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https://www.readbyqxmd.com/read/29029068/considering-health-equity-when-moving-from-evidence-based-guideline-recommendations-to-implementation-a-case-study-from-an-upper-middle-income-country-on-the-grade-approach
#1
Javier Eslava-Schmalbach, Paola Mosquera, Juan Pablo Alzate, Kevin Pottie, Vivian Welch, Elie A Akl, Janet Jull, Eddy Lang, Srinivasa Vittal Katikireddi, Rachel Morton, Lehana Thabane, Bev Shea, Airton T Stein, Jasvinder Singh, Ivan D Florez, Gordon Guyatt, Holger Schünemann, Peter Tugwell
The availability of evidence-based guidelines does not ensure their implementation and use in clinical practice or policy making. Inequities in health have been defined as those inequalities within or between populations that are avoidable, unnecessary and also unjust and unfair. Evidence-based clinical practice and public health guidelines ('guidelines') can be used to target health inequities experienced by disadvantaged populations, although guidelines may unintentionally increase health inequities. For this reason, there is a need for evidence-based clinical practice and public health guidelines to intentionally target health inequities experienced by disadvantaged populations...
October 3, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29025128/opioid-therapy-for-chronic-pain-overview-of-the-2017%C3%A2-us-department-of-veterans-affairs-and-us-department-of-defense-clinical-practice-guideline
#2
Jack M Rosenberg, Brandon M Bilka, Sara M Wilson, Christopher Spevak
Description: The US Department of Veterans Affairs (VA) and US Department of Defense (DoD) revised the 2010 clinical practice guideline (CPG) for the management of opioid therapy for chronic pain, considering the specific needs of the VA and DoD and new evidence regarding prescribing opioid medication for non-end-of-life-related chronic pain. This paper summarizes the major recommendations and compares them with the US Centers for Disease Control and Prevention (CDC) guideline for prescribing opioids...
September 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29016505/implementing-a-systematic-approach-to-reduce-cesarean-birth-rates-in-nulliparous-women
#3
Amy D Bell, Saju Joy, Susan Gullo, Robert Higgins, Eleanor Stevenson
OBJECTIVE: To implement a systematic approach to safely reduce nulliparous cesarean birth rates. METHODS: This is a quality improvement project at two rural community hospitals and one urban community hospital in North Carolina. These facilities implemented a systematic approach to reduce nulliparous cesarean birth rates, aligning with recommendations developed by the Council on Patient Safety in Women's Health Care: Patient Safety Bundle on the Safe Reduction of Primary Cesarean Births...
October 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28994452/comparison-of-the-guidelines-of-the-clinical-pharmacogenetics-implementation-consortium-and-the-dutch-pharmacogenetics-working-group
#4
REVIEW
Pcd Bank, K E Caudle, J J Swen, R S Gammal, M Whirl-Carrillo, T E Klein, M V Relling, H-J Guchelaar
Both the Clinical Pharmacogenetics Implementation Consortium (CPIC) and Dutch Pharmacogenetics Working Group provide therapeutic recommendations for well-known gene-drug pairs. Published recommendations show a high rate of concordance. However, as a result of different guideline development methods used by these two consortia, differences between the published guidelines exist. The aim of this paper is to compare both initiatives and explore these differences, with the objective to achieve harmonization.
June 9, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28988959/decision-making-frameworks-and-considerations-for-informing-coverage-decisions-for-healthcare-interventions-a-critical-interpretive-synthesis
#5
Rebecca L Morgan, Leah Kelley, Gordon Guyatt, Ana Johnson, John N Lavis
OBJECTIVE: To guide decision-making about whether or not to pay for a new healthcare intervention, a number of existing frameworks systematically weigh scientific evidence, cost, and social and ethical values. Each framework has strengths and limitations. This study aims to review and summarize available frameworks, and generate an integrated framework, if and where applicable, highlighting particular issues faced with expensive but effective and desirable healthcare interventions. STUDY DESIGN AND SETTING: We conducted a critical interpretive synthesis to inform decision-making about healthcare interventions...
October 5, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28964433/cost-effectiveness-analysis-of-natriuretic-peptide-testing-and-specialist-management-in-patients-with-suspected-acute-heart-failure
#6
Edward A Griffin, David Wonderling, Andrew J Ludman, Abdallah Al-Mohammad, Martin R Cowie, Suzanna M C Hardman, John J V McMurray, Jason Kendall, Polly Mitchell, Aminat Shote, Katharina Dworzynski, Jonathan Mant
OBJECTIVES: To determine the cost-effectiveness of natriuretic peptide (NP) testing and specialist outreach in patients with acute heart failure (AHF) residing off the cardiology ward. METHODS: We used a Markov model to estimate costs and quality-adjusted life-years (QALYs) for patients presenting to hospital with suspected AHF. We examined diagnostic workup with and without the NP test in suspected new cases, and we examined the impact of specialist heart failure outreach in all suspected cases...
September 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28958579/-needs-assessment-to-improve-the-applicability-and-methodological-quality-of-a-german-s3-guideline
#7
Marion Burckhardt, Cristina Hoffmann, Brigitte Nink-Grebe, Sylvia Sänger
BACKGROUND: Clinical practice guidelines can change the practice in healthcare only if their recommendations are implemented in a comprehensive way. The German S3 guideline "Local Therapy of Chronic Wounds in Patients with Peripheral Vascular Disease, Chronic Venous Insufficiency, and Diabetes" will be updated in 2017. The emphasis here is on the guideline's validity, user-friendliness and implementation into practice. Therefore, the aim was to identify the improvements required in regard to the guideline's methods and content presentation...
September 25, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28944160/strategies-for-assessing-gfr-and-albuminuria-in-the-living-kidney-donor-evaluation
#8
Lesley A Inker, Naya Huang, Andrew S Levey
PURPOSE OF REVIEW: The international guideline development group Kidney Disease Improving Global Outcomes (KDIGO) recently published a comprehensive set of recommendations for living donor evaluation which contains a new framework for decision making in the evaluation of kidney donor candidates. RECENT FINDINGS: The guidelines recommend that decisions to accept or decline a candidate donor should be based on incorporation of multiple sources of information pertaining to the donor candidate's likelihood of serious adverse outcomes after donation...
March 2017: Current Transplantation Reports
https://www.readbyqxmd.com/read/28935065/no-250-recurrent-urinary-tract-infection
#9
Annette Epp, Annick Larochelle
OBJECTIVE: To provide an update of the definition, epidemiology, clinical presentation, investigation, treatment, and prevention of recurrent urinary tract infections in women. OPTIONS: Continuous antibiotic prophylaxis, post-coital antibiotic prophylaxis, and acute self-treatment are all efficient alternatives to prevent recurrent urinary tract infection. Vaginal estrogen and cranberry juice can also be effective prophylaxis alternatives. EVIDENCE: A search of PubMed and The Cochrane Library for articles published in English identified the most relevant literature...
October 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28935064/no-231-guidelines-for-the-management-of-vasa-previa
#10
Robert Gagnon
OBJECTIVES: To describe the etiology of vasa previa and the risk factors and associated condition, to identify the various clinical presentations of vasa previa, to describe the ultrasound tools used in its diagnosis, and to describe the management of vasa previa. OUTCOMES: Reduction of perinatal mortality, short-term neonatal morbidity, long-term infant morbidity, and short-term and long-term maternal morbidity and mortality. EVIDENCE: Published literature on randomized trials, prospective cohort studies, and selected retrospective cohort studies was retrieved through searches of PubMed or Medline, CINAHL, and the Cochrane Library, using appropriate controlled vocabulary (e...
October 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28935062/no-260-ultrasound-in-twin-pregnancies
#11
Lucie Morin, Kenneth Lim
OBJECTIVE: To review the literature with respect to the use of diagnostic ultrasound in the management of twin pregnancies. To make recommendations for the best use of ultrasound in twin pregnancies. OUTCOMES: Reduction in perinatal mortality and morbidity and short- and long-term neonatal morbidity in twin pregnancies. Optimization of ultrasound use in twin pregnancies. EVIDENCE: Published literature was retrieved through searches of PubMed and the Cochrane Library in 2008 and 2009 using appropriate controlled vocabulary (e...
October 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28928084/follow-up-care-for-survivors-of-prostate-cancer-clinical-management-a-program-in-evidence-based-care-systematic-review-and-clinical-practice-guideline
#12
A Loblaw, L H Souter, C Canil, R H Breau, M Haider, L Jamnicky, R Morash, M Surchin, A Matthew
AIMS: This clinical practice guideline was developed to provide evidence-based guidance on the frequency by which prostate-specific antigen (PSA) levels should be tested in men after curative-intent treatment for prostate cancer and to define the most appropriate diagnostic testing if biochemical recurrence occurs. MATERIALS AND METHODS: An electronic search using OVID was used to systematically search the MEDLINE and EMBASE databases for systematic reviews and primary literature...
November 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28925929/canadian-guidelines-for-controlled-pediatric-donation-after-circulatory-determination-of-death-summary-report
#13
Matthew J Weiss, Laura Hornby, Bram Rochwerg, Michael van Manen, Sonny Dhanani, V Ben Sivarajan, Amber Appleby, Mary Bennett, Daniel Buchman, Catherine Farrell, Aviva Goldberg, Rebecca Greenberg, Ram Singh, Thomas A Nakagawa, William Witteman, Jill Barter, Allon Beck, Kevin Coughlin, Alf Conradi, Cynthia Cupido, Rosanne Dawson, Anne Dipchand, Darren Freed, Karen Hornby, Valerie Langlois, Cheryl Mack, Meagan Mahoney, Deepak Manhas, Christopher Tomlinson, Samara Zavalkoff, Sam D Shemie
OBJECTIVES: Create trustworthy, rigorous, national clinical practice guidelines for the practice of pediatric donation after circulatory determination of death in Canada. METHODS: We followed a process of clinical practice guideline development based on World Health Organization and Canadian Medical Association methods. This included application of Grading of Recommendations Assessment, Development, and Evaluation methodology. Questions requiring recommendations were generated based on 1) 2006 Canadian donation after circulatory determination of death guidelines (not pediatric specific), 2) a multidisciplinary symposium of national and international pediatric donation after circulatory determination of death leaders, and 3) a scoping review of the pediatric donation after circulatory determination of death literature...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28911999/living-systematic-reviews-4-living-guideline-recommendations
#14
Elie A Akl, Joerg J Meerpohl, Julian Elliott, Lara A Kahale, Holger J Schünemann
While it is important for the evidence supporting practice guidelines to be current, that is often not the case. The advent of living systematic reviews has made the concept of "living guidelines" realistic, with the promise to provide timely, up-to-date and high quality guidance to target users. We define living guidelines as an optimization of the guideline development process to allow updating individual recommendations as soon as new relevant evidence becomes available. A major implication of that definition is that the unit of update is the individual recommendation, and not the whole guideline...
September 1, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28903729/dynamic-etl-a-hybrid-approach-for-health-data-extraction-transformation-and-loading
#15
Toan C Ong, Michael G Kahn, Bethany M Kwan, Traci Yamashita, Elias Brandt, Patrick Hosokawa, Chris Uhrich, Lisa M Schilling
BACKGROUND: Electronic health records (EHRs) contain detailed clinical data stored in proprietary formats with non-standard codes and structures. Participating in multi-site clinical research networks requires EHR data to be restructured and transformed into a common format and standard terminologies, and optimally linked to other data sources. The expertise and scalable solutions needed to transform data to conform to network requirements are beyond the scope of many health care organizations and there is a need for practical tools that lower the barriers of data contribution to clinical research networks...
September 13, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28893810/developing-a-clinician-friendly-tool-to-identify-useful-clinical-practice-guidelines-g-trust
#16
Allen F Shaughnessy, Akansha Vaswani, Bonnie K Andrews, Deborah R Erlich, Frank D'Amico, Joel Lexchin, Lisa Cosgrove
BACKGROUND: Clinicians are faced with a plethora of guidelines. To rate guidelines, they can select from a number of evaluation tools, most of which are long and difficult to apply. The goal of this project was to develop a simple, easy-to-use checklist for clinicians to use to identify trustworthy, relevant, and useful practice guidelines, the Guideline Trustworthiness, Relevance, and Utility Scoring Tool (G-TRUST). METHODS: A modified Delphi process was used to obtain consensus of experts and guideline developers regarding a checklist of items and their relative impact on guideline quality...
September 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28893307/interventions-to-control-myopia-progression-in-children-protocol-for-an-overview-of-systematic-reviews-and-meta-analyses
#17
Efthymia Prousali, Asimina Mataftsi, Nikolaos Ziakas, Andreas Fontalis, Periklis Brazitikos, Anna-Bettina Haidich
BACKGROUND: Myopia is a common visual disorder with increasing prevalence among developed countries of the world. Myopia constitutes a substantial risk factor for several ocular conditions that can lead to blindness. The purpose of this study is to conduct an overview of systematic reviews and meta-analyses in order to identify and appraise robust research evidence regarding the management of myopia progression in children and adolescents. METHODS: A literature search will be conducted in MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE), and Health Technology Assessment (HTA) Database via Centre for Reviews and Dissemination (CRD)...
September 11, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28892432/patient-clinician-communication-american-society-of-clinical-oncology-consensus-guideline
#18
Timothy Gilligan, Nessa Coyle, Richard M Frankel, Donna L Berry, Kari Bohlke, Ronald M Epstein, Esme Finlay, Vicki A Jackson, Christopher S Lathan, Charles L Loprinzi, Lynne H Nguyen, Carole Seigel, Walter F Baile
Purpose To provide guidance to oncology clinicians on how to use effective communication to optimize the patient-clinician relationship, patient and clinician well-being, and family well-being. Methods ASCO convened a multidisciplinary panel of medical oncology, psychiatry, nursing, hospice and palliative medicine, communication skills, health disparities, and advocacy experts to produce recommendations. Guideline development involved a systematic review of the literature and a formal consensus process. The systematic review focused on guidelines, systematic reviews and meta-analyses, and randomized controlled trials published from 2006 through October 1, 2016...
September 11, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28892282/diabetic-foot-infection-antibiotic-therapy-and-good-practice-recommendations
#19
Nicholas D Barwell, Marion C Devers, Brian Kennon, Helen E Hopkinson, Claire McDougall, Matthew J Young, Hannah M A Robertson, Duncan Stang, Stephanie J Dancer, Andrew Seaton, Graham P Leese
BACKGROUND: Healthcare events related to diabetic foot disease carry a burden of morbidity, mortality and economic cost. Prompt identification of clinical infection with appropriate tissue sampling limits use of broad spectrum empirical antibiotics and improves antibiotic stewardship. Staphylococcus aureus remains the commonest infecting organism and high-dose flucloxacillin remains the empirical antibiotic of choice for antibiotic naïve patients. Barriers to microbe-specific treatment include: adequate tissue sampling, delays in culture results, drug allergies and the emergence of multidrug-resistant organisms which can complicate the choice of targeted antibiotics...
September 11, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28891406/clinical-practice-guideline-evaluation-of-the-neck-mass-in-adults
#20
Melissa A Pynnonen, M Boyd Gillespie, Benjamin Roman, Richard M Rosenfeld, David E Tunkel, Laura Bontempo, Itzhak Brook, Davoren Ann Chick, Maria Colandrea, Sandra A Finestone, Jason C Fowler, Christopher C Griffith, Zeb Henson, Corinna Levine, Vikas Mehta, Andrew Salama, Joseph Scharpf, Deborah R Shatzkes, Wendy B Stern, Jay S Youngerman, Maureen D Corrigan
Objective Neck masses are common in adults, but often the underlying etiology is not easily identifiable. While infections cause most of the neck masses in children, most persistent neck masses in adults are neoplasms. Malignant neoplasms far exceed any other etiology of adult neck mass. Importantly, an asymptomatic neck mass may be the initial or only clinically apparent manifestation of head and neck cancer, such as squamous cell carcinoma (HNSCC), lymphoma, thyroid, or salivary gland cancer. Evidence suggests that a neck mass in the adult patient should be considered malignant until proven otherwise...
September 2017: Otolaryngology—Head and Neck Surgery
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