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Clinical practice guideline

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https://www.readbyqxmd.com/read/28918559/prostate-cancer-screening-by-prostate-specific-antigen-psa-a-relevant-approach-for-the-small-population-of-the-cayman-islands
#1
Shravana Kumar Jyoti, Camille Blacke, Pallavi Patil, Vibha P Amblihalli, Amanda Nicholson
INTRODUCTION: The common tool for diagnosing prostate cancer is prostate-specific antigen (PSA), but the high sensitivity and low specificity of PSA testing are the problems in clinical practice. There are no proper guidelines to investigate the suspected prostate cancer in the Cayman Islands. We correlated PSA levels with the incidence of prostate cancers by tissue diagnosis and proposed logical protocol for prostate screening by using PSA test in this small population. MATERIALS AND METHODS: A total of 165 Afro Caribbean individuals who had prostate biopsy done after the investigations for PSA levels from year 2005 to 2015 were studied retrospectively...
September 16, 2017: Cancer Causes & Control: CCC
https://www.readbyqxmd.com/read/28917831/-grade-evidence-to-decision-etd-frameworks-a-systematic-and-transparent-approach-to-making-well-informed-healthcare-choices-2-clinical-practice-guidelines
#2
Pablo Alonso-Coello, Andrew D Oxman, Jenny Moberg, Romina Brignardello-Petersen, Elie A Akl, Marina Davoli, Shaun Treweek, Reem A Mustafa, Per O Vandvik, Joerg Meerpohl, Gordon H Guyatt, Holger J Schünemann
Clinicians do not have the time or resources to consider the underlying evidence for the myriad decisions they must make each day and, as a consequence, rely on recommendations from clinical practice guidelines. Guideline panels should consider all the relevant factors (criteria) that influence a decision or recommendation in a structured, explicit, and transparent way and provide clinicians with clear and actionable recommendations. In this article, we will describe the EtD frameworks for clinical practice recommendations...
September 13, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/28917630/decision-making-about-healthcare-related-tests-and-diagnostic-strategies-international-guidelines-show-variability-in-their-approaches
#3
Reem A Mustafa, Wojtek Wiercioch, Ingrid Arevalo-Rodriguez, Adrienne Cheung, Barbara Prediger, Liudmila Ivanova, Matthew Ventresca, Jan Brozek, Nancy Santesso, Patrick Bossuyt, Amit X Garg, Nancy Lloyd, Monika Lelgemann, Diedrich Bühler, Holger Schünemann
OBJECTIVE: To describe and compare current practices in developing guidelines about the use of health care related tests and diagnostic strategies (HCTDS) STUDY DESIGN AND SETTING: We sampled 37 public health and clinical practice guidelines about HCTDS from various sources without language restrictions. RESULTS: Detailed descriptions of the systems used to assess the quality of evidence and develop recommendations were challenging to find within guidelines. We observed much variability among and within organizations with respect to how they develop recommendations about HCTDS...
September 13, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28917594/key-steps-in-conducting-systematic-reviews-for-underpinning-clinical-practice-guidelines-methodology-of-the-european-association-of-urology
#4
Thomas Knoll, Muhammad Imran Omar, Steven Maclennan, Virginia Hernández, Steven Canfield, Yuhong Yuan, Max Bruins, Lorenzo Marconi, Hein Van Poppel, James N'Dow, Richard Sylvester
CONTEXT: The findings of systematic reviews (SRs) and meta-analyses (MAs) are used for clinical decision making. The European Association of Urology has committed increasing resources into the development of high quality clinical guidelines based on such SRs and MAs. OBJECTIVE: In this paper, we have summarised the process of conducting SRs for underpinning clinical practice guidelines under the auspices of the European Association of Urology Guidelines Office. EVIDENCE ACQUISITION: The process involves explicit methods and the findings should be reproducible...
September 13, 2017: European Urology
https://www.readbyqxmd.com/read/28916956/transitioning-to-minimal-footwear-a-systematic-review-of-methods-and-future-clinical-recommendations
#5
REVIEW
Joe P Warne, Allison H Gruber
BACKGROUND: Recent interest in barefoot running has led to the development of minimalist running shoes that are popular in distance runners. A careful transition to these shoes has been suggested and examined in the literature. However, no guidelines based on systematic evidence have been presented. The purpose of this review is to systematically examine the methods employed in the literature to transition to minimal footwear (MFW), as well as the outcomes to these studies in distance runners...
September 15, 2017: Sports Medicine—Open
https://www.readbyqxmd.com/read/28916246/pre-clinical-toxicology-considerations-for-vaccine-development
#6
REVIEW
Nabil Al-Humadi
Vaccine development requires pre-clinical toxicology studies, following good laboratory practice (GLP), before first in human (phase I) use. Many factors are critical in the final outcome of any pre-clinical toxicology study. The study design is one of these critical factors and should be carefully planned to avoid any false negative and/or false positive results. Preparation is another most critical factor in a successful study. Major changes in any procedure during the course of study should be avoided by all means...
September 12, 2017: Vaccine
https://www.readbyqxmd.com/read/28915960/pleiotropic-effects-of-metformin-to-rescue-statin-induced-muscle-injury-and-insulin-resistance-a-proposed-mechanism-and-potential-clinical-implications
#7
Nicholas W Carris, Srinivas M Tipparaju, David J Magness, Kalyan C Chapalamadugu, Ronald R Magness
The 2013 American Heart Association Blood Cholesterol Guidelines increased the number of patients recommended for statin therapy in the United States to 56million. Two common statin side effects are muscle pain, referred to as "statin-associated muscle symptoms", and increased risk for new onset type-2-diabetes mellitus. Up to 25% of statin users report muscle symptoms resulting in many patients being switched to lower dose or lower potency statins, or refusing statins altogether. The most likely signaling mechanisms for statin-associated muscle symptoms overlaps with the proposed mechanism of statin-induced insulin resistance...
September 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28915908/advances-in-paediatrics-in-2016-current-practices-and-challenges-in-allergy-autoimmune-diseases-cardiology-endocrinology-gastroenterology-infectious-diseases-neonatology-nephrology-neurology-nutrition-pulmonology
#8
REVIEW
Carlo Caffarelli, Francesca Santamaria, Dora Di Mauro, Carla Mastrorilli, Silvia Montella, Sergio Bernasconi
This review reports main progresses in various pediatric issues published in Italian Journal of Pediatrics and in international journals in 2016. New insights in clinical features or complications of several disorders may be useful for our better understanding. They comprise severe asthma, changing features of lupus erythematosus from birth to adolescence, celiac disease, functional gastrointestinal disorders, Moebius syndrome, recurrent pneumonia. Risk factors for congenital heart defects, Kawasaki disease have been widely investigated...
September 16, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28915897/development-of-a-complex-intervention-to-promote-appropriate-prescribing-and-medication-intensification-in-poorly-controlled-type-2-diabetes-mellitus-in-irish-general-practice
#9
Mark E Murphy, Molly Byrne, Atieh Zarabzadeh, Derek Corrigan, Tom Fahey, Susan M Smith
BACKGROUND: Poorly controlled type 2 diabetes mellitus (T2DM) can be seen as failure to meet recommended targets for management of key risk factors including glycaemic control, blood pressure and lipids. Poor control of risk factors is associated with significant morbidity, mortality and healthcare costs. Failure to intensify medications for patients with poor control of T2DM when indicated is called clinical inertia and is one contributory factor to poor control of T2DM. We aimed to develop a theory and evidence-based complex intervention to improve appropriate prescribing and medication intensification in poorly controlled T2DM in Irish general practice...
September 16, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28915890/barriers-and-enablers-for-the-development-and-implementation-of-allied-health-clinical-practice-guidelines-in-south-african-primary-healthcare-settings-a-qualitative-study
#10
J M Dizon, K Grimmer, Q Louw, S Machingaidze, H Parker, H Pillen
BACKGROUND: The South African allied health (AH) primary healthcare (PHC) workforce is challenged with the complex rehabilitation needs of escalating patient numbers. The application of evidence-based care using clinical practice guidelines (CPGs) is one way to make efficient and effective use of resources. Although CPGs are common for AH in high-income countries, there is limited understanding of how to do this in low- to middle-income countries. This paper describes barriers and enablers for AH CPG uptake in South African PHC...
September 15, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28914846/-analysis-of-the-efficiency-of-antimicrobial-treatment-for-community-acquired-pneumonia-in-clinical-practice
#11
O V Zhukova, O V Ruina, S V Kononova, T M Konyshkina
AIM: To analyze actual drug consumption based on the defined daily dose (DDD analysis) and to analyze the utilization of drugs based on their proportion of the total defined daily doses (DU90% analysis) for the antimicrobial therapy of community-acquired pneumonia (CAP) in clinical practice at a hospital in Russia. MATERIAL AND METHODS: The investigation materials were the data of 117 case histories of male (51.3%) and female (48.7%) patients hospitalized with CAP at Nizhny Novgorod City Clinical Hospital Five in 2015...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28914697/are-we-ready-to-treat-hepatitis-c-virus-in-individuals-with-opioid-use-disorder-assessment-of-readiness-in-european-countries-on-the-basis-of-an-expert-generated-model
#12
Nat Wright, Jens Reimer, Lorenzo Somaini, Carlos Roncero, Icro Maremmani, Nicolas Simon, Peter Krajci, Richard Littlewood, Oscar D'Agnone, Hannu Alho, Benjamin Rolland
Individuals with a history of injecting drugs have a high prevalence of chronic hepatitis C (HCV) infection. Many have a history of opioid use disorder (OUD). Despite novel treatments with improved efficacy and tolerability, treatment is limited in the group. A faculty of experts shared insights from clinical practice to develop an HCV care-readiness model. Evidence and expert knowledge was collected. Ten experts developed a model of three factors (with measures): 'healthcare engagement', 'guidance' and 'place'...
September 13, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28914663/physicians-decision-making-when-implementing-buprenorphine-with-new-patients-conjoint-analyses-of-data-from-a-cohort-of-current-prescribers
#13
Hannah K Knudsen, Michelle R Lofwall, Sharon L Walsh, Jennifer R Havens, Jamie L Studts
OBJECTIVES: Few studies have considered how providers make decisions to prescribe buprenorphine to new patients with opioid use disorder. This study examined the relative importance of patients' clinical, financial, and social characteristics on physicians' decision-making related to willingness to prescribe buprenorphine to new patients and the number of weeks of medication that they are willing to initially prescribe after induction. METHODS: A national sample of 1174 current prescribers was surveyed...
September 13, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28914273/patterns-and-appropriateness-of-thrombophilia-testing-in-an-academic-medical-center
#14
Nicholas Cox, Stacy A Johnson, Sara Vazquez, Ryan P Fleming, Matthew T Rondina, David Kaplan, Stephanie Chauv, Gabriel V Fontaine, Scott M Stevens, Scott Woller, Daniel M Witt
BACKGROUND: Clinical guidelines recommend against routine use of thrombophilia testing in patients with acute thromboembolism. Thrombophilia testing rarely changes acute management of a thrombotic event. OBJECTIVE: To determine appropriateness of thrombophilia testing in a teaching hospital. DESIGN: Retrospective cohort study. SETTING: One academic medical center in Utah. PARTICIPANTS: All patients who received thrombophilia testing between July 1, 2014, and December 31, 2014...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28914216/-driving-with-alzheimer-s-disease
#15
M Jacobs, E P 't Hart, R A C Roos
OBJECTIVE: To summarise the available literature on driving with Alzheimer's disease (AD) and to investigate the relationship between driving and cognitive functioning. DESIGN: Literature review. METHOD: A systematic search of the electronic databases PubMed/MEDLINE was conducted to select the relevant literature on the driving competence of patients with Alzheimer's disease. RESULTS: A total of 31 studies were selected that investigated driving competence in AD using either an on-road driving assessment or a driving simulator...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28913985/asthma-biomarkers-do-they-bring-precision-medicine-closer-to-the-clinic
#16
REVIEW
Ioana Agache, Liliana Rogozea
Measurement of biomarkers has been incorporated within clinical research of asthma to characterize the population and to associate the disease with environmental and therapeutic effects. Regrettably, at present, there are no specific biomarkers, none is validated or qualified, and endotype-driven choices overlap. Biomarkers have not yet reached clinical practice and are not included in current asthma guidelines. Last but not least, the choice of the outcome upholding the value of the biomarkers is extremely difficult, since it has to reflect the mechanistic intervention while being relevant to both the disease and the particular person...
November 2017: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/28913958/preoperative-nutritional-management-of-bariatric-patients-in-australia-the-current-practice-of-dietitians
#17
Ruth Bourne, Judith Tweedie, Fiona Pelly
AIM: The aim of this observational study was to investigate the reported practices of Australian dietitians managing bariatric surgery patients in the preoperative stage. METHODS: An online survey of dietitians providing nutritional care to bariatric patients was developed for the purpose of this investigation. The survey questions were guided by the Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic and Nonsurgical Support of the Bariatric Surgery Patient guidelines and current literature...
September 15, 2017: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
https://www.readbyqxmd.com/read/28912836/methods-for-enhancing-the-reproducibility-of-biomedical-research-findings-using-electronic-health-records
#18
REVIEW
Spiros Denaxas, Kenan Direk, Arturo Gonzalez-Izquierdo, Maria Pikoula, Aylin Cakiroglu, Jason Moore, Harry Hemingway, Liam Smeeth
BACKGROUND: The ability of external investigators to reproduce published scientific findings is critical for the evaluation and validation of biomedical research by the wider community. However, a substantial proportion of health research using electronic health records (EHR), data collected and generated during clinical care, is potentially not reproducible mainly due to the fact that the implementation details of most data preprocessing, cleaning, phenotyping and analysis approaches are not systematically made available or shared...
2017: BioData Mining
https://www.readbyqxmd.com/read/28912290/achieving-high-quality-care-a-view-from-nice
#19
REVIEW
Gillian Leng, Gemma Partridge
The National Institute for Health and Care Excellence (NICE) was established in 1999 to provide evidence-based guidance. The task of producing guidance by reviewing primary research data and using an advisory committee to develop evidence-based recommendations, is not straightforward. Guidance production is, however, less challenging than the task of putting evidence-based recommendations into practice.NICE is very sensitive to this challenge as, since 1999, over 1500 pieces of NICE guidance have been published...
September 14, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28912010/first-week-weight-dip-and-reaching-growth-targets-in-early-life-in-preterm-infants
#20
Jorine A Roelants, Koen F M Joosten, Brigitte M A van der Geest, Jessie M Hulst, Irwin K M Reiss, Marijn J Vermeulen
BACKGROUND & AIMS: Aggressive parenteral nutritional practices were implemented in clinical practice over a decade ago to prevent early growth retardation in preterm infants. We aimed to study adherence to current nutritional recommendations in a population of very preterm infants, and to evaluate growth in early life. METHODS: Preterm infants (gestational age <30 weeks and birth weight <1500 g) were included in a prospective observational cohort study. Data on parenteral and enteral intake were collected on days 1-7, 14, 21 and 28 (d28) of life...
August 31, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
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