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"Clinical guidelines"

Simona Sobrero, Eva Pagano, Elisa Piovano, Lorenzo Bono, Manuela Ceccarelli, Anna Ferrero, Chiara Macchi, Marinella Mistrangelo, Silvia Patriarca, Elisa Tripodi, Roberto Zanetti, Oscar Bertetto, Giovannino Ciccone, Paolo Zola
BACKGROUND: In the northwestern Italian region of Piedmont, current statistics on hospitalizations show that surgical treatment for ovarian cancer (OC) is taking place in many small hospitals, as opposed to a more centralized approach. A population-based clinical audit was promoted to investigate whether OC is being managed according to clinical guidelines, identify determinants of lack of adherence to guidelines, and evaluate the association between adherence to guidelines and survival...
November 2016: International Journal of Gynecological Cancer
Cheryl Rodgers, Mary C Hooke, Jessica Ward, Lauri A Linder
OBJECTIVE: To report evidence regarding assessment methods and management strategies for symptom clusters among children and adolescents with cancer. DATA SOURCES: Published research and clinical guidelines. CONCLUSION: Although a number of studies have identified multiple co-occurring symptoms in children and adolescents with cancer, only a few have included analyses aimed at identifying symptom clusters. Evidence is limited for symptom cluster management strategies...
October 21, 2016: Seminars in Oncology Nursing
Stephen L Kopecky, Douglas C Bauer, Martha Gulati, Jeri W Nieves, Andrea J Singer, Peter P Toth, James A Underberg, Taylor C Wallace, Connie M Weaver
Description: Calcium is the dominant mineral present in bone and a shortfall nutrient in the American diet. Supplements have been recommended for persons who do not consume adequate calcium from their diet as a standard strategy for the prevention of osteoporosis and related fractures. Whether calcium with or without vitamin D supplementation is beneficial or detrimental to vascular health is not known. Methods: The National Osteoporosis Foundation and American Society for Preventive Cardiology convened an expert panel to evaluate the effects of dietary and supplemental calcium on cardiovascular disease based on the existing peer-reviewed scientific literature...
October 25, 2016: Annals of Internal Medicine
John F Strang, Haley Meagher, Lauren Kenworthy, Annelou L C de Vries, Edgardo Menvielle, Scott Leibowitz, Aron Janssen, Peggy Cohen-Kettenis, Daniel E Shumer, Laura Edwards-Leeper, Richard R Pleak, Norman Spack, Dan H Karasic, Herbert Schreier, Anouk Balleur, Amy Tishelman, Diane Ehrensaft, Leslie Rodnan, Emily S Kuschner, Francie Mandel, Antonia Caretto, Hal C Lewis, Laura G Anthony
Evidence indicates an overrepresentation of youth with co-occurring autism spectrum disorders (ASD) and gender dysphoria (GD). The clinical assessment and treatment of adolescents with this co-occurrence is often complex, related to the developmental aspects of ASD. There are no guidelines for clinical care when ASD and GD co-occur; however, there are clinicians and researchers experienced in this co-occurrence. This study develops initial clinical consensus guidelines for the assessment and care of adolescents with co-occurring ASD and GD, from the best clinical practices of current experts in the field...
October 24, 2016: Journal of Clinical Child and Adolescent Psychology
Pupalan Iyngkaran, Samia R Toukhsati, Merlin C Thomas, Michael V Jelinek, David L Hare, John D Horowitz
BACKGROUND: Beta-blockers (BBs) are the mainstay prognostic medication for all stages of chronic heart failure (CHF). There are many classes of BBs, each of which has varying levels of evidence to support its efficacy in CHF. However, most CHF patients have one or more comorbid conditions such as diabetes, renal impairment, and/or atrial fibrillation. Patient enrollment to randomized controlled trials (RCTs) often excludes those with certain comorbidities, particularly if the symptoms are severe...
2016: Clinical Medicine Insights. Cardiology
Erin Koffel, Imran S Khawaja, Anne Germain
Sleep disturbances are common in adults with PTSD and range from insomnia and nightmares to periodic leg movements and disruptive nocturnal behaviors. Together these findings suggest profound disturbances in rapid eye movement (REM) and non-REM (NREM) sleep, although there is a lack of consensus regarding a distinct profile of objective sleep disturbances associated with PTSD. Prospective, longitudinal studies have established that sleep disturbances represent a risk factor for the development and course of PTSD, suggesting that sleep is an important neurobiological mechanism in the etiology and maintenance of this disorder...
March 2016: Psychiatric Annals
Tomasz Dzierżanowski, Aleksandra Ciałkowska-Rysz
PURPOSE: Based on the international reports, consumption of opioid analgesics in Poland is relatively low. There is limited information on possible impediments to optimal opioid use. This study was aimed to identify possible barriers to access to opioid analgesics and causes of failure to comply with current clinical guidelines. METHODS: Consumption data per capita in 2000-2015 were analyzed in terms of oral morphine equivalents in total, per prescription type, per reimbursement status, to identify the impact of regulations specific for Poland...
October 22, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Landon W Trost, Ricardo Munarriz, Run Wang, Allen Morey, Laurence Levine
INTRODUCTION: The field of sexual medicine is continuously advancing, with novel outcomes reported on a regular basis. Given the rapid evolution, updated guidelines are essential to inform practicing clinicians on best practices. AIM: To summarize the current literature and provide clinical guidelines on penile traction therapy, vacuum erection devices, and penile revascularization. METHODS: A consensus panel was held with leading sexual medicine experts during the 2015 International Consultation on Sexual Medicine (ICSM)...
November 2016: Journal of Sexual Medicine
Tim Stokes, Elizabeth J Shaw, Janette Camosso-Stefinovic, Mari Imamura, Lovney Kanguru, Julia Hussein
BACKGROUND: Maternal mortality remains a major international health problem in low- and middle-income countries (LMIC), and most could have been prevented by quality improvement interventions already demonstrated to be effective, such as clinical guideline implementation strategies. The aim of this systematic review was to synthesise qualitative evidence on guideline implementation strategies to improve obstetric care practice in LMIC in order to identify barriers and enablers to their successful implementation...
October 22, 2016: Implementation Science: IS
Andrew Bottomley, Madeline Pe, Jeff Sloan, Ethan Basch, Franck Bonnetain, Melanie Calvert, Alicyn Campbell, Charles Cleeland, Kim Cocks, Laurence Collette, Amylou C Dueck, Nancy Devlin, Hans-Henning Flechtner, Carolyn Gotay, Eva Greimel, Ingolf Griebsch, Mogens Groenvold, Jean-Francois Hamel, Madeleine King, Paul G Kluetz, Michael Koller, Daniel C Malone, Francesca Martinelli, Sandra A Mitchell, Carol M Moinpour, Jammbe Musoro, Daniel O'Connor, Kathy Oliver, Elisabeth Piault-Louis, Martine Piccart, Francisco L Pimentel, Chantal Quinten, Jaap C Reijneveld, Christoph Schürmann, Ashley Wilder Smith, Katherine M Soltys, Martin J B Taphoorn, Galina Velikova, Corneel Coens
Measures of health-related quality of life (HRQOL) and other patient-reported outcomes generate important data in cancer randomised trials to assist in assessing the risks and benefits of cancer therapies and fostering patient-centred cancer care. However, the various ways these measures are analysed and interpreted make it difficult to compare results across trials, and hinders the application of research findings to inform publications, product labelling, clinical guidelines, and health policy. To address these problems, the Setting International Standards in Analyzing Patient-Reported Outcomes and Quality of Life Endpoints Data (SISAQOL) initiative has been established...
October 18, 2016: Lancet Oncology
David Faraoni, Simon Thomas Schaefer
Randomized controlled trials (RCTs) are considered the gold standard for clinical research, thus having a high impact on clinical guidelines and our daily patients' care. However, various treatment strategies which we consider "evidence based" have never been subject to a prospective RCT, as we would rate it unethical to withheld an established treatment to individuals in an placebo controlled trial.In a recent BMC Anesthesiology publication, Trentino et al. analyzed the usefulness of observational studies in assessing benefit and risk of different transfusion strategies...
October 21, 2016: BMC Anesthesiology
Matthias Samwald, Hong Xu, Kathrin Blagec, Philip E Empey, Daniel C Malone, Seid Mussa Ahmed, Patrick Ryan, Sebastian Hofer, Richard D Boyce
Pre-emptive pharmacogenomic (PGx) testing of a panel of genes may be easier to implement and more cost-effective than reactive pharmacogenomic testing if a sufficient number of medications are covered by a single test and future medication exposure can be anticipated. We analysed the incidence of exposure of individual patients in the United States to multiple drugs for which pharmacogenomic guidelines are available (PGx drugs) within a selected four-year period (2009-2012) in order to identify and quantify the incidence of pharmacotherapy in a nation-wide patient population that could be impacted by pre-emptive PGx testing based on currently available clinical guidelines...
2016: PloS One
Laura Chahda, Bernice A Mathisen, Lindsay B Carey
PURPOSE: Given minimal studies describing the role and practice of speech-language pathologists (SLPs) in adult palliative care, the aim of this review was to compile a database of research literature, examine the potential research gaps and to consider material that specifically discussed the need for and/or use of procedures and protocols for SLPs working in palliative care that would support the development of SLP palliative care guidelines. METHOD: A scoping review was conducted utilising Arksey and O'Malley's framework with the goal of exploring any key concepts and approaches utilised by SLPs in adult palliative care, plus any literature and/or recommendations regarding SLP practice in adult palliative care settings...
October 20, 2016: International Journal of Speech-language Pathology
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
Simon Sawyer, Jan Coles, Angela Williams, Brett Williams
CONTEXT: Intimate partner violence (IPV) is a significant cause of morbidity and mortality in women worldwide. Numerous health organisations have called for increased education for health care practitioners who encounter IPV patients and the first clinical guidelines for health services responding to IPV were recently published. This renewed focus has created a need to examine the current evidence for IPV education so that it may inform the next generation of educational interventions...
November 2016: Medical Education
Jiang Li, Kai Su, Fang Li, Wei Tang, Yao Huang, Le Wang, Huiyao Huang, Jufang Shi, Min Dai
BACKGROUND: Lung cancer is the most common malignancy and screening can decrease the mortality. High quality screening guideline is necessary and important for effective work. Our study is to review and evaluate the basic characteristics and methodology quality of the current global lung cancer screening guidelines so as to provide useful information for domestic study in the future. METHODS: Electronic searches were done in English and Chinese databases including PubMed, the Cochrane Library, Web of Science, Embase, CNKI, CBM, Wanfang, and some cancer official websites...
October 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Peter Kruzliak, Alexander Berezin, Alexander Kremzer, Tatyana Samura, Roman Benacka, Ioana Mozos, Emmanuel Egom, Luis Rodrigo
BACKGROUND: Biomechanical stress and inflammatory biomarkers relate to global contractility dysfunction; however, adding these biomarkers into a risk model constructed on clinical data does not improve its prediction value in chronic heart failure (CHF). AIM: The aim of this study was to evaluate whether biomarkers predict declining of left ventricular global contractility function in diabetic patients with ischemia-induced CHF. PATIENTS AND METHODS: The study retrospectively evolved 54 diabetic patients who had systolic or diastolic ischemia-induced CHF that was defined as left-ventricular ejection fraction (LVEF) ≤45% or 46-55% respectively assessed by quantitative echocardiography and other conventional criteria according to current clinical guidelines...
September 1, 2016: Folia Medica
Ann Marie Flannery, Mandeep S Tamber, Catherine Mazzola, Paul Klimo, Lissa C Baird, Rachana Tyagi, David F Bauer, Alexandra Beier, Susan Durham, Alexander Y Lin, Catherine McClung-Smith, Laura Mitchell, Dimitrios Nikas
BACKGROUND: Positional plagiocephaly is a common problem seen by pediatricians, pediatric neurologists, and pediatric neurosurgeons. OBJECTIVE: To create evidence-based guidelines for the treatment of pediatric positional plagiocephaly. METHODS: This guideline was prepared by the Plagiocephaly Guideline Task Force, a multidisciplinary team made up of physician volunteers (clinical experts), medical librarians, and clinical guidelines specialists...
November 2016: Neurosurgery
Stefan Wagner
Blood pressure self-measurement has been used extensively as part of several clinical processes including in the home monitoring setting for mitigating white coat effect and gaining more detailed insights into the blood pressure variability of patients over time. Self-measurement of BP is also being used as part of telemonitoring and telemedicine processes, as well as in the waiting rooms and self-measurement rooms of general practice clinics, specialized hospital department's outpatient clinics, and in other types of care facilitates and institutions...
October 19, 2016: Advances in Experimental Medicine and Biology
Jamie J Kirkham, Sarah Gorst, Douglas G Altman, Jane M Blazeby, Mike Clarke, Declan Devane, Elizabeth Gargon, David Moher, Jochen Schmitt, Peter Tugwell, Sean Tunis, Paula R Williamson
BACKGROUND: Core outcome sets (COS) can enhance the relevance of research by ensuring that outcomes of importance to health service users and other people making choices about health care in a particular topic area are measured routinely. Over 200 COS to date have been developed, but the clarity of these reports is suboptimal. COS studies will not achieve their goal if reports of COS are not complete and transparent. METHODS AND FINDINGS: In recognition of these issues, an international group that included experienced COS developers, methodologists, journal editors, potential users of COS (clinical trialists, systematic reviewers, and clinical guideline developers), and patient representatives developed the Core Outcome Set-STAndards for Reporting (COS-STAR) Statement as a reporting guideline for COS studies...
October 2016: PLoS Medicine
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