Established evidence‐based treatment guidelines help mitigate disparities in quality of emergency care

2021 ◽  
Author(s):  
Stacy A. Trent ◽  
Nigel George ◽  
Edward P. Havranek ◽  
Adit A. Ginde ◽  
Jason S. Haukoos
Keyword(s):  
Emergency Care ◽  
Treatment Guidelines ◽  
Evidence Based ◽  
Evidence Based Treatment

Recurrent meningeal sarcoma successfully treated with stereotactic radiosurgery

2012 ◽  
Vol 10 (5) ◽  
pp. 434-438 ◽  
Author(s):  
Michael Cummings ◽  
Varun Chowdhry ◽  
Hemangini Shah ◽  
Jason Back ◽  
Gloria A. Kennedy
Keyword(s):  
Stereotactic Radiosurgery ◽  
Treatment Guidelines ◽  
Primary Resection ◽  
Rapid Progression ◽  
Evidence Based ◽  
Full Time ◽  
Evidence Based Treatment ◽  
Meningeal Sarcoma ◽  
Multifocal Recurrence

Primary intracranial meningeal sarcoma is a rare neurological malignancy without strong evidence-based treatment guidelines. The authors describe a boy with primary meningeal sarcoma who symptomatically presented at 10 months of age and was treated with primary resection. The patient had multifocal recurrence approximately 2 years later. Given the location and rapid progression of the disease, the boy was treated with Gamma Knife surgery. He had a complete radiographic response 3 years posttreatment. He attends school full time and enjoys good quality of life. Based on local control and response to radiosurgery, the authors suggest that multifocal meningeal sarcomas not amenable to resection can be effectively managed with stereotactic radiosurgery.

scholarly journals Chronic pancreatitis.Evidence based management guidelines of the Hungarian Pancreatic Study Group

2015 ◽  
Vol 156 (7) ◽  
pp. 262-288 ◽  
Author(s):  
Tamás Takács ◽  
László Czakó ◽  
Zsolt Dubravcsik ◽  
Gyula Farkas ◽  
Péter Hegyi ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Treatment Guidelines ◽  
Task Force ◽  
Correct Diagnosis ◽  
Study Group ◽  
Evidence Based ◽  
International Guidelines ◽  
Basic Reference ◽  
Evidence Based Guideline

Chronic pancreatitis is an inflammatory disease associated with structural and functional damage of the pancreas. In most cases pain, maldigestion and weight loss are the leading sympthoms, which significantly worsen the quality of life. Correct diagnosis and differential diagnosis of chronic pancreatitis and treatment of these patients requires up-to-date and evidence based treatment guidelines. The Hungarian Pancreatic Study Group proposed to prepare an evidence based guideline based on the available international guidelines and evidence. The preparatory and consultation task force appointed by the Hungarian Pancreatic Study Group translated and complemented and/or modified the international guidelines if it was necessary. 123 relevant clinical questions in 11 topics were defined. Evidence was classified according to the UpToDate®grading system. The draft of the guidelines were presented and discussed at the consensus meeting in September 12, 2014. All clinial questions were accepted with total or strong agreement. The present guideline is the first evidence based chronic pancreatitis guideline in Hungary. This guideline provides very important and helpful data for tuition, everyday practice and proper financing of chronic pancreatitis. Therefore, the authors believe that these guidelines will widely become a basic reference in Hungary. Orv. Hetil., 2015, 156(7), 262–288.

scholarly journals Pharmacological Augmentation in Unipolar Depression: A Guide to the Guidelines

2020 ◽  
Vol 23 (9) ◽  
pp. 587-625 ◽  
Author(s):  
Rachael W Taylor ◽  
Lindsey Marwood ◽  
Emanuella Oprea ◽  
Valeria DeAngel ◽  
Sarah Mather ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Evidence Based ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Comprehensive Overview ◽  
Objective Evidence ◽  
Resistant Depression ◽  
Evidence Based Care ◽  
Guidelines For Depression

Abstract Background Pharmacological augmentation is a recommended strategy for patients with treatment-resistant depression. A range of guidelines provide advice on treatment selection, prescription, monitoring and discontinuation, but variation in the content and quality of guidelines may limit the provision of objective, evidence-based care. This is of importance given the side effect burden and poorer long-term outcomes associated with polypharmacy and treatment-resistant depression. This review provides a definitive overview of pharmacological augmentation recommendations by assessing the quality of guidelines for depression and comparing the recommendations made. Methods A systematic literature search identified current treatment guidelines for depression published in English. Guidelines were quality assessed using the Appraisal of Guidelines for Research and Evaluation II tool. Data relating to the prescription of pharmacological augmenters were extracted from those developed with sufficient rigor, and the included recommendations compared. Results Total of 1696 records were identified, 19 guidelines were assessed for quality, and 10 were included. Guidelines differed in their quality, the stage at which augmentation was recommended, the agents included, and the evidence base cited. Lithium and atypical antipsychotics were recommended by all 10, though the specific advice was not consistent. Of the 15 augmenters identified, no others were universally recommended. Conclusions This review provides a comprehensive overview of current pharmacological augmentation recommendations for major depression and will support clinicians in selecting appropriate treatment guidance. Although some variation can be accounted for by date of guideline publication, and limited evidence from clinical trials, there is a clear need for greater consistency across guidelines to ensure patients receive consistent evidence-based care.

Fatigue and HIV

2017 ◽  
Author(s):  
William Breitbart ◽  
Anna L. Dickerman
Keyword(s):  
Quality Of Life ◽  
Treatment Adherence ◽  
Symptom Management ◽  
Treatment Strategies ◽  
Hiv And Aids ◽  
Evidence Based ◽  
Important Condition ◽  
Evidence Based Treatment ◽  
The Past

Fatigue is commonly reported by persons with HIV and AIDS and is associated with impaired physical function, reduced quality of life, and suboptimal treatment adherence. Patients regard fatigue as an important condition to be addressed because it is disabling and distressing. In the past, fatigue was overlooked and undertreated by physicians, but clinicians caring for persons with HIV and AIDS have been giving more attention to symptom management and patients’ quality of life. Increased attention to symptom management in HIV and AIDS warrants familiarity with major issues in evaluation and treatment of fatigue. This chapter reviews the definition and assessment of fatigue, prevalence of fatigue in HIV/AIDS and its impact on patients, medical and psychological causes of fatigue, and evidence-based treatment strategies.

Treatment of interictal psychiatric disorder in epilepsy. I. Affective and anxiety disorders

2002 ◽  
Vol 14 (1) ◽  
pp. 39-43 ◽  
Author(s):  
Cm van der Feltz-Cornelis
Keyword(s):  
Anxiety Disorders ◽  
Psychiatric Disorder ◽  
Affective Disorders ◽  
Treatment Guidelines ◽  
Systematic Research ◽  
Evidence Based ◽  
Evidence Based Treatment ◽  
General Psychiatry ◽  
Dsm Iv ◽  
Patients With Epilepsy

Background:Interictal affective disorders are common in patients with epilepsy and there is a need for evidence-based treatment guidelines.Objective:This paper gives an overview of research concerning treatment of interictal affective disorders and interictal anxiety disorders in epilepsy.Methods:Literature review supplemented by clinical experience.Results:Interictal psychiatric disorder can be characterized as intermittent pleomorphic psychopathology. The most common manifestations are interictal dysphoric disorder (IDD) and depression. There is a lack of randomized control trials (RCTs) concerning effectiveness and side-effects of antidepressants in epilepsy patients.Conclusion:Treatment implications of the concept of IDD and other interictal disorders are an optimized dosage of anti-epileptics in combination with antidepressants. This coincides with recent guidelines concerning combinations of psychotropic medication, such as for depression and bipolar disorder, in general psychiatry. Systematic research involving the DSM-IV categories of generalized anxiety disorder, panic disorder and agoraphobia and depression is not yet available. Prevalence and treatment of interictal anxiety disorders and depressive disorder in epilepsy should be the subject of further research, in order to enable development of evidence-based treatment guidelines for these disorders in epilepsy patients.

PTSD Treatment of African American Adults in Primary Care: The Gap Between Current Practice and Evidence-Based Treatment Guidelines

2011 ◽  
Vol 103 (7) ◽  
pp. 585-593 ◽  
Author(s):  
Ruth Elaine Graves ◽  
John R. Freedy ◽  
Notalelomwan U. Aigbogun ◽  
William B. Lawson ◽  
Thomas A. Mellman ◽  
...  
Keyword(s):  
Primary Care ◽  
African American ◽  
Current Practice ◽  
Treatment Guidelines ◽  
Evidence Based ◽  
Evidence Based Treatment ◽  
Ptsd Treatment ◽  
African American Adults

scholarly journals Malignant Bowel Obstruction in Advanced Gynecologic Cancers: An Updated Review from a Multidisciplinary Perspective

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Yeh Chen Lee ◽  
Nazlin Jivraj ◽  
Catherine O’Brien ◽  
Tanya Chawla ◽  
Eran Shlomovitz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bowel Obstruction ◽  
Treatment Guidelines ◽  
Clinical Trial Design ◽  
Major Complication ◽  
Evidence Based ◽  
Malignant Bowel Obstruction ◽  
Gynecologic Cancers ◽  
The Impact

Malignant bowel obstruction (MBO) is a major complication in women with advanced gynecologic cancers which imposes a significant burden on patients, caregivers, and healthcare systems. Symptoms of MBO are challenging to palliate and result in progressive decompensation of already vulnerable patients with limited therapeutic options and a short prognosis. However, there is a paucity of guidelines or innovative approaches to improve the care of women who develop MBO. MBO is a complex clinical situation that requires a multidisciplinary approach to ensure the appropriate treatment modality and interprofessional care to optimally manage these patients. This review summarizes the current literature on the different approaches targeting MBO management including surgical intervention, chemotherapy, total parenteral nutrition, and pharmacological treatment. In addition, the impact of MBO management on patients’ quality of life (QOL) is examined. This article focuses on the challenges in developing evidence-based treatment guidelines for MBO and barriers in clinical trial design for MBO and proposes strategies to advance the MBO management. Collaboration is essential to design studies that may improve the overall care and quality of life for these patients. Prospective data are needed to inform clinical practice, establish a new benchmark for evidence-based MBO management, and better understand the biology of MBO.

Psychosocial Factors and Diabetes Mellitus: Evidence-Based Treatment Guidelines

2005 ◽  
Vol 1 (3) ◽  
pp. 255-270 ◽  
Author(s):  
Frank Petrak ◽  
Stephan Herpertz ◽  
Christian Albus ◽  
Axel Hirsch ◽  
Bernhard Kulzer ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Psychosocial Factors ◽  
Treatment Guidelines ◽  
Evidence Based ◽  
Evidence Based Treatment
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