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Expert disagreement

Monika Mueller, Maddalena D'Addario, Matthias Egger, Myriam Cevallos, Olaf Dekkers, Catrina Mugglin, Pippa Scott
BACKGROUND: Systematic reviews and meta-analyses of observational studies are frequently performed, but no widely accepted guidance is available at present. We performed a systematic scoping review of published methodological recommendations on how to systematically review and meta-analyse observational studies. METHODS: We searched online databases and websites and contacted experts in the field to locate potentially eligible articles. We included articles that provided any type of recommendation on how to conduct systematic reviews and meta-analyses of observational studies...
May 21, 2018: BMC Medical Research Methodology
Kimberly Luu, Brent A Chang, Dianne Valenzuela, Donald Anderson
BACKGROUND: Among voice restoration options following laryngectomy, tracheoesophageal puncture (TEP) appears to be the most common. Currently, there is no consensus that exists with regards to the timing of performing TEP and the decision to perform a primary or secondary TEP has mostly been based on physician preference and expert opinion rather than data. OBJECTIVE OF REVIEW: The objective of this study was to compare primary and secondary tracheoesophageal puncture (TEP) for voice rehabilitation in laryngectomy patients in terms of success and complication rates...
May 16, 2018: Clinical Otolaryngology
Alex Smedley, Nate Yusupov, Alaa Almousa, Thomas Solbach, Ahmed K Toma, Joan P Grieve
OBJECTIVE: To compare multidisciplinary team (MDT) decision making at our centre with the suggested management from the recently published Unruptured Intracranial Aneurysm Treatment Score (UIATS), with particular focus on disagreements between the two bodies of expert opinion. DESIGN: A retrospective audit of local practice. SUBJECTS: Adult patients with incidental cerebral saccular aneurysms referred to The National Hospital for Neurology and Neurosurgery Neurovascular MDT...
May 15, 2018: British Journal of Neurosurgery
Nicholas Feinberg, Hiroko Matsumoto, Chun Wai Hung, Tricia St Hilaire, Jeff Pawelek, Jeffrey R Sawyer, Behrooz A Akbarnia, David L Skaggs, Benjamin D Roye, David P Roye, Michael G Vitale
STUDY DESIGN: Expert consensus building using combined Delphi method and Nominal group technique. OBJECTIVES: To identify the current state of equipoise surrounding the use of magnetically controlled growing rods (MCGRs) and to determine consensus for planning a randomized controlled trial (RCT) with MCGRs. BACKGROUND: The use of MCGRs for the treatment of early-onset scoliosis (EOS) is a new technology. Optimal use has not been thoroughly investigated and much uncertainty exists...
May 2018: Spine Deformity
Ângela Freitas, Paula Santana, Mónica D Oliveira, Ricardo Almendra, João C Bana E Costa, Carlos A Bana E Costa
BACKGROUND: Indicators are essential instruments for monitoring and evaluating population health. The selection of a multidimensional set of indicators should not only reflect the scientific evidence on health outcomes and health determinants, but also the views of health experts and stakeholders. The aim of this study is to describe the Delphi selection process designed to promote agreement on indicators considered relevant to evaluate population health at the European regional level...
April 27, 2018: BMC Public Health
Mrishta Brizmohun Appayya, Jim Adshead, Hashim U Ahmed, Clare Allen, Alan Bainbridge, Tristan Barrett, Francesco Giganti, John Graham, Phil Haslam, Edward W Johnston, Christof Kastner, Alexander P S Kirkham, Alexandra Lipton, Alan McNeill, Larissa Moniz, Caroline M Moore, Ghulam Nabi, Anwar R Padhani, Chris Parker, Amit Patel, Jacqueline Pursey, Jonathan Richenberg, John Staffurth, Jan van der Meulen, Darren Walls, Shonit Punwani
OBJECTIVES: To identify areas of agreement and disagreement in the implementation of multi-parametric MRI (mpMRI) of the prostate in the diagnostic pathway. MATERIALS AND METHODS: Fifteen UK experts in prostate mpMRI and/or prostate cancer management across the UK (involving 9 NHS centres to provide for geographical spread) participated in a consensus meeting following the UCLA-RAND Appropriateness Method, and were moderated by an independent chair. The experts considered 354 items pertaining to who can request an mpMRI, prostate mpMRI protocol, reporting guidelines, training, quality assurance (QA) and patient management based on mpMRI levels of suspicion for cancer...
April 26, 2018: BJU International
Bao-Yan Liu, Xing-Yue Yang, Xiao-Dong Wu, Jia Liu, Yan Liu, Feng-Xia Liang, Wen Jia, Wei-Juan Gang, Yuan-Yuan Tong, Feng Yang, Hai-Yan Li, Lei Lei, Li-Rong Jia, Yu-Jie Sun
BACKGROUND: With the worldwide use and modern development of acupuncture-moxibustion, there is disagreement on its basic definition. There has been an obstacle for clinical practice, research, and legislation. Considering this challenge, the World Federation of Acupuncture-Moxibustion Societies proposes to develop the definition and basic scope of acupuncture-moxibustion with a Delphi study. METHODS: A reactive Delphi method will be used to ask a group of experts to rate the relevance and clarity of a predesigned initial item list...
April 2018: Chinese Journal of Integrative Medicine
Nubia E Barbosa, Sandra M Forero, Claudia P Galeano, Edgar D Hernández, Nancy S Landinez, Katharina S Sunnerhagen, Margit Alt Murphy
PURPOSE: Fugl-Meyer Assessment (FMA) is the most widely used and recommended clinical scale for evaluation of sensorimotor impairment post stroke, but an official Spanish version is not available today. This study aimed to establish methodological structure for translation and cultural adaptation process and perform a transcultural validation of the upper and lower extremity FMA to Colombian Spanish. METHODS: Procedures included forward and backward translation, step-wise reviewing by bilingual and professional experts to ensure conceptual and semantic equivalence...
April 24, 2018: Disability and Rehabilitation
Anca M Hanea, Marissa F McBride, Mark A Burgman, Bonnie C Wintle
In risky situations characterized by imminent decisions, scarce resources, and insufficient data, policymakers rely on experts to estimate model parameters and their associated uncertainties. Different elicitation and aggregation methods can vary substantially in their efficacy and robustness. While it is generally agreed that biases in expert judgments can be mitigated using structured elicitations involving groups rather than individuals, there is still some disagreement about how to best elicit and aggregate judgments...
April 17, 2018: Risk Analysis: An Official Publication of the Society for Risk Analysis
Mark A Samaan, Bo Shen, Mahmoud H Mosli, Guangyong Zou, William J Sandborn, Lisa M Shackelton, Sigrid Nelson, Larry Stitt, Stuart Bloom, Darrell S Pardi, Paolo Gionchetti, James Lindsay, Simon Travis, Ailsa Hart, Mark S Silverberg, Brian G Feagan, Geert R D'Haens, Vipul Jairath
BACKGROUND & AIMS: Pouchitis is a common adverse event after proctocolectomy with ileal pouch anal anastomosis for ulcerative colitis. Evaluation of pouchitis disease activity and response to treatment requires use of validated indices. We assessed the reliability of items evaluating endoscopic pouchitis disease activity. METHODS: Twelve panelists used a modified RAND appropriateness methodology to rate the appropriateness of items evaluating endoscopic pouchitis disease activity derived from a systematic review, and also identified additional potential endoscopic items based on expert opinion...
April 13, 2018: Gastrointestinal Endoscopy
Scott J Millington, Robert T Arntfield, Robert Jie Guo, Seth Koenig, Pierre Kory, Vicki Noble, Haney Mallemat, Jordan R Schoenherr
OBJECTIVES: Although lung ultrasound (US) has been shown to have high diagnostic accuracy in patients presenting with acute dyspnea, its precision in critically ill patients is unknown. We investigated common areas of agreement and disagreement by studying 6 experts as they interpreted lung US studies in a cohort of intensive care unit (ICU) patients. METHODS: A previous study by our group asked experts to rate the quality of 150 lung US studies performed by 10 novices in a population of mechanically ventilated patients...
April 15, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Ana Rita S Valente, Andreia Hall, Helena Alvelos, Margaret Leahy, Luis M T Jesus
BACKGROUND: The appropriate use of language in context depends on the speaker's pragmatic language competencies. A coding system was used to develop a specific and adult-focused self-administered questionnaire to adults who stutter and adults who do not stutter, The Assessment of Language Use in Social Contexts for Adults, with three categories: precursors, basic exchanges, and extended literal/non-literal discourse. This paper presents the content validity, item analysis, reliability coefficients and evidences of construct validity of the instrument...
April 12, 2018: Logopedics, Phoniatrics, Vocology
Laurence Needleman, John J Cronan, Michael P Lilly, Geno J Merli, Srikar Adhikari, Barbara S Hertzberg, M Robert DeJong, Michael B Streiff, Mark H Meissner
Venous ultrasound is the standard imaging test for patients suspected of having acute deep venous thrombosis (DVT). There is variability and disagreement among authoritative groups regarding the necessary components of the test. Some protocols include scanning the entire lower extremity, whereas others recommend scans limited to the thigh and knee supplemented with serial testing. Some protocols use gray-scale ultrasound alone, whereas others include Doppler interrogation. Point-of-care ultrasound is recommended in some settings, and there is heterogeneity of these protocols as well...
April 3, 2018: Circulation
Katherine A Doiron, Tammy C Hoffmann, Elaine M Beller
BACKGROUND: Survivors of critical illness often experience a multitude of problems that begin in the intensive care unit (ICU) or present and continue after discharge. These can include muscle weakness, cognitive impairments, psychological difficulties, reduced physical function such as in activities of daily living (ADLs), and decreased quality of life. Early interventions such as mobilizations or active exercise, or both, may diminish the impact of the sequelae of critical illness. OBJECTIVES: To assess the effects of early intervention (mobilization or active exercise), commenced in the ICU, provided to critically ill adults either during or after the mechanical ventilation period, compared with delayed exercise or usual care, on improving physical function or performance, muscle strength and health-related quality of life...
March 27, 2018: Cochrane Database of Systematic Reviews
J Torrent-Farnell, M Comellas, J L Poveda, I Abaitua, L G Gutiérrez-Solana, J Pérez-López, J Cruz, J Urcelay, L Lizán
OBJECTIVES: To reach a consensus amongst experts on the most feasible actions to be undertaken to facilitate patient access to specialised care and orphan drugs (OD) in the public health sector in Spain. METHODS: Two Delphi rounds were completed. The questionnaire was based on a literature review and 2 focus groups. Agreement was sought on the desire (D) and prognosis (P) for the implementation within the next 5 years, on a 5-point Likert scale. Consensus was reached when ≥75% participants chose agreement (1-2) or disagreement options (4-5)...
March 15, 2018: Health Policy
Parthasarathy Madurantakam
Data sourcesCochrane Oral Health's Trials Register, Cochrane Central Register of Controlled Trials, Medline Ovid and Embase Ovid (up to February 2017); ongoing clinical trials were searched in as well as the World Health Organization International Clinical Trials Registry. Reference lists of included studies and relevant systematic reviews were searched. No restrictions were placed on the language or date of publication and study authors were contacted when necessary.Study selectionRandomised and quasi-randomised controlled trials assessing open and closed surgical exposures in palatally displaced canines with no restriction on age, presenting malocclusion or type of orthodontic treatment...
March 23, 2018: Evidence-based Dentistry
Natalia Olchanski, Ryan N Hansen, Elle Pope, Brittany D'Cruz, Jaime Fergie, Mitchell Goldstein, Leonard R Krilov, Kimmie K McLaurin, Barbara Nabrit-Stephens, Gerald Oster, Kenneth Schaecher, Fadia T Shaya, Peter J Neumann, Sean D Sullivan
Respiratory syncytial virus (RSV) infection is the most common cause of lower respiratory tract infection and the leading cause of hospitalization among young children, incurring high annual costs among US children under the age of 5 years. Palivizumab has been found to be effective in reducing hospitalization and preventing serious lower respiratory tract infections in high-risk infants. This paper presents a systematic review of the cost-effectiveness studies of palivizumab and describes the main highlights of a round table discussion with clinical, payer, economic, research method, and other experts...
March 2018: Open Forum Infectious Diseases
David R M Smith, F Christiaan K Dolk, Koen B Pouwels, Morag Christie, Julie V Robotham, Timo Smieszek
Objectives: To assess the appropriateness of prescribing systemic antibiotics for different clinical conditions in primary care, and to quantify 'ideal' antibiotic prescribing proportions in conditions for which antibiotic treatment is sometimes but not always indicated. Methods: Prescribing guidelines were consulted to define the appropriateness of antibiotic therapy for the conditions that resulted in antibiotic prescriptions between 2013 and 2015 in The Health Improvement Network (THIN) primary care database...
February 1, 2018: Journal of Antimicrobial Chemotherapy
Dominique Hansen, Gustavo Rovelo Ruiz, Patrick Doherty, Marie-Christine Iliou, Tom Vromen, Sally Hinton, Ines Frederix, Matthias Wilhelm, Jean-Paul Schmid, Ana Abreu, Marco Ambrosetti, Esteban Garcia-Porrero, Karin Coninx, Paul Dendale
Background Although disease-specific exercise guidelines for cardiovascular disease (CVD) are widely available, it remains uncertain whether these different exercise guidelines are integrated properly for patients with different CVDs. The aim of this study was to assess the inter-clinician variance in exercise prescription for patients with various CVDs and to compare these prescriptions with recommendations from the EXercise Prescription in Everyday practice and Rehabilitative Training (EXPERT) tool, a digital decision support system for integrated state-of-the-art exercise prescription in CVD...
May 2018: European Journal of Preventive Cardiology
Fanny Sampurno, Jia Zheng, Lydia Di Stefano, Jeremy L Millar, Claire Foster, Ferran Fuedea, Celestia Higano, Hartwig Hulan, Stephen Mark, Caroline Moore, Alison Richardson, Frank Sullivan, Neil S Wenger, Daniela Wittmann, Sue Evans
PURPOSE: We sought to develop a core set of clinical indicators to enable international benchmarking of localized prostate cancer management using data available in the TrueNTH (True North) Global Registry. MATERIALS AND METHODS: An international expert panel completed an online survey and participated in a face to face meeting. Participants included 3 urologists, 3 radiation oncologists, 2 psychologists, 1 medical oncologist, 1 nurse and 1 epidemiologist with prostate cancer expertise from a total of 7 countries...
March 1, 2018: Journal of Urology
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