scholarly journals Rigorous Assessment of Guidelines on COVID-19-Related Thrombotic or Thromboembolic Disease: Implications for Clinical Practice of Prevention, Diagnosis, and Treatment

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Jingyi Liang ◽  
Zhufeng Wang ◽  
Jiaxing Xie ◽  
Hanwen Liang ◽  
Jiamin Liang ◽  
...  
Keyword(s):  
International Organizations ◽  
Web Of Science ◽  
Thromboembolic Disease ◽  
Diagnosis And Treatment ◽  
Cochrane Library ◽  
High Quality ◽  
Agree Ii ◽  
Clinical Recommendations ◽  
Current Guidelines

Purpose. Severe COVID-19 patients were prone to develop venous thromboembolism. Unfortunately, to date, there is no evidence of any effective medications for thromboembolism in COVID-19. The management of the disease relies on symptomatic and supportive treatments, giving rise to a variety of guidelines. However, the quality of methodology and clinical recommendations remains unknown. Materials and Methods. We searched Medline, Cochrane Library, Web of Science, websites of international organizations and medical societies, and gray literature databases. Four well-trained appraisers independently evaluated the quality of eligible guidelines and extracted recommendations using well-recognized guideline appraisal tools. Furthermore, recommendations were extracted and reclassified according to a composite grading system. Results. The search identified 23 guidelines that offered 108 recommendations. Guidelines scored average on AGREE II criteria, with Scope and Purpose and Clarity of Presentation highest. Only five (22%) guidelines provided high-quality recommendations. The existed clinical recommendations were inconsistent in terms of prophylaxis, diagnosis, and treatment of thromboembolic disease to some extent. Conclusion. Current guidelines for COVID-19 thromboembolism are generally of low quality, and clinical recommendations on thromboembolism are principally supported by insufficient evidence. There is still an urgent need for more well-designed clinical trials as evidence to prevent adverse events and improve prognosis during COVID-19 treatment.

scholarly journals Appraisal of the Current Guidelines for Management of Malignant Left-Sided Colonic Obstruction Using the Appraisal of Guidelines Research and Evaluation II Instrument

2021 ◽  
pp. 1-9
Author(s):  
Paschalis Gavriilidis ◽  
Alan Askari ◽  
Nicola de’Angelis ◽  
Efstratios P. Gavriilidis ◽  
James Wheeler ◽  
...  
Keyword(s):  
Guideline Development ◽  
Colonic Obstruction ◽  
High Quality ◽  
Agree Ii ◽  
Guideline Quality ◽  
Domain V ◽  
Domain I ◽  
Current Guidelines ◽  
Agree Ii Instrument

Introduction: Colorectal cancer (CRC) is the fourth leading cause of death with 1.4 million new cases occurring annually worldwide. High-quality clinical practice guidelines are needed to tailor high-quality individualized treatment. The aim of the present study was to evaluate the methodological quality of the current guidelines for the management of acute malignant left-sided colonic bowel obstruction. Methods: A systematic search of the literature was carried out using electronic databases. The Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument was used to assess the quality of each guideline. Results: Search results returned a total of 14 guidelines appropriate for assessment. Both domain I (scope and purpose) and domain VI (editorial independence) were assessed with the same median score of 83%. The lowest scoring domain was domain V (applicability), scoring only 43%. The 2 guidelines that had the highest score were the National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN), each scoring 100%. However, there were significant variations in terms of quality. The NICE and New Zealand guidelines were voted unanimously for use unchanged, whilst 8 other guidelines were voted for use with modifications. Conclusion: Variation in guideline quality in CRC is a concern despite some clearly excellent published guidelines. All guidelines score poorly when it comes to describing how the guidelines could be applied. Lack of patient participation in guideline development is also a shortcoming that requires urgent redress.

scholarly journals Objective Measures to Assess Active Commuting Physical Activity to School in Young People: A Systematic Review Protocol and Practical Considerations

2020 ◽  
Vol 17 (16) ◽  
pp. 5936
Author(s):  
Pablo Campos-Garzón ◽  
Javier Sevil-Serrano ◽  
Yaira Barranco-Ruíz ◽  
Palma Chillón
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Young People ◽  
Web Of Science ◽  
Cochrane Library ◽  
Objective Measures ◽  
Active Commuting ◽  
School Based ◽  
Review Protocol

There are no systematic reviews that have identified the existing studies assessing active commuting physical activity (PA) to and from (to/from) school using objective measures, as well as the contribution of both walking and cycling to/from school to PA levels. To fill this gap in the literature, this systematic review will aim (a) to identify existing studies that assess active commuting PA to/from school with objective measures in young people and to examine the contribution of walking and cycling to/from school to PA levels, and (b) to propose an appropriate methodology and practical considerations to assess active commuting PA to/from school based on the studies identified. The review protocol was registered in PROSPERO (CRD42020162004). We will conduct a systematic search up to 2020 in five databases: PubMed, Web of Science, SPORTdiscuss, Cochrane Library, and National Transportation Library. Both the risk of bias and the quality of the identified studies will be evaluated through different instruments according to the design of each study. This systematic review will help to choose the most appropriate objective measures to assess active commuting PA to/from school and to promote walking and cycling to/from school to increase PA levels.

scholarly journals The quality of guidelines in non-pharmacological prevention and management of chemotherapy-induced neuropathy: A review

2018 ◽  
Author(s):  
Shahin Salarvand ◽  
Simin Hemati ◽  
Payman Adibi ◽  
Fariba Taleghani
Keyword(s):  
Methodological Quality ◽  
Stakeholder Involvement ◽  
Common Adverse Effect ◽  
Adaptation Process ◽  
Medical Sciences ◽  
High Quality ◽  
Agree Ii ◽  
Pharmacological Prevention ◽  
Agree Ii Instrument

Chemotherapy-induced peripheral neuropathy is a common adverse effect occurring in patients undergoing neurotoxic chemotherapy. However, there is no FDA-approved treatment option for it. Given the importance of clinical practice guidelines in this area, this study aimed to determine the methodological quality of extant CIPN guidelines. The study was done as part of the adaptation process of CIPN related CPGs at Isfahan University of Medical Sciences, Iran. A systematic search of published CPGs about chemotherapy-induced CIPN in which the AGREE II instrument was applied for appraising CPGs of CIPN was performed. In general, amongst all of the AGREE II Instrument’s domains in the evaluated CPGs, the clarity of presentation and stakeholder involvement domains took favorable scores; and other domains obtained unfavorable and relatively favorable scores. The quality of cancer therapy-induced neuropathy CPGs needs to be improved and designing high-quality CPGs must be considered.

scholarly journals Prevention, Diagnosis, and Treatment of COVID-19 in Infants and Children: A Systematic Review Study of Performed Protocols

2021 ◽  
Vol 15 (6) ◽  
Author(s):  
Mohammad Karimian ◽  
Feizollah Mansouri ◽  
Milad Borji ◽  
Asma Tarjoman ◽  
Somayeh Mahdikhani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Web Of Science ◽  
Library Science ◽  
Infants And Children ◽  
Diagnosis And Treatment ◽  
Cochrane Library ◽  
Viral Diseases ◽  
Age Group ◽  
Review Study ◽  
In Infants And Children

Context: Coronavirus disease 2019 (COVID-19) is one of the most dangerous viral diseases that started spreading in China in 2019 and has caused many deaths so far. Therefore, this study aimed to systematically review studies on the prevention, diagnosis, and treatment of coronavirus in infants and children. Evidence Acquisition: This is a systematic review study conducted in PubMed/Medline, Scopus, Embase, Cochrane Library, Science Direct, and Web of Science (ISI) databases on October 8 2020. Also, we searched Google Scholar to find all in-press articles. To extract data, a checklist was used, which included the author’s name, year of publication, purpose, age group of patients under study, and the protocol applied for coronavirus prevention, diagnosis, and treatment. The search was done with AND, OR, NOT strategies. The results of the study were reported in a descriptive manner using Endnote version 8 software. Results: According to the results of the basic search, 120 articles were extracted on the management of coronavirus. Of the articles extracted, 30 were articles related to children, of which only eight developed protocols for prevention, diagnosis, and treatment in infants and children. Of the studies extracted, six were from China, one from Iran, and one from Australia. It should be noted that the protocols for infants were extracted from two studies on infants and four studies on the pediatric group. Conclusions: It is proposed to consider and study this systematic review of coronavirus management in infants and children.

scholarly journals Management in the paediatric wards facing novel coronavirus infection: a rapid review of guidelines and consensuses

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e039897
Author(s):  
Wen-Yi Luo ◽  
Ji-Wen Sun ◽  
Wen-Lan Zhang ◽  
Qian Li ◽  
Ping Ni ◽  
...  
Keyword(s):  
Control Strategies ◽  
Stakeholder Involvement ◽  
Rapid Review ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Agree Ii ◽  
Relevant Evidence ◽  
And Control ◽  
Agree Ii Tool

ObjectivesRelevant guidelines and consensuses for COVID-19 contain recommendations aimed at optimising the management in paediatric wards. The goal of this study was to determine the quality of those recommendations and provide suggestions to hospital managers for the adjustment of existing hospital prevention and control strategies, and also to offer recommendations for further research.DesignA rapid review of the guidelines and consensuses for the management in paediatric wards facing COVID-19.MethodsPubMed, EMBASE, the Cochrane Library, UpToDate, China National Knowledge Infrastructure, the Wanfang database and relevant websites such as medlive.cn, dxy.cn, the National Health and Health Commission and the China Center for Disease Control and Prevention were systematically searched through late May 2020. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool was then used to assess the quality of the selected articles and summarise the relevant evidence concerning management in paediatric wards.ResultsA total of 35 articles were included, composed of 3 consensus guidelines, 25 expert consensuses and 7 expert opinions. Of the 35 papers, 24 were from China, 2 from the USA, 1 from Spain, 1 from Brazil, 1 from Saudi Arabia and 6 from multinational cooperative studies. Scores for the six domains of the AGREE II tool (scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, applicability and editorial independence) were 98.57%, 53.57%, 17.92%, 69.62%, 26.96% and 50.35%, respectively. Recommendations for nosocomial infection and control, human resource management as well as management of paediatric patients and their families were summarised.ConclusionsDue to the outbreak of COVID-19, the quality of rapid guidelines and consensuses for the management in paediatric wards affected by COVID-19 is unsatisfactory. In the future, it will be necessary to develop more high-quality guidelines or consensuses for the management in paediatric wards to deal with nosocomial outbreaks in order to fully prepare for emergency medical and health problems.

scholarly journals Critical appraisal and comparison of recommendations of clinical practice guidelines for treatment of schizophrenia in children and adolescents: a methodological survey protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e038646
Author(s):  
Maíra Ramos Alves ◽  
Cristiane de Cássia Bergamaschi ◽  
Flávia Blaseck Sorrilha ◽  
Izabela Fulone ◽  
Silvio Barberato-Filho ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Children And Adolescents ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Future Research ◽  
High Quality ◽  
Agree Ii ◽  
Ethical Approval ◽  
Over Time

IntroductionThe number of clinical practice guidelines (CPGs) have increased substantially mainly in the paediatric area of mental health. However, little is known about the quality or how recommendations for the treatment of disorders such as schizophrenia in children and adolescents have changed over time. The aim of this study will be to assess the quality of the development of CPGs for the treatment and management of schizophrenia in children and adolescents over time using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool and to compare the recommendations and interventions described in these documents.Methods and analysisCPGs will be identified using a prospective protocol through a systematic search of multiple databases (Medline, Embase, Health Systems Evidence, Epistemonikos, Lilacs, etc) and guideline websites from 2004 to December 2020. The quality of the guidelines will be assessed by three reviewers, independently using the AGREE II. CPGs will be considered of high-quality if they scored ≥60% in four or more domains of the AGREE II instrument. Non-parametric tests will be used to test for the change of quality over time. We will summarise the different evidence grading systems and compare the recommendations.Ethics and disseminationEthical approval is not required since it is a literature-based study. Future results of the research can be submitted for publication in scientific journals of high impact, peer reviewed and also published in national and international conferences. The results derived from this study will contribute to the improvement of health institutions and policies, informing about existing recommendation guidelines and about deficiencies and qualities found in those. This study may also identify key areas for future research. This study may guide the search and choice for high quality CPGs by health policy makers and health professionals and subsidise future adaptations.Protocol registration numberCRD42020164899.

scholarly journals Overview of evidence-based clinical practice guidelines for preoperative care: a systematic review.

2020 ◽  
Author(s):  
Agustín Ciapponi ◽  
Tapia-López Elena ◽  
Virgilio Sacha ◽  
Ariel Bardach
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Cochrane Library ◽  
Evidence Based ◽  
Agree Ii ◽  
Quality Of Evidence ◽  
Moderate Quality

Abstract Background Our aim was to summarize and compare relevant recommendations from evidence-based CPGs (EB-CPGs). Methods Systematic review of clinical practice guidelines. Data sources: PubMed, EMBase, Cochrane Library, LILACS, Tripdatabase and additional sources. In July 2017, we searched CPGs that were published in the last 10 years, without language restrictions, in electronic databases, and also searched specific CPG sources, reference lists and consulted experts. Pairs of independent reviewers selected EB-CPGs and rated their methodological quality using the AGREE-II instrument. We summarized recommendations, its supporting evidence and strength of recommendations according to the GRADE methodology. Results We included 16 EB-CPGs out of 2262 references identified. Only nine of them had searches within the last five years and seven used GRADE. The median (percentile 25-75) AGREE-II scores for rigor of development was 49% (35-76%) and the domain ‘applicability’ obtained the worst score: 16% (9-31%). We summarized 31 risk stratification recommendations, 21.6% of which were supported by high/moderate quality of evidence (41% of them were strong recommendations), and 16 therapeutic/preventive recommendations, 59% of which were supported by high/moderate quality of evidence (75.7% strong). We found inconsistency in ratings of evidence level. ‘Guidelines’ applicability’ and ‘monitoring’ were the most deficient domains. Only half of the EB-CPGs were updated in the past five years. Conclusions We present many strong recommendations that are ready to be considered for implementation as well as others to be interrupted, and we reveal opportunities to improve guidelines’ quality.

scholarly journals MODERN LASER TECHNOLOGIES IN ENDODONTICS

2021 ◽  
Vol 16 (4) ◽  
pp. 20-24
Author(s):  
Aleksandra Polevaya ◽  
Eleonora Borisova ◽  
Larisa Polevaya
Keyword(s):  
Laser Radiation ◽  
Dental Treatment ◽  
Endodontic Treatment ◽  
Long Term Results ◽  
Cochrane Library ◽  
Pulp Tissue ◽  
High Quality ◽  
Laser Technologies

Subject. Pulp tissue diseases are characterized by a wide prevalence, which makes it possible to consider the quality of endodontic dental treatment one of the most urgent problems of modern dentistry. High-quality treatment of complicated forms of caries is the prevention of odontogenic inflammatory processes, which include periodontitis, periostitis, osteomyelitis, abscess and phlegmon. Therefore, new tools and methods of treatment of complicated forms of caries are proposed, aimed at long-term preservation of teeth as a functional unit of the dental system. Objective: to analyze modern laser technologies in the treatment of complicated forms of caries. Materials and methods. The study was based on the search and study of original articles on the endodontic treatment of complicated forms of caries using laser radiation in the databases: Russian state library, eLibrary, PubMed, the Cochrane Library, Google Scholar. The main selection of materials was carried out by keywords. Results. The literature review describes the positive properties of laser radiation, its mechanism of action, the basics of its use in endodontic treatment, and its application in various branches of dentistry. Conclusions. Analyzing the literature data, we can conclude that the use of laser technologies in the treatment of complicated forms of caries is promising. It is possible to achieve high-quality cleaning of the root canal system and the best long-term results. However, the literature does not sufficiently cover the use of Er, Cr:YSGG laser with a wavelength of 2780 nm in the treatment of purulent pulpitis and pulp necrosis. In addition, taking into account the possibility of using lasers at a therapeutic appointment, it is possible to significantly improve the professional level of a dentist, improving the quality of dental care, reducing the number of complications and preventing various dental diseases.

scholarly journals Evaluación de la calidad de vida según el estado nutricional del paciente paliativo adulto: revisión sistemática

2017 ◽  
Vol 1 (4) ◽  
pp. 199 ◽  
Author(s):  
Ester Aracil-Lavado ◽  
Carmina Wanden-Berghe ◽  
Javier Sanz-Valero
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Palliative Care ◽  
Web Of Science ◽  
Cochrane Library ◽  
Calidad De Vida ◽  
Revisión Sistemática ◽  
Literatura Latinoamericana ◽  
The Cochrane Library

Objetivo: Revisar la literatura científica relacionada con la calidad de vida según el estado nutricional del paciente paliativo adulto.Método: Análisis crítico de los trabajos recuperados mediante revisión sistemática. Los datos se obtuvieron de la consulta directa y acceso, vía Internet, a las siguientes bases de datos bibliográficas del ámbito de las ciencias de la salud: MEDLINE (vía PubMed), The Cochrane Library, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINHAL), Web of Science y la Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS). Se consideró adecuado el uso de los Descriptores “Quality of life”, “Nutritional Status” y “Palliative care”, utilizando los filtros: «Humans», «Adult» y «Comparative Study» o «Clinical Trial». Fecha de la búsqueda: noviembre de 2016.Resultados: Tras aplicar los criterios de inclusión y exclusión se aceptaron 4 estudios para su revisión y análisis crítico. Al evaluar la calidad de los artículos seleccionados para la revisión mediante el cuestionario CONSORT, las puntuaciones oscilaron entre 11 y 20 sobre una puntuación máxima de 25.Conclusiones: El seguimiento nutricional de los enfermos estaba relacionado directamente con la mejora del estado nutricional, y se correspondía con el incremento de la calidad de vida. Sería deseable utilizar cuestionarios específicos y validados para evaluar la calidad de vida según el estado nutricional que permitirán minimizar cualquier tipo de subjetividad del paciente. Serían necesarios futuros estudios, con una adecuada población, que aclaren la relación directa entre el estado nutricional y la calidad de vida en los enfermos paliativos.

scholarly journals A Critical Review of the Scientific Evidence and Recommendations in COVID-19 Management Guidelines

2021 ◽  
Author(s):  
Jiaxing Xie ◽  
Zhufeng Wang ◽  
Jingyi Liang ◽  
Huimin Lin ◽  
Zhaowei Yang ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Web Sites ◽  
Critical Review ◽  
Web Of Science ◽  
Scientific Evidence ◽  
Cochrane Library ◽  
Level Of Evidence ◽  
Management Guidelines ◽  
Specialty Society

Abstract Background Little is known about the quality and potential impacts of the guidelines for COVID-19 management. Methods We systematically searched PubMed, Web of Science, Cochrane Library, guideline databases and specialty society Web sites to evaluate the quality of the retrieved guidelines using the Appraisal of Guidelines for Research and Evaluation II. Results A total of 66 guidelines were identified. Only 24% were categorized as “recommended” for clinical practice. The 211 identified recommendations for COVID-19 management were classified into four topics: respiratory support(27), ARDS management(31), anti-viral or immunomodulatory therapy(95), or other medicines(58). Only 63% and 56% recommendations were supported by, respectively, assessment of the strength of recommendation or level of evidence. There were notable discrepancies between the different guidelines regarding the recommendations on COVID-19 management. Conclusions The quality of the guidelines for COVID-19 management is heterogeneous, and the recommendations are rarely supported by evidence.

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