiliation(s)
- Jonas Fortmann
- Department of Medical Informatics, Faculty of Medicine, RWTH Aachen University
| | - Cord Spreckelsen
- Department of Medical Informatics, Faculty of Medicine, RWTH Aachen University
- Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, Germany
| |
Collapse
|
18
|
García Cano C, Sánchez López JC, Peñalver Peñalver A. [Quality of Clinical Practice Guidelines for COPD.]. Rev Esp Salud Publica 2019; 93:e201907041. [PMID: 31309932] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 07/03/2019] [Indexed: 06/10/2023] Open
Abstract
OBJECTIVE World Health Organization deem Chronic Obstructive Pulmonary Disease as the fourth leading cause of death in the world. Because of its impact on Public Health, it represents a great burden from an international economic point of view, despite it is an avoidable and treatable disease. Hence it is suitable to use Clinical Practice Guidelines which are recommendations systematically developed to aid decision making about health care to improve quality, and they must be subject to a review and update of an enriching methodological rigor. There is currently many Clinical Practice Guidelines for Chronic Obstructive Pulmonary Disease but there is insufficient evidence to determine if they have the degree of methological quality for been used in clinical practice. For which, we have evaluated the quality of these Clinical Practice Guidelines in Spanish using the AGREE II instrument. METHODS We carried out a systematic search to find the Clinical Practice Guidelines for Chronic Obstructive Pulmonary Disease published in Spanish between 2010-2017 and put a quality evaluation into effect by means of AGREE II instrument. RESULTS We got six guidelines wich achieved inclusion criteria of the study and we draw the compliance of the domains in these guidelines by means of AGREE II instrument: Scope and purpose (55.56-92.59%), Stakeholder involvement (37.04-79.63%), Rigour of development (29.86-84.72%), Clarity of presentation (90.74-100%), Applicability (5.56-63.89%) and Editorial independence (5.56-94.44%). CONCLUSIONS Only one guideline got the score to classify as Very Good Fulfilling/Very Hight Score; another four got Good Fulfilling/Hight Score; and last one got Low Fulfilling/Low Score.
Collapse
Affiliation(s)
- Cristian García Cano
- Enfermero de Atención Primaria en el Hospital del Vinalopó (Departamento Elche-Crevillente). Alicante. España
| | | | | |
Collapse
|
19
|
Esteller E, Carrasco M, Díaz-Herrera MÁ, Vila J, Sampol G, Juvanteny J, Sieira R, Farré A, Vilaseca I. Clinical Practice Guideline recommendations on examination of the upper airway for adults with suspected obstructive sleep apnoea-hypopnoea syndrome. Acta Otorrinolaringol Esp (Engl Ed) 2019; 70:364-72. [PMID: 30616837 DOI: 10.1016/j.otorri.2018.06.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/20/2018] [Accepted: 06/27/2018] [Indexed: 11/22/2022]
Abstract
In November 2014 the Spanish Society of Otolaryngology, the Spanish Sleep Society and the Spanish Society of Maxillofacial Surgery proposed and endorsed the development of a Clinical Practice Guideline on the physical examination of the upper airway in patients with obstructive sleep apnoea. The Guideline strictly followed the recommendations of the manual for the preparation of clinical practice guidelines of the National Health System 2007 and 2009 and the manual of the Scottish Intercollegiate Guidelines Network (SIGN) 2015. The final document could be highly useful for the purposes that were originally proposed: to act as a reference to unify the regions that should be explored in patients with obstructive sleep apnoea-hypopnoea syndrome, the type of examination and how to grade it, and specific to all the care areas to which these patients have access. The conclusions and recommendations are based on a thorough and up-to-date review of the literature with a high level of evidence, as well as the experience and knowledge demonstrated by all the members of the drafting group. This group was formed bearing in mind at all times the transversality of the project, and, therefore, specialists from all the involved areas participated (maxillofacial surgery, family medicine, pneumology, clinical neurophysiology, odontology and otolaryngology). The external reviewers of the final text were selected along the same lines.
Collapse
|
20
|
Abstract
Introduction This guideline was developed to present the evidence and provide clinical recommendations on prosthetic knee selection for unilateral amputation at the knee disarticulation or transfemoral level. Methods The guideline is based upon the best available evidence as it relates to prosthetic knee selection after unilateral knee disarticulation or transfemoral amputation. Recommendations are drawn from systematic review, meta-analysis, and additional published practice guidelines. Results Recommendation 1. Fluid knee benefits and indications: Knees with hydraulic or pneumatic swing resistance are indicated for active walkers, permitting increased walking comfort, speed, and symmetry.Recommendation 2. Microprocessor knee benefits: Compared with nonmicroprocessor knees:a) With respect to self-report indices and measures, microprocessor knees are indicated to reduce stumbles, falls, and associated frustrations as well as the cognitive demands of ambulation.b) With respect to self-report indices and measures, microprocessor knees are indicated to increase confidence while walking, self-reported mobility, satisfaction, well-being, and quality of life.c) With respect to physical performance indices and measures, microprocessor knees are indicated to increase self-selected walking speed, walking speed on uneven terrain, and metabolic efficiency during gait.Recommendation 3. Microprocessor knee equivalence: Given the comparable values observed with the use of microprocessor and nonmicroprocessor knees with regard to daily step counts, temporal and spatial gait symmetry, self-reported general health, and total costs of prosthetic rehabilitation, these parameters may not be primary indications in prosthetic knee joint selection.Recommendation 4. Microprocessor knees for limited community ambulators: Among limited community ambulators, microprocessor knees are indicated to enable increases in level ground walking speed and walking speed on uneven terrain while substantially reducing uncontrolled falls and increasing both measured and perceived balance. Conclusions These clinical practice guidelines summarize the available evidence related to prosthetic knee selection for individuals with unilateral knee disarticulation or transfemoral amputation. The noted clinical practice guidelines are meant to serve on as "guides." They may not apply to all patients and clinical situations.
Collapse
|
21
|
Abstract
OBJECTIVE Several countries have developed Clinical Practice Guidelines regarding treatment of perinatal depressive symptoms and perinatal use of antidepressant. We aimed to compare guidelines to guide clinicians in best clinical practice. METHODS An extensive search in guideline databases, MEDLINE and PsycINFO was performed. When no guidelines were (publicly) available online, we contacted psychiatric-, obstetric-, perinatal- and mood disorder societies of all first world countries and the five largest second world countries. Only Clinical Practice Guidelines adhering to quality criteria of the Appraisal of Guidelines for Research and Evaluation instrument and including a systematic review of evidence were included. Data extraction focussed on recommendations regarding continuation or withdrawal of antidepressants and preferred treatment in newly depressed patients. RESULTS Our initial search resulted in 1094 articles. After first screening, 40 full-text articles were screened. Of these, 24 were excluded for not being an official Clinical Practice Guidelines. In total, 16 Clinical Practice Guidelines were included originating from 12 countries. Eight guidelines were perinatal specific and eight were general guidelines. CONCLUSION During pregnancy, four guidelines advise to continue antidepressants, while there is a lack of evidence supporting this recommendation. Five guidelines do not specifically advise or discourage continuation. For new episodes, guidelines agree on psychotherapy (especially cognitive behavioural therapy) as initial treatment for mild to moderate depression and antidepressants for severe depression, with a preference for sertraline. Paroxetine is not preferred treatment for new episodes but switching antidepressants for ongoing treatment is discouraged (three guidelines). If mothers use antidepressants, observation of the neonate is generally recommended and breastfeeding encouraged.
Collapse
Affiliation(s)
- Nina M Molenaar
- Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands,Nina M Molenaar, Department of Psychiatry, Erasmus MC, Antwoordnummer 55, 3000 WB Rotterdam, The Netherlands.
| | | | - Philip Boyce
- Department of Psychiatry, Westmead Hospital, Westmead, NSW, Australia
| | - Veerle Bergink
- Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands,Current affiliation: Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
22
|
Abarshi E, Rietjens J, Robijn L, Caraceni A, Payne S, Deliens L, Van den Block L. International variations in clinical practice guidelines for palliative sedation: a systematic review. BMJ Support Palliat Care 2017; 7:223-229. [PMID: 28432090 DOI: 10.1136/bmjspcare-2016-001159] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 01/09/2017] [Accepted: 04/01/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Palliative sedation is a highly debated medical practice, particularly regarding its proper use in end-of-life care. Worldwide, guidelines are used to standardise care and regulate this practice. In this review, we identify and compare national/regional clinical practice guidelines on palliative sedation against the European Association for Palliative Care (EAPC) palliative sedation Framework and assess the developmental quality of these guidelines using the Appraisal Guideline Research and Evaluation (AGREE II) instrument. METHODS Using the PRISMA criteria, we searched multiple databases (PubMed, CancerLit, CINAHL, Cochrane Library, NHS Evidence and Google Scholar) for relevant guidelines, and selected those written in English, Dutch and Italian; published between January 2000 and March 2016. RESULTS Of 264 hits, 13 guidelines-Belgium, Canada (3), Ireland, Italy, Japan, the Netherlands, Norway, Spain, Europe, and USA (2) were selected. 8 contained at least 9/10 recommendations published in the EAPC Framework; 9 recommended 'pre-emptive discussion of the potential role of sedation in end-of-life care'; 9 recommended 'nutrition/hydration while performing sedation' and 8 acknowledged the need to 'care for the medical team'. There were striking differences in terminologies used and in life expectancy preceding the practice. Selected guidelines were conceptually similar, comparing closely to the EAPC Framework recommendations, albeit with notable variations. CONCLUSIONS Based on AGREE II, 3 guidelines achieved top scores and could therefore be recommended for use in this context. Also, domains 'scope and purpose' and 'editorial independence' ranked highest and lowest, respectively-underscoring the importance of good reportage at the developmental stage.
Collapse
Affiliation(s)
- Ebun Abarshi
- International Observatory on End-of-Life Care, Lancaster, United Kingdom
| | - Judith Rietjens
- Department of Public Health, Erasmus Medical Centre, Rotterdam, The Netherlands.,End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium
| | - Lenzo Robijn
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium
| | - Augusto Caraceni
- Fondazione IRCCS Instituto Nazionale dei Tumori, Milan, Italy.,European Palliative Care Research Center, Norwegian University of Science and Technology Trondheim Norway, EAPC Research Network
| | - Sheila Payne
- International Observatory on End-of-Life Care, Lancaster, United Kingdom
| | - Luc Deliens
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium.,Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - Lieve Van den Block
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium.,Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | | |
Collapse
|
23
|
Blyth CC, Haeusler GM, McMullan BJ, Kotecha RS, Slavin MA, Clark JE. Critical review of current clinical practice guidelines for antifungal therapy in paediatric haematology and oncology. Support Care Cancer 2017; 25:3289-90. [PMID: 28353037 DOI: 10.1007/s00520-017-3681-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 03/15/2017] [Indexed: 10/19/2022]
|
24
|
Radwan M, Akbari Sari A, Rashidian A, Takian A, Abou-Dagga S, Elsous A. Appraising the methodological quality of the clinical practice guideline for diabetes mellitus using the AGREE II instrument: a methodological evaluation. JRSM Open 2017; 8:2054270416682673. [PMID: 28203385 PMCID: PMC5298436 DOI: 10.1177/2054270416682673] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To evaluate the methodological quality of the Palestinian Clinical Practice Guideline for Diabetes Mellitus using the Translated Arabic Version of the AGREE II. DESIGN Methodological evaluation. A cross-cultural adaptation framework was followed to translate and develop a standardised Translated Arabic Version of the AGREE II. SETTING Palestinian Primary Healthcare Centres. PARTICIPANTS Sixteen appraisers independently evaluated the Clinical Practice Guideline for Diabetes Mellitus using the Translated Arabic Version of the AGREE II. MAIN OUTCOME MEASURES Methodological quality of diabetic guideline. RESULTS The Translated Arabic Version of the AGREE II showed an acceptable reliability and validity. Internal consistency ranged between 0.67 and 0.88 (Cronbach's α). Intra-class coefficient among appraisers ranged between 0.56 and 0.88. The quality of this guideline is low. Both domains 'Scope and Purpose' and 'Clarity of Presentation' had the highest quality scores (66.7% and 61.5%, respectively), whereas the scores for 'Applicability', 'Stakeholder Involvement', 'Rigour of Development' and 'Editorial Independence' were the lowest (27%, 35%, 36.5%, and 40%, respectively). CONCLUSIONS The findings suggest that the quality of this Clinical Practice Guideline is disappointingly low. To improve the quality of current and future guidelines, the AGREE II instrument is extremely recommended to be incorporated as a gold standard for developing, evaluating or updating the Palestinian Clinical Practice Guidelines. Future guidelines can be improved by setting specific strategies to overcome implementation barriers with respect to economic considerations, engaging of all relevant end-users and patients, ensuring a rigorous methodology for searching, selecting and synthesising the evidences and recommendations, and addressing potential conflict of interests within the development group.
Collapse
Affiliation(s)
- Mahmoud Radwan
- Department of Health Management and Economics, School of Public Health, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Akbari Sari
- School of Public Health, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Rashidian
- School of Public Health, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Takian
- Department of Health Management and Economics, School of Public Health, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanaa Abou-Dagga
- Department of Research Affairs and Graduates Studies, Islamic University of Gaza, Gaza Strip, Palestine
| | - Aymen Elsous
- Department of Health Management and Economics, School of Public Health, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
25
|
Shamshiri M, Fuh Suh B, Mohammadi N, Nabi Amjad R. A Survey of Adherence to Guidelines to Prevent Healthcare-Associated Infections in Iranian Intensive Care Units. Iran Red Crescent Med J 2016; 18:e27435. [PMID: 27621932 PMCID: PMC5004621 DOI: 10.5812/ircmj.27435] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 01/13/2016] [Accepted: 03/06/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Healthcare-associated infections (HAIs) are acquired by patients while receiving care. The highest incidence of HAIs has been documented in admissions to intensive care units. Adherence to evidence-based practices is the most important step for preventing HAIs. OBJECTIVES To determine the rate of adherence to evidence-based post-insertion recommended care practices after admission into the intensive care unit for the following devices: central line catheter, indwelling urinary catheter, and mechanical ventilator. PATIENTS AND METHODS A structured observational cross-sectional research design was used. Data were collected using a checklist and a self-report questionnaire. The minimum sample size required for this study was 276 post-insertion care episodes, and 332 episodes were observed. The ANOVA test was used to identify any significant differences among the mean scores of the three devices. RESULTS Overall observed adherence rates were 18.3%, 59.1%, and 43.1% for central line catheters, indwelling urinary catheter, and mechanical ventilator, respectively. Of the observed episodes of device care, only in 9.4% of the episodes was regular oral care performed for patients on mechanical ventilators and only in 19.3% of the episodes were indwelling urinary catheters properly secure after insertion. More so, in none (0.0%) of the episodes was the central line catheter hub disinfected before being accessed. CONCLUSIONS Evidence-based post-insertion recommended care practices were not consistently and uniformly implemented in the intensive care units. Establishment of a program for the surveillance of adherence to recommended guidelines is required for improving compliance by health professionals and the quality of preventive care.
Collapse
Affiliation(s)
- Mahmood Shamshiri
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, IR Iran
| | - Boudouin Fuh Suh
- Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences-International Campus, Tehran, IR Iran
| | - Nooredin Mohammadi
- Department of Critical Care Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, IR Iran
| | - Reza Nabi Amjad
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran
| |
Collapse
|
26
|
Abstract
By November 2013, a total of 125 clinical practice guidelines (CPGs) have been developed in Korea. However, despite the high burden of diseases and the clinical importance of CPGs, most chronic diseases do not have available CPGs. Merely 83 CPGs are related to chronic diseases, and only 40 guidelines had been developed in the last 5 yr. Considering the rate of the production of new evidence in medicine and the worsening burden from chronic diseases, the need for developing CPGs for more chronic diseases is becoming increasingly pressing. Since 2011, the Korean Academy of Medical Sciences and the Korea Centers for Disease Control and Prevention have been jointly developing CPGs for chronic diseases. However, priorities have to be set and resources need to be allocated within the constraint of a limited funding. This study identifies the chronic diseases that should be prioritized for the development of CPGs in Korea. Through an objective assessment by using the analytic hierarchy process and a subjective assessment with a survey of expert opinion, high priorities were placed on ischemic heart disease, cerebrovascular diseases, Alzheimer's disease and other dementias, osteoarthritis, neck pain, chronic kidney disease, and cirrhosis of the liver.
Collapse
Affiliation(s)
- Heui-Sug Jo
- Department of Health Management and Policy, Kangwon National University School of Medicine, Chuncheon, Korea
- The Executive Committee for Clinical Practice Guidelines, The Korean Academy of Medical Sciences, Seoul, Korea
| | - Dong Ik Kim
- Department of Radiology, Yonsei University Sevrance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Moo-Kyung Oh
- Department of Preventive Medicine, Kangwon National University Hospital, Chuncheon, Korea
| |
Collapse
|
27
|
Abstract
This study introduces the Clinical practice guidelines (CPGs) appraisal system by the Korean Academy of Medical Sciences (KAMS). Quality management policies for CPGs vary among different countries, which have their own cultures and health care systems. However, supporting developers in guideline development and appraisals using standardized tools are common practices. KAMS, an organization representing the various medical societies of Korea, has been striving to establish a quality management system for CPGs, and has established a CPGs quality management system that reflects the characteristics of the Korean healthcare environment and the needs of its users. KAMS created a foundation for the development of CPGs, set up an independent appraisal organization, enacted regulations related to the appraisals, and trained appraisers. These efforts could enhance the ability of each individual medical society to develop CPGs, to increase the quality of the CPGs, and to ultimately improve the quality of the information available to decision-makers.
Collapse
Affiliation(s)
- Heui-Sug Jo
- Department of Health Management and Policy, Kangwon National University, School of Medicine, Chuncheon, Korea
- The Executive Committee for Clinical Practice Guideline, The Korean Academy of Medical Sciences, Seoul, Korea
| | - Dong Ik Kim
- Department of Radiology, Yonsei University Sevrance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sung-Goo Chang
- The Executive Committee for Clinical Practice Guideline, The Korean Academy of Medical Sciences, Seoul, Korea
- Department of Urology, Kyung Hee University Medical Center, School of Medicine Kyung-Hee University, Seoul, Korea
| | - Ein-Soon Shin
- The Executive Committee for Clinical Practice Guideline, The Korean Academy of Medical Sciences, Seoul, Korea
- Research Agency for Clinical Practice Guidelines, KAMS Research Center, The Korean Academy of Medical Sciences, Seoul, Korea
| | - Moo-Kyung Oh
- Department of Preventive Medicine, Kangwon National University Hospital, Chuncheon, Korea
| |
Collapse
|
28
|
Serrano-Aguilar P, Trujillo-Martin MDM, Pérez de la Rosa A, Cuellar-Pompa L, Saavedra-Medina H, Linertova R, Perestelo-Perez L, Perez-Ramos J, Rivero-Santana A. Patient participation in a Clinical Guideline Development for Systemic Lupus Erythematosus. Patient Educ Couns 2015; 98:1156-1163. [PMID: 26095343 DOI: 10.1016/j.pec.2015.05.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 05/08/2015] [Accepted: 05/30/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To incorporate patients' perspective in the design of a clinical practice guideline (CPG) for Systemic Lupus Erythematosus in Spain. METHODS A systematic review (SR) of literature and a Delphi-based consultation to patients were carried out. RESULTS From the SR, most relevant health problems are classified as physical, psychological, familial, and socio-economic. Dissatisfaction is mainly due to unmet information needs and limited access to care. In the consultation (n=102), most frequently reported health problems were pain, fatigue, photosensitivity, mood disorders, renal damage, poor concentration, and memory loss. Dissatisfaction with poor coordination between primary and specialized care was reported. Information to improve self-management and on alternative therapies was requested. Relevant topics from both sources were merged and discussed by the guideline development group (including a patient representative) to set the key questions underpinning the CPG. CONCLUSION Patient involvement in CPG development by a combination of methods can enhance patient-centered care by achieving clinical practice responsive to their needs. PRACTICE IMPLICATIONS Involving patients in CPG development is feasible and useful to improve the advance of Health Services toward patient-centered care. A multicomponent strategy for involvement is suggested to address the gap between the available evidence and contextual current patient needs and preferences.
Collapse
Affiliation(s)
- Pedro Serrano-Aguilar
- Evaluation Service of the Canary Islands Health Service (SESCS), Santa Cruz de Tenerife, Spain; Spanish Network of Health Services Research for Chronic Diseases (REDISSEC), Madrid, Spain.
| | - Maria del Mar Trujillo-Martin
- Spanish Network of Health Services Research for Chronic Diseases (REDISSEC), Madrid, Spain; Canary Foundation for Health Care Research (FUNCANIS), Canary Islands, Spain
| | | | | | | | - Renata Linertova
- Spanish Network of Health Services Research for Chronic Diseases (REDISSEC), Madrid, Spain; Canary Foundation for Health Care Research (FUNCANIS), Canary Islands, Spain
| | - Lilisbeth Perestelo-Perez
- Evaluation Service of the Canary Islands Health Service (SESCS), Santa Cruz de Tenerife, Spain; Spanish Network of Health Services Research for Chronic Diseases (REDISSEC), Madrid, Spain
| | | | - Amado Rivero-Santana
- Spanish Network of Health Services Research for Chronic Diseases (REDISSEC), Madrid, Spain; Canary Foundation for Health Care Research (FUNCANIS), Canary Islands, Spain
| |
Collapse
|
29
|
de la Hoz Bradford AM, Ávila MJ, Bohórquez Peñaranda AP, García Valencia J, Arenas Borrero ÁE, Vélez Traslaviña Á, Jaramillo González LE, Gómez-Restrepo C. [ Clinical Practice Guidelines for Management of Schizophrenia: Evaluation Using AGREE II]. Rev Colomb Psiquiatr 2015; 44 Suppl 1:3-12. [PMID: 26576458 DOI: 10.1016/j.rcp.2015.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Accepted: 12/12/2014] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Colombia is developing multiple national practice guidelines from a range of diseases. Clinical practice guidelines represent a very useful tool to be able to take decision over a patient care that is widely available for the clinician. In psychiatry there are a good number of international clinical guidelines for the treatment of schizophrenia nevertheless there is no article that evaluate them scientifically METHODS In the settings of developing a Colombian schizophrenia practice guideline, a systematic search was performed in multiple databases and the results were then evaluated by two trained persons. We present the results globally and by domains. RESULTS We found 164 matches for possible guidelines. After screening 7 guidelines were evaluated with the AGREE II instrument. Globally and by the different domains, the National Institute for Health and Care Excellence (NICE) was the guideline that got the best score. From the guidelines that were reviewed, 4 were from Europe and only 2 were from Latin America. None of the guidelines used GRADE methodology for the recommendations. CONCLUSION The diversity of the schizophrenia treatment guidelines does not allow an easy adoption of the recommendation by a psychiatrist in Colombia.
Collapse
Affiliation(s)
- Ana María de la Hoz Bradford
- Médica, magístra en Epidemiología Clínica. Profesora del Departamento de Epidemiología Clínica y Bioestadística. Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Mauricio J Ávila
- Médico Servicio Social Obligatorio. Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Adriana Patricia Bohórquez Peñaranda
- Médica psiquiatra, magístra en Epidemiología Clínica. Profesora asistente del departamento de Psiquiatría y Salud Mental. Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Jenny García Valencia
- Médica psiquiatra, doctora en Epidemiología Clínica. Profesora titular del Departamento de Psiquiatría, Facultad de Medicina. Universidad de Antioquia, Medellín, Antioquia, Colombia
| | - Álvaro Enrique Arenas Borrero
- Médico psiquiatra, Magíster en Epidemiología Clínica. Profesor del departamento de Psiquiatría y Salud Mental. Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | | | - Carlos Gómez-Restrepo
- Médico psiquiatra, psicoanalista, psiquiatra de enlace, magíster en Epidemiología Clínica. Profesor titular y Director del Departamento de Epidemiología Clínica y Bioestadística. Pontificia Universidad Javeriana. Hospital Universitario San Ignacio, Bogotá, Colombia.
| |
Collapse
|
30
|
Ahunca Velásquez LF, García Valencia J, Bohórquez Peñaranda AP, Gómez-Restrepo C, Jaramillo González LE, Palacio Acosta C. [Psychosocial Interventions in Acute and Maintenance Treatment of Adult Patients Diagnosed With Schizophrenia]. ACTA ACUST UNITED AC 2015; 44 Suppl 1:75-89. [PMID: 26576464 DOI: 10.1016/j.rcp.2015.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 12/06/2014] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To determine the effectiveness of the psychosocial strategies designed to improve the outcomes in adults with schizophrenia in both, acute and stable phase of the disorder. This evidence is used to propose recommendation in the guidelines of integral attention for the diagnosis, treatment and psychosocial rehabilitation of adults with schizophrenia. METHODS A guideline for clinical practice was developed using the methodological framework of the Ministerio de la Protección Social to collect evidence and grading recommendations. A search, evaluation and synthesis of evidence were carried out. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced. RESULTS The psychoeducation and family intervention showed higher efficacy, compared with the usual treatment, to prevent relapses and hospital readmissions, to reduce family burden and to improve adherence to treatment. The social skill training was effective to improve symptoms, social functioning and quality of life. However, the quality of evidence was low. There was not enough evidence about the efficacy of occupational therapy, but considering patients preferences and its wide clinical utilization, the GDG suggested its inclusion. CONCLUSION Psychoeducation, family intervention and social skill training are recommended to be offered for the treatment of schizophrenia. Furthermore, occupational therapy is suggested for inpatients and outpatients with the disorder.
Collapse
Affiliation(s)
- Luisa Fernanda Ahunca Velásquez
- Médica Psiquiatra, subespecialista en Neuropsiquiatría. Estudiante de Maestría en Ciencias Clínicas, Facultad de Medicina, Universidad de Antioquia, Delegada Asociación Colombiana de Psiquiatría
| | - Jenny García Valencia
- Médica Psiquiatra, Magíster y Doctora en Epidemiología. Profesora Titular del Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia.
| | - Adriana Patricia Bohórquez Peñaranda
- Médica Psiquiatra, Magíster en Epidemiología Clínica. Profesora Asistente del Departamento de Psiquiatría y Salud Mental. Pontificia Universidad Javeriana
| | - Carlos Gómez-Restrepo
- Médico Psiquiatra, Psicoanalista, Psiquiatra de Enlace, Magíster en Epidemiología Clínica. Profesor Titular y Director del Departamento de Epidemiología Clínica y Bioestadística. Pontificia Universidad Javeriana. Hospital Universitario San Ignacio
| | | | - Carlos Palacio Acosta
- Médico Psiquiatra, Magíster en Epidemiología. Profesor Titular del Departamento de Psiquiatría, Decano de la Facultad de Medicina, Universidad de Antioquia
| |
Collapse
|
31
|
García Valencia J, Ahunca Velásquez LF, Bohórquez Peñaranda A, Gómez Restrepo C, Jaramillo González LE, Palacio Acosta C. [Psychotherapeutic Interventions in Acute and Maintenance Treatment of Adult Patients Diagnosed With Schizophrenia]. Rev Colomb Psiquiatr 2015; 44 Suppl 1:90-100. [PMID: 26576465 DOI: 10.1016/j.rcp.2015.05.011] [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] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 12/09/2014] [Indexed: 06/05/2023]
Abstract
OBJECTIVES To determine the effectiveness of the psychotherapeutic strategies designed to improve the outcomes in adults with schizophrenia in both, acute and stable phase of disease. This evidence is used to propose recommendation in the guidelines of integral attention for the diagnosis, treatment and psychosocial rehabilitation of adults with schizophrenia. METHODS A guideline for clinical practice was developed using the methodological framework of the Ministerio de la Protección Social to collect evidence and grading recommendations. A search, evaluation and synthesis of evidence were carried out. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced. RESULTS The cognitive behavioral therapy showed higher efficacy, compared with the usual treatment, to reduce positive symptoms, prevent relapses and hospital readmissions and to improve the occupational stats. However, the quality of evidence was low. There was not enough evidence about the efficacy of adherence, psychodynamic and support therapy. CONCLUSION Psychotherapeutic management must be offered to the patients with schizophrenia according to their needs and clinical characteristics. Among the different psychotherapeutic modalities, cognitive behavioral therapy is recommended.
Collapse
Affiliation(s)
- Jenny García Valencia
- Médica Psiquiatra, Magíster y Doctora en Epidemiología. Profesora Asociada del Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia., Medellín, Antioquia, Colombia.
| | - Luisa Fernanda Ahunca Velásquez
- Médica Psiquiatra, subespecialista en Neuropsiquiatría. Estudiante de Maestría en Ciencias Clínicas, Facultad de Medicina, Universidad de Antioquia, Delegada Asociación Colombiana de Psiquiatría, Medellín, Antioquia, Colombia
| | - Adriana Bohórquez Peñaranda
- Médica Psiquiatra, Magíster en Epidemiología Clínica. Profesora Titular del Departamento de Psiquiatría y Salud Mental. Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Carlos Gómez Restrepo
- Médico Psiquiatra, Psicoanalista, Psiquiatra de Enlace, Magíster en Epidemiología Clínica. Profesor Titular y Director del Departamento de Epidemiología Clínica y Bioestadística. Pontificia Universidad Javeriana. Hospital Universitario San Ignacio, Bogotá, Colombia
| | | | - Carlos Palacio Acosta
- Médico Psiquiatra, Magíster en Epidemiología. Profesor Titular del Departamento de Psiquiatría, Decano de la Facultad de Medicina, Universidad de Antioquia, Medellín, Antioquia, Colombia
| |
Collapse
|
32
|
Hay P, Chinn D, Forbes D, Madden S, Newton R, Sugenor L, Touyz S, Ward W. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders. Aust N Z J Psychiatry 2014; 48:977-1008. [PMID: 25351912 DOI: 10.1177/0004867414555814] [Citation(s) in RCA: 316] [Impact Index Per Article: 31.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES This clinical practice guideline for treatment of DSM-5 feeding and eating disorders was conducted as part of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) Clinical Practice Guidelines (CPG) Project 2013-2014. METHODS The CPG was developed in accordance with best practice according to the National Health and Medical Research Council of Australia. Literature of evidence for treatments of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), other specified and unspecified eating disorders and avoidant restrictive food intake disorder (ARFID) was sourced from the previous RANZCP CPG reviews (dated to 2009) and updated with a systematic review (dated 2008-2013). A multidisciplinary working group wrote the draft CPG, which then underwent expert, community and stakeholder consultation, during which process additional evidence was identified. RESULTS In AN the CPG recommends treatment as an outpatient or day patient in most instances (i.e. in the least restrictive environment), with hospital admission for those at risk of medical and/or psychological compromise. A multi-axial and collaborative approach is recommended, including consideration of nutritional, medical and psychological aspects, the use of family based therapies in younger people and specialist therapist-led manualised based psychological therapies in all age groups and that include longer-term follow-up. A harm minimisation approach is recommended in chronic AN. In BN and BED the CPG recommends an individual psychological therapy for which the best evidence is for therapist-led cognitive behavioural therapy (CBT). There is also a role for CBT adapted for internet delivery, or CBT in a non-specialist guided self-help form. Medications that may be helpful either as an adjunctive or alternative treatment option include an antidepressant, topiramate, or orlistat (the last for people with comorbid obesity). No specific treatment is recommended for ARFID as there are no trials to guide practice. CONCLUSIONS Specific evidence based psychological and pharmacological treatments are recommended for most eating disorders but more trials are needed for specific therapies in AN, and research is urgently needed for all aspects of ARFID assessment and management. EXPERT REVIEWERS Associate Professor Susan Byrne, Dr Angelica Claudino, Dr Anthea Fursland, Associate Professor Jennifer Gaudiani, Dr Susan Hart, Ms Gabriella Heruc, Associate Professor Michael Kohn, Dr Rick Kausman, Dr Sarah Maguire, Ms Peta Marks, Professor Janet Treasure and Mr Andrew Wallis.
Collapse
Affiliation(s)
- Phillipa Hay
- Members of the CPG Working Group School of Medicine and Centre for Health Research, University of Western Sydney, Australia School of Medicine, James Cook University, Townsville, Australia
| | - David Chinn
- Members of the CPG Working Group Capital and Coast District Health Board, Wellington, New Zealand
| | - David Forbes
- Members of the CPG Working Group School of Pediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Sloane Madden
- Members of the CPG Working Group Eating Disorders Service, Sydney Children's Hospital Network, Westmead, Australia; School of Psychiatry, University of Sydney, Australia
| | - Richard Newton
- Members of the CPG Working Group Mental Health CSU, Austin Health, Australia; University of Melbourne, Australia
| | - Lois Sugenor
- Members of the CPG Working Group Department of Psychological Medicine, University of Otago at Christchurch, New Zealand
| | - Stephen Touyz
- Members of the CPG Working Group School of Psychology and Centre for Eating and Dieting Disorders, University of Sydney, Australia
| | - Warren Ward
- Members of the CPG Working Group Eating Disorders Service Royal Brisbane and Women's Hospital; University of Queensland, Brisbane, Australia
| | | |
Collapse
|
33
|
Oh MK, Jo H, Lee YK. Improving the reliability of clinical practice guideline appraisals: effects of the Korean AGREE II scoring guide. J Korean Med Sci 2014; 29:771-5. [PMID: 24932076 PMCID: PMC4055808 DOI: 10.3346/jkms.2014.29.6.771] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 03/28/2014] [Indexed: 11/20/2022] Open
Abstract
The Korean translated Appraisal of Guidelines for Research and Evaluation II (Korean AGREE II) instrument was distributed into Korean medical societies in 2011. However, inter-rater disagreement issues still exist. The Korean AGREE II scoring guide was therefore developed to reduce inter-rater differences. This study examines the effects of the Korean AGREE II scoring guide to reduce inter-rater differences. Appraisers were randomly assigned to two groups (Scoring Guide group and Non-Scoring Guide group). The Korean AGREE II instrument was provided to both groups. However, the scoring guide was offered to Scoring Guide group only. Total 14 appraisers were participated and each guideline was assessed by 8 appraisers. To evaluate the reliability of the Korean AGREE II scoring guide, correlation of scores among appraisers and domain-specific intra-class correlation (ICC) were compared. Most scores of two groups were comparable. Scoring Guide group showed higher reliability at all guidelines. They showed higher correlation among appraisers and higher ICC values at almost all domains. The scoring guide reduces the inter-rater disagreement and improves the overall reliability of the Korean-AGREE II instrument.
Collapse
Affiliation(s)
- Moo-Kyung Oh
- Department of Preventive Medicine, Kangwon National University Hospital, Chuncheon, Korea
| | - Heuisug Jo
- Department of Preventive Medicine, Kangwon National University Hospital, Chuncheon, Korea
- Department of Health Management and Policy, Kangwon National University School of Medicine, Chuncheon, Korea
- The Executive Committee for Clinical Practice Guideline, The Korean Academy of Medical Sciences, Seoul, Korea
| | - You Kyoung Lee
- The Executive Committee for Clinical Practice Guideline, The Korean Academy of Medical Sciences, Seoul, Korea
- Department of Laboratory Medicine and Genetics, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
- Department of Laboratory Medicine and Genetics, Soonchunhyang University College of Medicine, Cheonan, Korea
| |
Collapse
|
34
|
Hammermeister K, Bronsert M, Henderson WG, Coombs L, Hosokawa P, Brandt E, Bryan C, Valuck R, West D, Liaw W, Ho M, Pace W. Risk-adjusted comparison of blood pressure and low-density lipoprotein (LDL) noncontrol in primary care offices. J Am Board Fam Med 2013; 26:658-68. [PMID: 24204062 PMCID: PMC4544740 DOI: 10.3122/jabfm.2013.06.130017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES Population-level control of modifiable cardiovascular disease (CVD) risk factors is suboptimal. The objectives of this study were (1) to demonstrate the use of electronically downloaded electronic health record (EHR) data to assess guideline concordance in a large cohort of primary care patients, (2) to provide a contemporary assessment of blood pressure (BP) and low-density lipoprotein (LDL) noncontrol in primary care, and (3) to demonstrate the effect of risk adjustment of rates of noncontrol of BP and LDL for differences in patient mix on these clinic-level performance measures. METHODS This was an observational comparative effectiveness study that included 232,172 adult patients ≥18 years old with ≥1 visit within 2 years in 33 primary care clinics with EHRs. The main measures were rates of BP and LDL noncontrol based on current guidelines and were calculated from electronically downloaded EHR data. Rates of noncontrol were risk-adjusted using multivariable models of patient-level variables. RESULTS Overall, 16.0% of the 227,122 patients with known BP and 14.9% of the 136,771 patients with known LDL were uncontrolled. Clinic-level, risk-adjusted BP noncontrol ranged from 7.7% to 26.5%, whereas that for LDL ranged from 5.8% to 23.6%. Rates of noncontrol exceeded an achievable benchmark for 85% (n = 28) and 79% (n = 26) of the 33 clinics for BP and LDL, respectively. Risk adjustment significantly influences clinic rank order for rate of noncontrol. CONCLUSIONS We demonstrated that the use of electronic collection of data from a large cohort of patients from fee-for-service primary care clinics is feasible for the audit of and feedback on BP and LDL noncontrol. Rates of noncontrol for most clinics are substantially higher than those achievable. Risk adjustment of noncontrol rates results in a rank-order of clinics very different from that achieved with nonadjusted data.
Collapse
Affiliation(s)
- Karl Hammermeister
- Colorado Health Outcomes Program, University of Colorado School of Medicine, Aurora CO
- Division of Cardiology, University of Colorado School of Medicine, Aurora CO
| | - Michael Bronsert
- Colorado Health Outcomes Program, University of Colorado School of Medicine, Aurora CO
| | - William G. Henderson
- Colorado Health Outcomes Program, University of Colorado School of Medicine, Aurora CO
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora CO
| | - Letoynia Coombs
- Department of Family Medicine, University of Colorado School of Medicine, Aurora CO
| | - Patrick Hosokawa
- Colorado Health Outcomes Program, University of Colorado School of Medicine, Aurora CO
| | - Elias Brandt
- National Research Network, American Academy of Family Physicians, Leawood KS
| | | | - Robert Valuck
- Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora CO
| | - David West
- Colorado Health Outcomes Program, University of Colorado School of Medicine, Aurora CO
- Department of Family Medicine, University of Colorado School of Medicine, Aurora CO
| | - Winston Liaw
- Virginia Commonwealth University, Fairfax Family Medicine Residency Program, Fairfax, VA
| | - Michael Ho
- Denver VA Medical Center, Denver CO, and University of Colorado School of Medicine, Aurora CO
| | - Wilson Pace
- Colorado Health Outcomes Program, University of Colorado School of Medicine, Aurora CO
- Department of Family Medicine, University of Colorado School of Medicine, Aurora CO
- National Research Network, American Academy of Family Physicians, Leawood KS
| |
Collapse
|
35
|
Behjati M. Suggested indications of clinical practice guideline for stem cell-therapy in cardiovascular diseases: A stepwise appropriate use criteria for regeneration therapy. ARYA Atheroscler 2013; 9:306-10. [PMID: 24302941 PMCID: PMC3845691] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 06/29/2013] [Indexed: 11/16/2022]
Abstract
Despite astonishing progress concerning cardiovascular diseases, patients are still suffering from complications of acute insults. Due to reverse remodeling and improper myocyte rebuilding, heart failure has become a common problem these days which needs more powerful myocardial reconstructing strategies. Indeed, no option cases afflicted with non-healing peripheral vascular diseases; refractory stable and unstable angina is the other field with paucity of proper treatments. For these cases, stem cell-based therapies became optimistic treatment, but lack of guideline-based indications regarding stem-cell is still a major problem which limits application of these cells for such end-stage cases. Here, an outline of appropriateness criteria for stem cell-based therapy is suggested.
Collapse
Affiliation(s)
- Mohaddeseh Behjati
- Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran,Correspondence to: Mohaddeseh Behjati,
| |
Collapse
|
36
|
Salari H, Ostovar R, Esfandiari A, Keshtkaran A, Akbari Sari A, Yousefi Manesh H, Rakhshan A. Evidence for Policy Making: Clinical Appropriateness Study of Lumbar Spine MRI Prescriptions Using RAND Appropriateness Method. Int J Health Policy Manag 2013; 1:17-21. [PMID: 24596832 DOI: 10.15171/ijhpm.2013.04] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 04/04/2013] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND MRI is a new and expensive diagnostic technology, which has been used increasingly all over the world. Low back pain is a worldwide prevalent disorder and MRI technique is one of the several ways to diagnose it. This paper aims to identify the appropriateness of lumbar spine MRI prescriptions in Shiraz teaching hospitals using standardized RAND Appropriateness Method (RAM) criteria in 2012. METHODS This study consisted of two phases. The first phase involved a qualitative enquiry and the second phase had a quantitative cross-sectional nature. In the first phase RAM was used for developing lumbar spine MRI indications and scenarios. In the second phase, the finalized scenarios were compared with the history and physical examination of 300 patients with low back pain. The rate of appropriateness of lumbar spine MRI prescription was then calculated. RESULTS Of 300 cases of lumbar spine MRI prescriptions, approximately 167 (56%) were considered inappropriate, 72 (24%) were uncertain, and 61 (20%) were deemed to be appropriate. The economic burden of inappropriate prescriptions was calculated at 88,009,000 Rials. In addition, the types of expertise and physical examination were considered as related factors to appropriateness of prescriptions. CONCLUSION In conclusion, a large proportion of lumbar spine MRI prescriptions, which result in financial burden on the insurance companies and the patients alike is unnecessary. This study suggests that policy makers consider this evidence while decision-making. Our findings highlight the imperative role of Health Technology Assessment (HTA) and Clinical Practice Guidelines (CPGs). As a result, developing local clinical guidelines may create the commitment needed in physicians in prescribing appropriate prescriptions within the health sector. The study further recommends that appropriate scenarios should be considered as a criterion for payment and reimbursement.
Collapse
Affiliation(s)
- Hedayat Salari
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; Research Center for Health Services Management, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman , Iran
| | - Rahim Ostovar
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Atefeh Esfandiari
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; Research Center for Health Services Management, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman , Iran
| | - Ali Keshtkaran
- Department of Medical Informatics and Management, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Akbari Sari
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Yousefi Manesh
- Shiraz Medical Students Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Rakhshan
- Department of Foreign Languages, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
37
|
Jo MW, Lee JY, Kim NS, Kim SY, Sheen S, Kim SH, Lee SI. Assessment of the quality of clinical practice guidelines in Korea using the AGREE Instrument. J Korean Med Sci 2013; 28:357-65. [PMID: 23487579 PMCID: PMC3594597 DOI: 10.3346/jkms.2013.28.3.357] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 01/04/2013] [Indexed: 11/23/2022] Open
Abstract
The objective of this study was to conduct the systematic evaluation of methodological quality of clinical practice guidelines (CPGs) in Korea. The authors conducted a very comprehensive literature search to identify potential CPGs for evaluation. CPGs were selected which were consistent with a predetermined criteria. Four reviewers evaluated the quality of the CPGs using the Appraisal of Guidelines, Research and Evaluation (AGREE) Instrument. AGREE item scores and standardized domain scores were calculated. The inter-rater reliability of each domain was evaluated using the intra-class correlation coefficient (ICC). Consequently, 66 CPGs were selected and their quality evaluated. ICCs for CPG appraisal using the AGREE Instrument ranged from 0.626 to 0.877. Except for the "Scope and Purpose" and "Clarity and Presentation domains", 80% of CPGs scored less than 40 in all other domains. This review shows that many Korean research groups and academic societies have made considerable efforts to develop CPGs, and the number of CPGs has increased over time. However, the quality of CPGs in Korea were not good according to the AGREE Instrument evaluation. Therefore, we should make more of an effort to ensure the high quality of CPGs.
Collapse
Affiliation(s)
- Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin Yong Lee
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - Nam-Soon Kim
- Health Policy Research Division, Korea Institute for Health and Social Affairs, Seoul, Korea
| | - Soo-Young Kim
- Department of Family Medicine, Hallym University College of Medicine, Seoul, Korea
| | - Seungsoo Sheen
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Seon Ha Kim
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang-il Lee
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
38
|
Lee YK, Shin ES, Shim JY, Min KJ, Kim JM, Lee SH. Developing a scoring guide for the Appraisal of Guidelines for Research and Evaluation II instrument in Korea: a modified Delphi consensus process. J Korean Med Sci 2013; 28:190-4. [PMID: 23400114 PMCID: PMC3565128 DOI: 10.3346/jkms.2013.28.2.190] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 12/07/2012] [Indexed: 11/20/2022] Open
Abstract
Korea has a relatively short history in the development and use of clinical practice guidelines (CPGs). Additionally, it has been difficult to employ the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument due to the lack of consensus and the presence of differences in Korean medical settings and in the Korean socio-cultural environment. An AGREE II scoring guide was therefore developed to reduce differences among evaluators using the same tool. In consideration of the importance of using a quantitative measure of satisfaction with the elements described in the AGREE II manual, a final draft was developed through a Delphi consensus process. Ninety-two draft scoring guides for anchor points 1, 3, 5, and 7 (full score) in 23 items were developed. Consensus was defined as agreement among at least 70% of the raters. Agreement on 88 draft scoring guidelines was reached in the first Delphi round, and agreement for the remaining four was achieved in the second round. The development of an AGREE II scoring guide in this study is expected to contribute to improving the CPG environment.
Collapse
Affiliation(s)
- You Kyoung Lee
- Department of Laboratory Medicine and Genetics, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Ein Soon Shin
- Department of Preventive Medicine & Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Jae-Yong Shim
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea
| | - Kyung Joon Min
- Department of Psychiatry, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jun-Mo Kim
- Department of Urology, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Sun Hee Lee
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | | | | |
Collapse
|