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Expert disagreement

Lizanne Eva van den Akker, Heleen Beckerman, Emma Hubertine Collette, Isaline Catharine Josephine Maria Eijssen, Joost Dekker, Vincent de Groot
BACKGROUND: Fatigue is a frequently occurring symptom of multiple sclerosis (MS) that limits social participation. OBJECTIVE: To systematically determine the short and long-term effects of cognitive behavioral therapy (CBT) for the treatment of MS-related fatigue. DATA SOURCES: Pubmed, Cochrane, EMBASE, Psychology and Behavioral Sciences Collection, ERIC, PsychINFO, Cinahl, PsycARTICLES, and relevant trial registers were searched up to February 2016...
November 2016: Journal of Psychosomatic Research
Maria Agapova, Brian B Bresnahan, Mitchell Higashi, Larry Kessler, Louis P Garrison, Beth Devine
The American College of Radiology develops evidence-based practice guidelines to aid appropriate utilization of radiological procedures. Panel members use expert opinion to weight trade-offs and consensus methods to rate appropriateness of imaging tests. These ratings include an equivocal range, assigned when there is disagreement about a technology's appropriateness and the evidence base is weak or for special circumstances. It is not clear how expert consensus merges with the evidence base to arrive at an equivocal rating...
October 19, 2016: Journal of Evaluation in Clinical Practice
Johannes Roth, Viviana Ravagnani, Marina Backhaus, Peter Balint, Alessandra Bruns, George A Bruyn, Paz Collado, Lorenia De la Cruz, Severine Guillaume-Czitrom, Troels Herlin, Cristina Hernandez, Annamaria Iagnocco, Sandrine Jousse-Joulin, Stefano Lanni, Vibke Lilleby, Clara Malattia, Silvia Magni-Manzoni, Consuelo Modesto, Ana Narrodi, Juan-Carlos Nieto, Sarah Ohrndorf, Linda Rossi, Anne-Marit Selvaag, Nanno Swen, Tracy Ting, Nikolay Tzaribachev, Patricia Vega-Fernandez, Jelena Vojinovic, Daniel Windschall, Maria-Antonietta D'Agostino, Esperanza Naredo
Objectives Musculoskeletal ultrasonography (US) has the potential to be an important tool in the assessment of disease activity in childhood arthritides. To assess pathology, clear definitions for synovitis need to be developed first. The aim of this study was to develop and validate these definitions through an international consensus process. Methods The decision on which US techniques to use, the components to be included in the definitions as well as the final wording were developed by 31 ultrasound experts in a consensus process...
October 16, 2016: Arthritis Care & Research
Shannon E Kelly, David Moher, Tammy J Clifford
OBJECTIVES: Rapid reviews are characterized as an accelerated evidence synthesis approach with no universally accepted methodology or definition. This modified Delphi consensus study aimed to develop a comprehensive set of defining characteristics for rapid reviews that may be used as a functional definition. METHODS: Expert panelists with knowledge in rapid reviews and evidence synthesis were identified. In the first round, panelists were asked to answer a seventeen-item survey addressing a variety of rapid review topics...
October 11, 2016: International Journal of Technology Assessment in Health Care
Clement Hamani, Tipu Aziz, Bastiaan R Bloem, Peter Brown, Stephan Chabardes, Terry Coyne, Kelly Foote, Edgar Garcia-Rill, Etienne C Hirsch, Andres M Lozano, Paolo A M Mazzone, Michael S Okun, William Hutchison, Peter Silburn, Ludvic Zrinzo, Mesbah Alam, Laurent Goetz, Erlick Pereira, Anand Rughani, Wesley Thevathasan, Elena Moro, Joachim K Krauss
Several lines of evidence over the last few years have been important in ascertaining that the pedunculopontine nucleus (PPN) region could be considered as a potential target for deep brain stimulation (DBS) to treat freezing and other problems as part of a spectrum of gait disorders in Parkinson disease and other akinetic movement disorders. Since the introduction of PPN DBS, a variety of clinical studies have been published. Most indicate improvements in freezing and falls in patients who are severely affected by these problems...
October 11, 2016: Stereotactic and Functional Neurosurgery
Guillaume Bonnaud, Audrey Haennig, Jonathan Levy, Nicolas Sigur, Alain Ledit, Philippe Cabarrot, Patrick Faure, Catherine Auzimour, Asmaa El Atmani, Xavier Hebuterne, Laurent Peyrin-Biroulet
BACKGROUND: Recently, treatment algorithms were developed in France additionally to ECCO recommendations that should be used as reference for ulcerative colitis (UC) management. Nevertheless, their implementation in clinical practice remains challenging. AIMS: To evaluate the prevalence of the use of these UC management algorithms in 127 patients followed by private gastroenterologists. METHODS: Charts of all UC patients seen during the year 2015 (n=127) by 10 gastroenterologists were reviewed...
September 3, 2016: Digestive and Liver Disease
I H Zaal-Schuller, D L Willems, F V P M Ewals, J B van Goudoever, M A de Vos
BACKGROUND: End-of-life decisions (EoLD) often concern children with profound intellectual and multiple disabilities (PIMD). Yet, little is known about how parents and physicians discuss and make these decisions. AIMS: The objective of this research was to investigate the experiences of the parents and the involved physician during the end-of-life decision-making (EoLDM) process for children with PIMD. METHODS: In a retrospective, qualitative study, we conducted semi-structured interviews with the physicians and parents of 14 children with PIMD for whom an EoLD was made within the past two years...
September 22, 2016: Research in Developmental Disabilities
J H Lefevre, S Benoist
GOAL: To report the current clinical practice of French physicians for rectal cancer in various complex settings. METHODS: Nineteen clinical situations and four surveillance modalities were proposed to a panel of experts via 11 learned societies. The answers of 48 experts and the impact of colorectal specialists on therapeutic options were compared to those of other participants. RESULTS: A total of 722 physicians [surgeons=319 (44%), gastro-intestinal oncologists=305 (42%), radiotherapists=98 (14%)] participated in this study...
September 20, 2016: Journal of Visceral Surgery
Duncan McKechnie, Julie Pryor, Murray J Fisher
PURPOSE: To examine patient characteristics that contribute to falls in the inpatient traumatic brain injury (TBI) rehabilitation setting. METHOD: A three-round modified Delphi technique that engaged a multidisciplinary panel of 11 health experts was used. Group median score and disagreement index were used to measure agreement between participants about patient characteristics that contribute to falls. RESULTS: All panel members participated in each questionnaire round...
September 14, 2016: Disability and Rehabilitation
V A Eley, L K Callaway, A A J van Zundert, J Lipman, C Gallois
Caring for obese pregnant women presents challenges for all medical professionals. Despite a lack of supporting evidence, expert opinion and international guidelines suggest early labour epidural insertion for obese women. Anecdotally this is not supported by all anaesthetists. This qualitative study explored the experiences of anaesthetists regarding early epidural analgesia in obese parturients, to answer the research question: Are anaesthetists consistent in how they apply early epidural analgesia in obese parturients? Personal in-depth interviews with 42 specialist anaesthetists working in south-east Queensland, Australia, were completed between February and April, 2015...
September 2016: Anaesthesia and Intensive Care
Marten A Lantinga, Alexander J M Darding, Ruud G L de Sévaux, Ahsan Alam, Chantal P Bleeker-Rovers, Mickaël Bobot, Emilie Cornec-Le Gall, Tom J G Gevers, Ziad Hassoun, Esther Meijer, Michal Mrug, Frederik Nevens, Luiz F Onuchic, York Pei, Giorgina B Piccoli, Yves Pirson, Gopala K Rangan, Roser Torra, Folkert W Visser, François Jouret, Nada Kanaan, Wim J G Oyen, Tatsuya Suwabe, Vicente E Torres, Joost P H Drenth
BACKGROUND: Cyst infection is one of the complications of autosomal dominant polycystic kidney disease and polycystic liver disease. The diagnosis is typically made on a mix of clinical, laboratory and imaging abnormalities but the importance of individual items is uncertain. We aimed to perform a Delphi survey amongst physicians to achieve consensus on diagnostic criteria. METHODS: We retrieved diagnostic items from the literature and conducted physician and patient interviews...
September 3, 2016: Nephron
Fernando Bermejo San José, Mireia Barceló Barceló-Bru, Miquel Ribera-Pibernat, José Luís Poveda-Andrés, Luciano Sanromán-Álvarez
OBJECTIVE: Patient compliance in chronic inflammatory diseases is essential to achieve treatment effectiveness. The study objective is to develop a recommendations document for healthcare professionals to encourage treatment compliance. METHODS: A sequential methodology was followed: 1. Systematic review of EBM Reviews, Embase and MedLine without time restriction of interventions on compliance in chronic inflammatory diseases. Studies were selected according to previously defined criteria (confirmed diagnosis of chronic inflammatory disease of patients included, assessment of adherence interventions and experimental study design)...
September 2016: Farmacia Hospitalaria
Rebekah H Nagler, Jennifer A Lueck, Lauren S Gray
BACKGROUND: There is substantial expert disagreement about the use of mammography to screen for breast cancer, and this disagreement routinely plays out in the media. Evidence suggests that some women are aware of the controversy over mammography, but less is known about whether immigrant and other underserved women have heard about it and, if so, how they react to it. OBJECTIVE: To explore immigrant women's awareness of and reactions to mammography controversy...
August 26, 2016: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
Luca Ceriani, Sally Barrington, Alberto Biggi, Bogdan Malkowski, Ur Metser, Annibale Versari, Maurizio Martelli, Andrew Davies, Peter W Johnson, Emanuele Zucca, Stéphane Chauvie
The International Extranodal Lymphoma Study Group (IELSG)-37 is a prospective randomized trial assessing the role of consolidation mediastinal radiotherapy after immunochemotherapy to patients with newly diagnosed primary mediastinal large B-cell lymphoma (PMBCL). It is a positron emission tomography (PET) response-guided study where patients obtaining a complete metabolic response on an end-of-therapy PET-computed tomography (CT) scan evaluated by a central review are randomized to receive radiotherapy or no further treatment...
August 22, 2016: Hematological Oncology
Mitko Veta, Paul J van Diest, Mehdi Jiwa, Shaimaa Al-Janabi, Josien P W Pluim
BACKGROUND: Tumor proliferation speed, most commonly assessed by counting of mitotic figures in histological slide preparations, is an important biomarker for breast cancer. Although mitosis counting is routinely performed by pathologists, it is a tedious and subjective task with poor reproducibility, particularly among non-experts. Inter- and intraobserver reproducibility of mitosis counting can be improved when a strict protocol is defined and followed. Previous studies have examined only the agreement in terms of the mitotic count or the mitotic activity score...
2016: PloS One
E Jean C Hay-Smith, Melanie Brown, Lynley Anderson, Gareth J Treharne
BACKGROUND: Many health researchers are clinicians. Dual-role experiences are common for clinician-researchers in research involving patient-participants, even if not their own patients. To extend the existing body of literature on why dual-role is experienced, we aimed to develop a typology of common catalysts for dual-role experiences to help clinician-researchers plan and implement methodologically and ethically sound research. METHODS: Systematic searching of Medline, CINAHL, PsycINFO, Embase and Scopus (inception to 28...
2016: BMC Medical Research Methodology
O Giotakos, E Papadomarkaki
Over the last few years, Internet has become an integral part of daily life. An abundant source of information and a principal gateway of communication between individuals, Internet has been continuously gaining considerable ground as a tool of awareness and intervention in the area of public health. With regard to the field of mental health, Internet exhibits a credible potential in facilitating dialogue not only between experts and their beneficiaries but also between stakeholders. Moreover and with regard to various aspects of public concern, it can serve as a circulation portal of educational material between students and teachers...
April 2016: Psychiatrikē, Psychiatriki
Giovanna Muscogiuri, Barbara Altieri, Cedric Annweiler, Giancarlo Balercia, H B Pal, Barbara J Boucher, John J Cannell, Carlo Foresta, Martin R Grübler, Kalliopi Kotsa, Luca Mascitelli, Winfried März, Francesco Orio, Stefan Pilz, Giacomo Tirabassi, Annamaria Colao
The objective was to provide the current state of the art regarding the role of vitamin D in chronic diseases (osteoporosis, cancer, cardiovascular diseases, dementia, autism, type 1 and type 2 diabetes mellitus, male and female fertility). The document was drawn up by panelists that provided their contribution according to their own scientific expertise. Each scientific expert supplied a first draft manuscript on a specific aspect of the document's topic that was subjected to voting by all experts as "yes" (agreement with the content and/or wording) or "no" (disagreement)...
July 18, 2016: Archives of Toxicology
Omar A Jarral, Kamran Baig, Christopher Pettengell, Rakesh Uppal, David P Taggart, Ara Darzi, Stephen Westaby, Thanos Athanasiou
BACKGROUND: In the United Kingdom, cardiothoracic surgeons have led the outcome reporting revolution seen over the last 20 years. The objective of this survey was to assess cardiothoracic surgeons' opinions on the topic, with the aim of guiding future debate and policy making for all subspecialties. METHODS AND RESULTS: A questionnaire was developed using interviews with experts in the field. In January 2015, the survey was sent out to all consultant cardiothoracic surgeons in the United Kingdom (n=361)...
July 2016: Circulation. Cardiovascular Quality and Outcomes
D V M Bishop, Margaret J Snowling, Paul A Thompson, Trisha Greenhalgh
Delayed or impaired language development is a common developmental concern, yet there is little agreement about the criteria used to identify and classify language impairments in children. Children's language difficulties are at the interface between education, medicine and the allied professions, who may all adopt different approaches to conceptualising them. Our goal in this study was to use an online Delphi technique to see whether it was possible to achieve consensus among professionals on appropriate criteria for identifying children who might benefit from specialist services...
2016: PloS One
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