scholarly journals Canadian Asthma Consensus Conference Summary of Recommendations

1996 ◽  
Vol 3 (2) ◽  
pp. 89-101 ◽  
Author(s):  
Pierre Ernst ◽  
J Mark Fitzgerald ◽  
Sheldon Spier
Keyword(s):  
Ambulatory Care ◽  
Consensus Statement ◽  
Scientific Evidence ◽  
Local Level ◽  
Asthma Management ◽  
Consensus Conference ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Optimal Approach ◽  
Evidence Based Guidelines

The Asthma Committee of the Canadian Thoracic Society invited a group of Canadian physicians with a particular interest in asthma to meet in Montebello, Quebec, March 9-12, 1995 to arrive at a consensus statement on the optimal approach to the management of asthma in the pediatric and adult ambulatory care settings. The societies and associations represented are listed in the appendix with the names of the contributors to this document. The objectives of the Montebello conference were: 1. To review the current ambulatory care management of asthma in Canada; 2. To develop guidelines with the participation of family physicians and specialists; 3. To develop guidelines which are evidence-based; 4. In creating evidence-based guidelines to focus attention on aspects of asthma management that are currently not supported by randomized controlled trials; 5. To develop strategies that allow for the implementation of rational guidelines at a local level. Recommendations were based on a critical review of the scientific literature by small groups prior to the meeting and are categorized according to the strength of the scientific evidence supporting each recommendation (Table 1).

Buprenorphine management: a conundrum for the anesthesiologist and beyond - a one-act play

2020 ◽  
Vol 45 (8) ◽  
pp. 656-659
Author(s):  
Shilen Thakrar ◽  
Josh Lee ◽  
Caitlin E Martin ◽  
John Butterworth IV
Keyword(s):  
Patient Outcomes ◽  
Perioperative Management ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Local Level ◽  
Evidence Based ◽  
National Guidelines ◽  
Evidence Based Guidelines ◽  
One Act ◽  
Patient Centric

We have witnessed a worldwide upsurge of streamlined enhanced recovery after surgery (ERAS) pathways advocating for consistency and compliance within their guidelines. At a recent national conference, two experts defended their institutional policies on perioperative management of buprenorphine, one defending its continuation, while the other suggesting its discontinuation. The moderator diplomatically proclaimed the need to have guidance at the institutional level and following it for favorable patient outcomes. Unfortunately, perioperative management of buprenorphine remains an understudied topic with a lack of national guidelines leading to variations at a local level despite its increased use nationally in the current opioid crisis. Although the moderator made a valid statement, we demonstrate via our one-act play the importance of recognizing a subset of the population within an ERAS pathway that necessitates multidisciplinary discussion, communication, and patient-centric care to formulate a perioperative plan coordinating a patient’s care. More robust research is needed to minimize variability in current practices and to further develop comprehensive evidence-based guidelines that encompass risk factors and anticipated postsurgical and peripartum pain for patients on buprenorphine.

scholarly journals Health professionals’ adherence to evidence-based obesity guidelines: a cohort study.

2019 ◽  
Author(s):  
Nuria Trujillo Garrido ◽  
Mariangeles Bernal ◽  
Maria José Santi Cano
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Health Professionals ◽  
Medical Records ◽  
Scientific Evidence ◽  
Behavioural Change ◽  
Overweight And Obesity ◽  
Evidence Based ◽  
Practice Methods ◽  
Evidence Based Guidelines

Abstract BACKGROUND The prevalence of obesity is on the increase worldwide and yet scientific evidence shows that primary care professionals are not adequately addressing overweight and obesity. In this study, we evaluate how obesity guidelines are being implemented in routine clinical practice. METHODS The study obtained the following data on a cohort of 209 obese patients attending primary care consultations: electronic medical records, body mass index (BMI), waist circumference (WC), cardiovascular risk factors, comorbidities and whether or not their health professional adhered to obesity evidence-based guidelines. RESULTS 57.9% of the participants were women and their average age was 65.8 ± 12.7 years. Only 25.4% of the medical records met all the criteria established in the therapeutic guidelines regarding diet prescription. This percentage was significantly higher in males than females (36.4% vs 17.4, p = 0.002). 1.4% met the criteria for physical activity and 1.5% for behavioural change activities. In the multivariate analysis, the variable associated with the most favourable BMI and WC figures, after adjusting for age, was a follow up by health professionals on physical activity (β=0.347, p=0.027, CI=0.429-6.868; β=0.367, p=0.024, CI=1.256-17.556) during routine check-ups with women. CONCLUSIONS We detected low adherence to the evidence-based guidelines among professionals. Recording dietetic prescription and physical exercise in the patient's medical record is associated with a better control of obesity. This data suggest that primary health care should be improved for obese patient.

scholarly journals Postoperative controls of ventilation tubes in children - by general practitioner or otolaryngologist? Study protocol for a multicenter, randomized, controlled trial (The ConVenTu study)

2020 ◽  
Author(s):  
Bjarne Austad ◽  
Ann Helen Nilsen ◽  
Anne-Sofie Helvik ◽  
Grethe Albrektsen ◽  
Ståle Nordgård ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Tympanic Membrane ◽  
Postoperative Care ◽  
Controlled Trial ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Multicenter Randomized Controlled Trial ◽  
Ventilation Tubes ◽  
Regional Health Authorities ◽  
Evidence Based Guidelines

Abstract Background Insertion of ventilation tubes (VTs) in the tympanic membrane is one of the most common ambulatory surgeries performed on children. Postoperative care may continue for two or more years and is today mostly done by otolaryngologists. Controls by general practitioners (GPs) may represent a sufficient level of health care regarding clinical outcome, but there exist no evidence-based guidelines concerning the level of expertise for this task. Aim To evaluate whether postoperative care after surgery with VTs performed by GPs represent a sufficient alternative to otolaryngologists. Methods/design Randomized controlled trial including patients from seven hospitals in all four Regional Health Authorities in Norway. A total of 400 children aged 3-10 years will be randomized to postoperative care by either otolaryngologist or their regular GP after surgery with VTs in the tympanic membrane. Two years after surgery we will compare hearing thresholds, middle ear function, complication rate, health related quality of life as well as the guardians’ evaluations of the postoperative care. Discussion Results from the ConVenTu study are expected to contribute with knowledge necessary to develop evidence-based guidelines regarding the level of expertise for safe postoperative care for children after surgery with VTs.

Evidence-based policy analysis? The strange case of the randomized controlled trials of community-led total sanitation

2020 ◽  
Vol 36 (1) ◽  
pp. 191-221 ◽  
Author(s):  
Dale Whittington ◽  
Mark Radin ◽  
Marc Jeuland
Keyword(s):  
Randomized Controlled Trials ◽  
Treatment Effects ◽  
Cost Benefit Analysis ◽  
Local Level ◽  
Research Programme ◽  
Economic Benefits ◽  
Controlled Trials ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Evidence Based Policy

Abstract Our purpose in this paper is to review the findings of 14 randomized controlled trials (RCTs) of community-led total sanitation (CLTS) and recent rural sanitation interventions to assess their usefulness and implications for sanitation policy-making in low- and middle-income countries. The results of the RCT research programme to evaluate CLTS and related sanitation interventions suggest that the magnitude of the treatment effects was much smaller and uncertain than proponents once anticipated. For example, of the ten studies that reported results for reductions in childhood diarrhoea, only three found statistically significant decreases. Surprisingly, the RCT research teams and their funders do not seem to have thought about how their multi-million dollar research agenda would support decision-making on sanitation. Information on the parameters needed for cost-effectiveness analysis or benefit–cost analysis was not collected. However, making reasonable assumptions about the missing information on parameter values, we show that cost–benefit analysis may still ‘save’ CLTS because small treatment effects may still yield net positive economic benefits if the costs of implementing CLTS programmes are modest. We also discuss the need to move beyond the desire for sanitation policies that are proven to be effective globally, and the importance of focusing on analysis of the local sanitation situation. We describe the data needed to make this shift in policy focus from the global to the local level and stress the importance of interdisciplinary communication between the proponents of RCTs and ‘evidence-based policy’, and economists who will be responsible for the economic analysis of investments in CLTS and other sanitation interventions. We also argue that the results of these RCTs highlight the importance of coordinating investments in piped water and sanitation with investments in improved housing.

scholarly journals Scientific framework of homeopathy: evidence-based homeopathy

2021 ◽  
Vol 7 (23) ◽  
pp. 72-92
Author(s):  
Michel Van Wassenhoven
Keyword(s):  
Scientific Evidence ◽  
Daily Practice ◽  
Evidence Based ◽  
Review Of Literature ◽  
High Dilution ◽  
Randomized Controlled ◽  
Palabras Clave ◽  
Meta Analyses ◽  
Based Medicine ◽  
Scientific Framework

This paper aims at considering all important aspects of the scientific framework of homeopathic practice, looking at the levels of scientific evidence of each aspect in an objective way, through an extensive review of literature. Levels of evidence considered are: I) existence of meta-analyses and/or systematic positive reviews of literature; IIa) multiple positive randomized controlled trials (RCTs); IIb) some positive RCTs; IIIa) positive multiple cohorts studies; IIIb) positive studies with some cohorts; IV) opinion of experts (clinical and daily practice cases). Conclusions are clear: homeopathy must stay within the framework of medical practice, and it is even a necessity for public health. Keywords: Evidence-Based medicine, Homeopathy, Scientific framework, Literature review.   Marco científico da homeopatia: homeopatia baseada em evidéncias Resumo O presente artigo aborda aspectos importantes do marco científico da prática homeopática, focando os níveis de evidéncia de cada um deles de maneira objetica, através de uma revisão extensa da literatura. Os níveis de evidéncia considerados são: I) existéncia de meta-análises e/ou revisões sistemáticas positivas da literatura; IIa) múltiplos estudos randomizados controlados (RCTs) positivos; IIb) alguns RCTs positivos; IIIa) estudos de coortes múltiplas positivos; IIIb) estudos com algumas coortes positivos; IV) opinião de expertos (casos clínicos da prática cotidiana). As conclusões são claras: a homeopatia deve permanecer dentro do marco da prática médica, sendo, inclusive, uma necessidade para a saúde pública. Palavras-chave: Medicina Baseada em Evidéncias, Homeopatia, Estrutura ciéntifica, Revisão de literatura.   Marco científico de la homeopatía: homeopatía basada en evidencia Resumen Este artículo aborda aspectos importantes del marco científico de la práctica homeopática, enfocando los niveles de evidencia de cada aspecto, de modo objetivo, mediante una revisión extensiva de la literatura. Los niveles de evidencia considerados son: I) existencia de meta-análisis y/o revisiones sistemáticas positivas de la literatura; IIa) múltiples ensayos randomizados controlados (RCTs) positivos; IIb) algunos RCTs positivos; IIIa) estudios con cohortes múltiplas positivos; IIIb) estudios con algunas cohortes positivos; IV) opinión de expertos (casos clínicos de la práctica cotidiana). Las conclusiones son claras: la homeopatía debe permanecer dentro del marco de la práctica médica, siendo, inclusive, una necesidad para la salud pública. Palabras-clave: Medicina enbasada en evidencia, homeopatía, estructura científica, Revisión de la literatura.   Correspondence author: Michel van Wassenhoven, [email protected] How to cite this article: Wassenhoven MV. Scientific framework of homeopathy: Evidence-based Homeopathy. Int J High Dilution Res [online]. 2008 [cited YYYY Mmm DD]; 7(23): 72-92. Available from: http://journal.giri-society.org/index.php/ijhdr/article/view/286/354.  

Laparoscopic ventral incisional hernia repair: evidence-based guidelines of the first Italian Consensus Conference

Hernia ◽  
2013 ◽  
Vol 17 (5) ◽  
pp. 557-566 ◽  
Author(s):  
D. Cuccurullo ◽  
M. Piccoli ◽  
F. Agresta ◽  
S. Magnone ◽  
F. Corcione ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Incisional Hernia Repair ◽  
Consensus Conference ◽  
Evidence Based ◽  
Ventral Incisional Hernia ◽  
Evidence Based Guidelines

Gout and Hyperuricemia: New Guidelines and Treatments

2008 ◽  
Vol 22 (1) ◽  
pp. 104-115
Author(s):  
Geoffrey C. Wall ◽  
Sarah A. Cooper
Keyword(s):  
Inflammatory Arthritis ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Randomized Controlled Studies ◽  
European League Against Rheumatism ◽  
Acute Attacks ◽  
New Guidelines ◽  
Evidence Based Guidelines ◽  
New Compounds ◽  
European League

Gout is the most common inflammatory arthritis in western countries and the incidence is increasing. Additionally, evidence now exists that cases of severe, refractory gout seem to be increasing. The management of gout and hyperuricemia has remained largely unchanged for decades and includes antiinflammatories used initially for acute attacks and primarily allopurinol to prevent future attacks. Evidence-based guidance for the management of gout and hyperuricemia has been plagued by a lack of randomized, controlled studies and the lack of new medications. Recently evidence-based guidelines by the European League Against Rheumatism were published; one of the first attempts by a major medical body to assess the state of gout and hyperuricemia treatment. Additionally, several new compounds seem poised to be released for hyperuricemia treatment. This review details the important aspects of the gout guidelines relating to pharmacotherapy and critically examines the data surrounding new modalities to decrease serum uric acid.

scholarly journals ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma

2020 ◽  
Vol 31 (1) ◽  
pp. 12-39
Author(s):  
Nicole Concin ◽  
Xavier Matias-Guiu ◽  
Ignace Vergote ◽  
David Cibula ◽  
Mansoor Raza Mirza ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Endometrial Carcinoma ◽  
European Society ◽  
Large Body ◽  
Consensus Conference ◽  
Evidence Based ◽  
Gynaecological Oncology ◽  
European Consensus ◽  
Evidence Based Guidelines

A European consensus conference on endometrial carcinoma was held in 2014 to produce multi-disciplinary evidence-based guidelines on selected questions. Given the large body of literature on the management of endometrial carcinoma published since 2014, the European Society of Gynaecological Oncology (ESGO), the European SocieTy for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP) jointly decided to update these evidence-based guidelines and to cover new topics in order to improve the quality of care for women with endometrial carcinoma across Europe and worldwide.

Sign in / Sign up

Export Citation Format

Share Document