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Journal articles on the topic 'Medical guideline'

Author: Grafiati

Published: 9 March 2023

Last updated: 10 March 2023

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1

Serban, R., and A. ten Teije. "Exploiting Thesauri Knowledge in Medical Guideline Formalization." Methods of Information in Medicine 48, no. 05 (2009): 468–74. http://dx.doi.org/10.3414/me0629.

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Summary Objectives: As in software product lifecycle, the effort spent in maintaining medical knowl edge in guidelines can be reduced, if modularization, formalization and tracking of domain knowledge are employed across the guideline development phases. Methods: We propose to exploit and combine knowledge templates with medical background knowledge from existing thesauri in order to produce reusable building blocks used in guideline development. These templates enable easier guideline formalization, by describing how chunks of medical knowledge can be combined into more complex ones and how they are linked to a textual representation. Results: By linking our ontology used in guideline formalization with existing thesauri, we can use compilations of thesauri knowledge as building blocks for modeling and maintaining the content of a medical guideline. Conclusions: Our paper investigates whether medical knowledge acquired from several medical thesauri can be molded on a guideline pattern, such that it supports building of executable models of guidelines.

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Walsh, Mary Norine. "Guideline-Directed Medical Therapy." Journal of the American College of Cardiology 80, no. 16 (October 2022): 1542–44. http://dx.doi.org/10.1016/j.jacc.2022.08.739.

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Platz, Thomas. "Practice Guidelines in Neurorehabilitation." Neurology International Open 01, no. 03 (June 2017): E148—E152. http://dx.doi.org/10.1055/s-0043-103057.

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AbstractPractice guidelines are scientifically based practice recommendations. They can be consensus-based and provided by a single medical society (S1 guideline) or developed by a group of national medical societies with a structured consensus process (S2k guideline). S2k guidelines are a good opportunity to develop valid practice guidelines with a broad supporting base when health topics are either complex or when clinical evidence is limited. Evidence-based guidelines rest on a systematic search and critical appraisal of the available evidence and represent the highest quality level for guidelines; they can be developed by single medical societies (S2e guideline) or jointly by several national medical societies (S3 guideline). They reflect the state of the art and generate a high degree of confidence that their recommendations support optimal treatment. The German neurorehabilitation society (DGNR) provides evidence-based guidelines for motor rehabilitation after stroke (arm, mobility, spasticity).

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Rafi, Aisha, Muhammad Idrees Anwar, Ayesha Younas, and Shamaila Manzoor. "Paradigm shift in medical education due to the COVID-19 pandemic: guidelines for developing a blended learning curriculum in medical education." F1000Research 11 (October 7, 2022): 37. http://dx.doi.org/10.12688/f1000research.74779.2.

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Background: The coronavirus disease 2019 (COVID-19) pandemic has transformed the world’s economy, health and education in a blink of an eye. Almost 1 billion learners have been affected across the globe. This has resulted in a paradigm shift to blended learning. Therefore, it was felt necessary to provide practical guidelines for the development of blended curriculum in medical education. It would help to overcome the challenges faced due to unprecedented transformation of medical education on account of pandemic. Methods: Guidelines based on personal experience of the authors and literature search were developed using the complex adapted blended learning system (CALBS) framework. Seven experts developed these guidelines using the nominal group technique. The consent form and literature for CABLS framework was shared with experts. The experts developed the guidelines independently during phase one of the technique. After a given time, phase 2 started with moderator mediated discussion about the individual guidelines developed by the experts. After discussion and mutual consensus four types of guideline ideas were developed. During the third phase the experts ranked the guideline ideas on a scale of 1 to 5. The guideline idea that ranked highest was selected as a final guideline for developing a blended learning curriculum. Results: The group consensus resulted in developing seven guidelines for a blended course or curriculum in medical education. These guidelines are based on a conceptual framework supplemented by expert’s own personal experience and current evidence from literature. Conclusions: These guidelines would provide a comprehensive and systematic approach to develop a blended learning curriculum in medical education.

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Rafi, Aisha, Muhammad Idrees Anwar, Ayesha Younas, and Shamaila Manzoor. "Paradigm shift in medical education due to the COVID-19 pandemic: guidelines for developing a blended learning curriculum in medical education." F1000Research 11 (January 12, 2022): 37. http://dx.doi.org/10.12688/f1000research.74779.1.

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Background: The coronavirus disease 2019 (COVID-19) pandemic has transformed the world’s economy, health and education in a blink of an eye. Almost 1 billion learners have been affected across the globe. This has resulted in a paradigm shift to blended learning. Therefore, it was felt necessary to provide practical guidelines for the development of blended curriculum in medical education. It would help to overcome the challenges faced due to unprecedented transformation of medical education on account of pandemic. Methods: Guidelines based on personal experience of the authors and literature search were developed using the complex adapted blended learning system (CALBS) framework. Seven experts developed these guidelines using the nominal group technique. The consent form and literature for CABLS framework was shared with experts. The experts developed the guidelines independently during phase one of the technique. After a given time, phase 2 started with moderator mediated discussion about the individual guidelines developed by the experts. After discussion and mutual consensus four types of guideline ideas were developed. During the third phase the experts ranked the guideline ideas on a scale of 1 to 5. The guideline idea that ranked highest was selected as a final guideline for developing a blended learning curriculum. Results: The group consensus resulted in developing seven guidelines for a blended course or curriculum in medical education. These guidelines are based on a conceptual framework supplemented by expert’s own personal experience and current evidence from literature. Conclusions: These guidelines would provide a comprehensive and systematic approach to develop a blended learning curriculum in medical education.

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&NA;. "Guideline 9A: Guidelines on Evoked Potentials." Journal of Clinical Neurophysiology 23, no. 2 (April 2006): 125–37. http://dx.doi.org/10.1097/00004691-200604000-00010.

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Gerberich, Amanda, Samantha Spencer, and Heather Ipema. "National Guideline Clearinghouse Is No More: Keep Calm and Search On." Annals of Pharmacotherapy 53, no. 4 (November 18, 2018): 434–36. http://dx.doi.org/10.1177/1060028018815852.

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In July 2018, the National Guideline Clearinghouse lost funding, leaving fewer freely available online guideline collections. Based on the authors’ experience of the 3 major guideline-focused databases that are currently available (Guidelines International Network, the Turning Research into Practice database, and Guideline Central) an easy to use resource with stringent inclusion criteria is currently lacking, though new resources are in development. These 3 resources vary in scope, and none stood out as an all-encompassing favorite. Regardless of the source used to find and access guidelines, clinicians must evaluate guideline quality and currency before using them in clinical practice.

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O’Connor, Christopher M. "Guideline-Directed Medical Therapy Clinics." JACC: Heart Failure 7, no. 5 (May 2019): 442–43. http://dx.doi.org/10.1016/j.jchf.2019.04.001.

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Jiang, Zhu-ming, Si-yan Zhan, Li Zuo, Xiao-wei Jia, Hai Fang, Xiao-xiao Li, Xin Ye, and Run-lin Gao. "Guideline for [Clinical Guidelines Constitution/Amendment] in China." International Journal for Quality in Health Care 31, no. 7 (November 2, 2018): 568–74. http://dx.doi.org/10.1093/intqhc/mzy214.

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Abstract Quality problem or issue Chinese medical institutions need clinical guidelines to improve healthcare quality. Unfamiliarity with clinical methodology and procedures leads to poor quality. Initial assessment This study examined 327 clinical guidelines made in China during the period of 2006–10 and found these clinical guidelines have many problems in terms of guideline making procedures-compliant process, conflicts of interest disclosure. Choice of solution Chinese Medical Association organized a working group in 2014 to make a national [Guideline for Clinical Guidelines Constitution/Amendment] and invited multidiscipline experts to prove its possibility. Implementation Experts investigated and reviewed numerous domestic and foreign published literature within the past 2 years, concluded that a clinical guideline should have following seven components: I. Objective; II. General Principle; III. Procedure and Methodology; IV. Confirmation, Publication and Dissemination; V. Update and Amendment; VI. Implementation and Outcome Validation; VII. Reference. Evaluation The [Guideline for Clinical Guidelines Constitution/Amendment] will improve the quality of Chinese clinical guidelines and regulate applications, as well as outcome evaluations of clinical guidelines in China. Lessons learned Standardized methodology and procedures are important for constituting high-quality clinical guidelines.

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&NA;. "Guideline 7: Guidelines for Writing EEG Reports." Journal of Clinical Neurophysiology 23, no. 2 (April 2006): 118–21. http://dx.doi.org/10.1097/00004691-200604000-00008.

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&NA;. "Guideline 9B: Guidelines on Visual Evoked Potentials." Journal of Clinical Neurophysiology 23, no. 2 (April 2006): 138–56. http://dx.doi.org/10.1097/00004691-200604000-00011.

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Pyon, Eunice Y. "Primer on Clinical Practice Guidelines." Journal of Pharmacy Practice 26, no. 2 (March 4, 2013): 103–11. http://dx.doi.org/10.1177/0897190012474233.

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Clinical practice guidelines (CPGs) are valuable tools for health care providers and support evidence-based medicine (EBM). Many organizations, including medical associations and government-affiliated agencies, develop and publish guidelines using varying methods. Unfortunately, many guidelines are not appropriately developed and certain recommendations are not based on the best available evidence. Recent efforts by EBM advocates are contributing to the improved quality of CPGs and more tools are becoming available to promote high-quality guideline development and use. This article describes the guideline development process and associated concerns and the advances in the field of CPGs. Tools to access and evaluate guidelines are also provided. Health care professionals equipped with an understanding of the process of guideline creation and tools for evaluation can appropriately utilize guidelines to improve patient care.

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Lee, Sung nack. "Guideline for Foundation of Medical School." Journal of the Korean Medical Association 40, no. 2 (1997): 156. http://dx.doi.org/10.5124/jkma.1997.40.2.156.

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KITAMURA, Kiyoshi. "JAMJE guideline for medical journal editors." Journal of Information Processing and Management 56, no. 6 (2013): 363–73. http://dx.doi.org/10.1241/johokanri.56.363.

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Choi, Youn Seon, and Hyun Sook Kim. "Hospice Medical Guideline, Non-Cancer Diseases." Korean Journal of Hospice and Palliative Care 13, no. 2 (June 1, 2010): 69–75. http://dx.doi.org/10.14475/kjhpc.2010.13.2.69.

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Choi, Youn Seon, and Hyun Sook Kim. "Hospice Medical Guideline, Non-Cancer Diseases." Korean Journal of Hospice and Palliative Care 13, no. 2 (June 1, 2010): 69–75. http://dx.doi.org/10.14475/kjhpc.2011.13.2.69.

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Hess, Connie N., and Marc P. Bonaca. "Guideline-Directed Medical Therapy in PAD." JACC: Cardiovascular Interventions 16, no. 3 (February 2023): 344–46. http://dx.doi.org/10.1016/j.jcin.2022.10.015.

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Hume, Stacey, Tanya N. Nelson, Marsha Speevak, Elizabeth McCready, Ron Agatep, Harriet Feilotter, Jillian Parboosingh, Dimitri J. Stavropoulos, Sherryl Taylor, and Tracy L. Stockley. "CCMG practice guideline: laboratory guidelines for next-generation sequencing." Journal of Medical Genetics 56, no. 12 (July 12, 2019): 792–800. http://dx.doi.org/10.1136/jmedgenet-2019-106152.

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PurposeThe purpose of this document is to provide guidance for the use of next-generation sequencing (NGS, also known as massively parallel sequencing or MPS) in Canadian clinical genetic laboratories for detection of genetic variants in genomic DNA and mitochondrial DNA for inherited disorders, as well as somatic variants in tumour DNA for acquired cancers. They are intended for Canadian clinical laboratories engaged in developing, validating and using NGS methods.Methods of statement developmentThe document was drafted by the Canadian College of Medical Geneticists (CCMG) Ad Hoc Working Group on NGS Guidelines to make recommendations relevant to NGS. The statement was circulated for comment to the CCMG Laboratory Practice and Clinical Practice committees, and to the CCMG membership. Following incorporation of feedback, the document was approved by the CCMG Board of Directors.DisclaimerThe CCMG is a Canadian organisation responsible for certifying medical geneticists and clinical laboratory geneticists, and for establishing professional and ethical standards for clinical genetics services in Canada. The current CCMG Practice Guidelines were developed as a resource for clinical laboratories in Canada and should not be considered to be inclusive of all information laboratories should consider in the validation and use of NGS for a clinical laboratory service.

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Biezen, Ruby, Cassandra Roberts, Kirsty Buising, Karin Thursky, Douglas Boyle, Phyllis Lau, Malcolm Clark, and Jo-Anne Manski-Nankervis. "How do general practitioners access guidelines and utilise electronic medical records to make clinical decisions on antibiotic use? Results from an Australian qualitative study." BMJ Open 9, no. 8 (August 2019): e028329. http://dx.doi.org/10.1136/bmjopen-2018-028329.

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ObjectiveThis study aimed to explore how general practitioners (GPs) access and use both guidelines and electronic medical records (EMRs) to assist in clinical decision-making when prescribing antibiotics in Australia.DesignThis is an exploratory qualitative study with thematic analysis interpreted using the Theory of Planned Behaviour (TPB) framework.SettingThis study was conducted in general practice in Victoria, Australia.ParticipantsTwenty-six GPs from five general practices were recruited to participate in five focus groups between February and April 2018.ResultsGPs expressed that current EMR systems do not provide clinical decision support to assist with antibiotic prescribing. Access and use of guidelines were variable. GPs who had more clinical experience were less likely to access guidelines than younger and less experienced GPs. Guideline use and guideline-concordant prescribing was facilitated if there was a practice culture encouraging evidence-based practice. However, a lack of access to guidelines and perceived patients’ expectation and demand for antibiotics were barriers to guideline-concordant prescribing. Furthermore, guidelines that were easy to access and navigate, free, embedded within EMRs and fit into the clinical workflow were seen as likely to enhance guideline use.ConclusionsCurrent barriers to the use of antibiotic guidelines include GPs’ experience, patient factors, practice culture, and ease of access and cost of guidelines. To reduce inappropriate antibiotic prescribing and to promote more rational use of antibiotic in the community, guidelines should be made available, accessible and easy to use, with minimal cost to practicing GPs. Integration of evidence-based antibiotic guidelines within the EMR in the form of a clinical decision support tool could optimise guideline use and increase guideline-concordant prescribing.

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Fonarow, Gregg C. "Get with The Guidelines and Guideline Directed Medical Therapy: Why it Matters." Journal of Cardiac Failure 28 (2022): 4. http://dx.doi.org/10.1016/j.cardfail.2022.07.007.

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Wolf, Terri P., and Dana Ann Little. "Compliance with National Comprehensive Cancer Network guidelines for antiemesis in cisplatin regimens." Journal of Clinical Oncology 34, no. 7_suppl (March 1, 2016): 280. http://dx.doi.org/10.1200/jco.2016.34.7_suppl.280.

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280 Background: The members of a network of community cancer centers affiliated with an academic medical center report following National Comprehensive Cancer Network (NCCN) guidelines. To determine guideline compliance, cisplatin regimens were audited. Cisplatin was selected because of its wide use, high emetic potential, and the impact on QOL for patients with unmanaged nausea and vomiting.The community cancer centers affiliated with an academic medical center report following National Comprehensive Cancer Network (NCCN) guidelines for treatment plans. To determine guideline compliance rates, cisplatin regimens were audited. Cisplatin was selected because of its wide use, high emetic potential, and the impact on QOL for patients with unmanaged nausea and vomiting. Methods: Prior to a chart audit, medical oncologists were surveyed on their knowledge of NCCN antiemesis guidelines, frequency of prescribing based on guidelines, and reasons for not using guidelines. Auditors identified patient charts through billing records and reviewed cycle 1 day 1 orders of cisplatin regimens. Secondary data was collected on hydration orders and home medications for antiemesis. Results: Guideline adherence varied from 0% to 76% with overall adherence at 28%. Dexamethasone doses ranged from 2-20 mg (guideline 12 mg) as did serotonin antagonists (5HT3) ordered at higher IV doses of 24-32 mg (guideline 8-16 mg). Conclusions: Although cancer centers report following the guidelines, this study did not find consistent adherence. The cancer center with the highest adherence rate works closely with a pharmacist and has built order sets with the guidelines. One cancer center had wide variances among practitioners. The variances increase the potential for error. The cancer center with lowest adherence rate used 10 mg doses of dexamethasone because the drug is delivered in 10 mg vials. This study identified multiple systems issues impacting guideline compliance. Managing nausea and vomiting is important for patient QOL and to manage costs by decreasing hospitalizations, treatment delays, and nutritional deficits. Understanding prescribing habits relative to guidelines provides an opportunity to change practice and reduce variability.

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&NA;. "Guideline 5: Guidelines for Standard Electrode Position Nomenclature." Journal of Clinical Neurophysiology 23, no. 2 (April 2006): 107–10. http://dx.doi.org/10.1097/00004691-200604000-00006.

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Sukkay, Sasicha, and Prapatpong Upala. "Development of Housing Standards and Spatial Design Guidelines for Mobility Handicaps in Thailand." Asian Social Science 13, no. 12 (November 28, 2017): 112. http://dx.doi.org/10.5539/ass.v13n12p112.

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The objectives of this research are 1) to compare the standards of housing design for mobility disabled at the domestic and universal levels, 2) to standardize the developing process of housing design guideline for mobility handicapped properly with the context of Thailand, and 3) to evaluate the proficiency of the guideline by employing both qualitative and quantitative research methods. Regarding the guidelines comparison, the results indicated that the available housing design guidelines in Thailand had excluded the spatial allocation standard for supporting the mobility dependency as well as some particular dwelling functions had been abandoned from these guidelines. Furthermore, it appeared that these design guidelines were not constituted based on the participatory of multidisciplinary experts, for instance, medical and architectural professionals. This research had initiated an evaluating process for the guideline’s competence by using four indicators,namely, 1) comprehension, 2) completeness, 3) convenience, and 4) composition of design. The rating scale questionnaires were distributed to the two sampling groups comprising the group of 30 experienced Government agencies and the group of 30 mobility handicapped. The data collection consisted of two main steps: 1) the assessment of the comparative study-based guideline and 2) the assessment of the participatory-based guideline. The data retrieved from these two phases were analyzed by the inferential statistics, Paired Sample t-test. The results revealed the differences between these two sampling groups in every design category at the significance level of 0.05. It was clear that the participatory-based guideline was more efficient than the comparative study-based guideline (p ≤ 0.005). Besides, the evaluating scores addressed by the group of experienced Government agencies and the group of mobility disabled representative were discovered significantly contrary.

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Choi, Hayun, Soyoung Youn, Yoo Hyun Um, Tae Won Kim, Gawon Ju, Hyuk Joo Lee, Chungsuk Lee, et al. "Korean Clinical Practice Guideline for the Diagnosis and Treatment of Insomnia in Adults." Psychiatry Investigation 17, no. 11 (November 25, 2020): 1048–59. http://dx.doi.org/10.30773/pi.2020.0146.

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Objective We aim to present a clinical guideline for the diagnosis and treatment of insomnia in adults by reviewing and integrating existing clinical guidelines. The purpose of this guideline is to assist clinicians who perform evidence-based insomnia treatment.Methods We selected literature that may be appropriate for use in guideline development from evidence-based practice guidelines that have been issued by an academic or governmental institution within the last five years. The core question of this guideline was made in sentence form including Patient/Problem, Intervention, Comparison, Outcome (PICO) elements. After searching PubMed, EMBASE, and medical guideline issuing agencies, three guidelines were judged to be the most appropriately reviewed, up-to-date, and from trusted sources.Results The Appraisal of Guidelines for Research and Evaluation (AGREE) II tool was used to evaluate the quality of the three clinical guidelines. The final outcome of the guideline development process is a total of 15 recommendations that report the strength of the recommendation, the quality of evidence, a summary of content, and considerations in applying the recommendation.Conclusion It is vital for clinical guidelines for insomnia to be developed and continually updated in order to provide more accurate evidence-based treatments to patients.

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Bukhari, M. "The National Osteoporosis Guideline Group's new guidelines: what is new?" Rheumatology 48, no. 4 (January 30, 2009): 327–29. http://dx.doi.org/10.1093/rheumatology/ken454.

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Moynihan, Ray, Alexandra Lai, Huw Jarvis, Geraint Duggan, Stephanie Goodrick, Elaine Beller, and Lisa Bero. "Undisclosed financial ties between guideline writers and pharmaceutical companies: a cross-sectional study across 10 disease categories." BMJ Open 9, no. 2 (February 2019): e025864. http://dx.doi.org/10.1136/bmjopen-2018-025864.

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ObjectivesTo investigate the proportion of potentially relevant undisclosed financial ties between clinical practice guideline writers and pharmaceutical companies.DesignCross-sectional study of a stratified random sample of Australian guidelines and writers.SettingGuidelines available from Australia’s National Health and Medical Research Council guideline database, 2012–2014, stratified across 10 health priority areas.Population402 authors of 33 guidelines, including up to four from each area, dependent on availability: arthritis/musculoskeletal (3); asthma (4); cancer (4); cardiovascular (4); diabetes (4); injury (3); kidney/urogenital (4); mental health (4); neurological (1); obesity (1). For guideline writers with no disclosures, or who disclosed no ties, a search of disclosures in the medical literature in the 5 years prior to guideline publication identified potentially relevant ties, undisclosed in guidelines. Guidelines were included if they contained recommendations of medicines, and writers included if developing or writing guidelines.Main outcome measuresProportions of guideline writers with potentially relevant undisclosed financial ties to pharmaceutical companies active in the therapeutic area; proportion of guidelines including at least one writer with a potentially relevant undisclosed tie.Results344 of 402 writers (86%; 95% CI 82% to 89%) either had no published disclosures (228) or disclosed they had no ties (116). Of the 344 with no disclosed ties, 83 (24%; 95% CI 20% to 29%) had potentially relevant undisclosed ties. Of 33 guidelines, 23 (70%; 95% CI 51% to 84%) included at least one writer with a potentially relevant undisclosed tie. Writers of guidelines developed and funded by governments were less likely to have undisclosed financial ties (8.1%vs30.6%; risk ratio 0.26; 95% CI 0.13 to 0.53; p<0.001).ConclusionsAlmost one in four guideline writers with no disclosed ties may have potentially relevant undisclosed ties to pharmaceutical companies. These data confirm the need for strategies to ensure greater transparency and more independence in relationships between guidelines and industry.

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Siehnel, Jeremy T., Jill E. Lavigne, Elizabeth A. Rightmier, Will T. Bossard, Na Li, and Judianne C. Slish. "A Retrospective Study of Patient Factors That Indicate Provider Nonadherence to an Institutional Clostridium difficile Treatment Guideline." Journal of Pharmacy Practice 31, no. 2 (June 1, 2017): 169–74. http://dx.doi.org/10.1177/0897190017710349.

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Background: Clostridium difficile infection (CDI) is treated most often with metronidazole or vancomycin. Both have been effective in treatment of mild to moderate infection. In more severe cases, vancomycin may be more effective. Objectives: The primary objectives were to quantify the severity of CDI and to describe overall adherence to the institutional CDI guideline. Secondary objectives were to assess factors associated with adherence to the guidelines. Methods: Retrospective analysis of the electronic medical record was used to evaluate adherence to institutional guidelines. Data collected included demographics and other factors potentially contributing to adherence: Charlson comorbidity index, severity of infection, recurrence, intensive care unit (ICU) admission, infectious diseases (ID) consult, total duration and number of antibiotics, alternative therapies, and acid suppression. Descriptive statistics and bivariate analyses were used to describe and compare factors associated with guideline adherence; multivariate logistic regression assessed independent predictors of adherence. Results: A total of 387 patients met the inclusion criteria. CDI severity was 55.8% mild/moderate cases, 42.4% severe, 0.5% fulminant, and 1.3% prophylaxis. Overall, institutional guideline adherence was 51.9%. In bivariate analyses, 5 factors were associated with nonadherence to guidelines: older age, ICU admission, duration of antibiotics, mild/moderate and severe infection (all P < .05). In the logistic regression model, severe infection ( P < .001) and longer duration of antibiotics ( P < .05) were independently associated with guideline nonadherence. Conclusion: In this study, 42.4% of the patients met criteria for severe infection. Providers for patients with severe infection and longer duration of antibiotic therapy were less likely to adhere to the institutional guideline.

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Link, Terri. "Guideline Implementation: Sterilization." AORN Journal 109, no. 6 (May 28, 2019): 772–82. http://dx.doi.org/10.1002/aorn.12668.

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Elit, L., L. Zitzelberger, M. Fung Kee Fung, M. Brouwers, I. D. Graham, and G. Browman. "Use of systemic therapy in women with recurrent ovarian cancer—Development of a national clinical practice guideline." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 16033. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.16033.

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16033 Background: To develop a national guideline on the use of systemic therapy for women with recurrent ovarian cancer. Methods: In March 2005, the Society of Gynecologic Oncologists of Canada (GOC) held a workshop with clinicians and methodologists to begin the process of defining specific recommendations for the management of recurrent ovarian cancer in the Canadian context. An adaptation process developed by the Canadian Strategy for Cancer Control (CSCC) Clinical practice Guidelines Action Group (CPG-AG) was used. Guideline adaptation modifies existing guidelines to fit a local organizational and cultural context. A draft guideline was developed and sent to practitioners from across Canada for feedback. Relevant comments were incorporated. Results: A literature review identified seven guidelines which were assessed for quality by six reviewers using the AGREE instrument. Data on guideline quality, currency and content (recommendations) was used by the pan-Canadian panel in an informal consensus process which resulted in the initial draft of a guideline. A sub-panel reviewed the draft and made further edits to ensure the guideline's appropriateness for a national context. Practitioner feedback was requested from 165 health care providers who treat ovarian cancer from across Canada. Overall response rate was 37%. Respondents included gynecologic oncologists (62.5%), medical oncologists (25%), radiation oncologists (3%), internal medicine (3%), gynecologists (1%) and psychosocial oncology (1%). Overall response to the guideline was positive. All comments were reviewed by the sub-panel and the guideline was edited appropriately. Conclusions: This was the first undertaking of the creation of an interdisciplinary guideline in gynecologic oncology with input from health care providers from across Canada. Feedback from the panel and external practitioners indicated that this was a worthwhile process. Our goal was to vet this work in the Canadian context so as to inform provincial decision-makers concerning access to expensive systemic therapy. The guideline has been endorsed by the national organization and will be available to practitioners and decision makers on the organization's website. No significant financial relationships to disclose.

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Inwald, Elisabeth C., Christian Albring, Erika Baum, Maria Beckermann, Kai J. Bühling, Günter Emons, Thomas Gudermann, et al. "Perimenopause and Postmenopause – Diagnosis and Interventions. Guideline of the DGGG and OEGGG (S3-Level, AWMF Registry Number 015-062, September 2020)." Geburtshilfe und Frauenheilkunde 81, no. 06 (June 2021): 612–36. http://dx.doi.org/10.1055/a-1361-1948.

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Abstract Aim The aim of the interdisciplinary S3-guideline Perimenopause and Postmenopause – Diagnosis and Interventions is to provide help to physicians as they inform women about the physiological changes which occur at this stage of life and the treatment options. The guideline should serve as a basis for decisions taken during routine medical care. This short version lists the statements and recommendations given in the long version of the guideline together with the evidence levels, the level of recommendation, and the strength of consensus. Methods The statements and recommendations are largely based on methodologically high-quality publications. The literature was evaluated by experts and mandate holders using evidence-based medicine (EbM) criteria. The search for evidence was carried out by the Essen Research Institute for Medical Management (EsFoMed). To some extent, this guideline also draws on an evaluation of the evidence used in the NICE guideline on Menopause and the S3-guidelines of the AWMF and has adapted parts of these guidelines. Recommendations Recommendations are given for the following subjects: diagnosis and therapeutic interventions for perimenopausal and postmenopausal women, urogynecology, cardiovascular disease, osteoporosis, dementia, depression, mood swings, hormone therapy and cancer risk, as well as primary ovarian insufficiency.

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Burgers, Jako S. "Guideline Quality and Guideline Content: Are They Related?" Clinical Chemistry 52, no. 1 (January 1, 2006): 3–4. http://dx.doi.org/10.1373/clinchem.2005.059345.

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Sandhu, Alexander T., and Paul A. Heidenreich. "The Affordability of Guideline-Directed Medical Therapy." Circulation 143, no. 11 (March 16, 2021): 1073–75. http://dx.doi.org/10.1161/circulationaha.120.053291.

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標準委員会. "Guideline for Steilization of Medical Device Validation." JAPANES JOURNAL OF MEDICAL INSTRUMENTATION 68, no. 9 (September 1, 1998): 399–406. http://dx.doi.org/10.4286/ikakikaigaku.68.9_399.

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標準委員会. "Guideline for Sterilization of Medical Device Validation." JAPANES JOURNAL OF MEDICAL INSTRUMENTATION 68, no. 7 (July 1, 1998): 295–311. http://dx.doi.org/10.4286/ikakikaigaku.68.7_295.

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Pearle, Margaret S., David S. Goldfarb, Dean G. Assimos, Gary Curhan, Cynthia J. Denu-Ciocca, Brian R. Matlaga, Manoj Monga, et al. "Medical Management of Kidney Stones: AUA Guideline." Journal of Urology 192, no. 2 (August 2014): 316–24. http://dx.doi.org/10.1016/j.juro.2014.05.006.

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Fonarow, Gregg C., Ann Marie Navar, and Clyde W. Yancy. "Impediments to Implementing Guideline-Directed Medical Therapies." JAMA Cardiology 4, no. 8 (August 1, 2019): 830. http://dx.doi.org/10.1001/jamacardio.2019.2276.

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Han, Mi Ah, Jae Hung Jung, and Eu Chang Hwang. "Presentation of benefits and harms in cancer screening guidelines for Koreans: a systematic review protocol." BMJ Open 12, no. 12 (December 2022): e065924. http://dx.doi.org/10.1136/bmjopen-2022-065924.

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IntroductionCancer screening guidelines should be based on the best available evidence, presenting both the benefits and harms of screening in a manner applicable to stakeholders. How the potential benefits and harms of screening are presented determine the intent of guideline developers and the delivery of recommendations. Therefore, we will systematically review the cancer screening guidelines for Koreans to evaluate the presentation and detailed ways of the benefits and harms of the recommended cancer screening practices.Methods and analysisTo identify cancer screening guidelines for Koreans, we will search international electronic databases, including MEDLINE, Embase and domestic literature databases (Korean Studies Information Service System, Research Information Sharing Service, KoreaMED, Korean Medical Database, National Assembly Library and Korea Institute of Science and Technology Information) as well as guideline databases (Guideline International Network, National Institute for Health and Care Excellence, Turning Research Into Practice medical database, WHO guidelines and Korean Medical Guideline Information Center), from inception to November 2022. We will include cancer screening guidelines for healthcare practitioners and patients. Furthermore, we will focus on the most updated guidelines when multiple versions of guidelines are available for a specific intervention and cancer pairs from the same development group. Two reviewers will independently and in duplicate conduct reference screening and data extraction. Data will be extracted based on recommendations from each guideline and how their benefits and harms are presented. The general characteristics of cancer screening guidelines, including cancer type, recommended screening methods, certainty of evidence, direction and strength of recommendation, will be collected. In addition, we will obtain key information on the presentation of the benefits and harms of screening interventions, including quantification of their relative and absolute effects of screening interventions. Finally, our findings will be presented descriptively, and a summary of the results will be provided.Ethics and disseminationEthics approval is not required as we will only use published materials. We will disseminate our findings through publication in peer-reviewed journals.

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Corb, G. J., Y. Liaw, C. A. Brandt, and R. N. Shiffman. "An Object-Oriented Framework for the Development of Computer-Based Guideline Implementations." Methods of Information in Medicine 38, no. 03 (1999): 148–53. http://dx.doi.org/10.1055/s-0038-1634190.

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AbstractClinical practice guidelines provide a means of directing medical care towards clinically appropriate and cost-effective interventions. A direct relationship exists between the integration of a guideline into clinical workflow and the effectiveness of the guideline in influencing clinicians’ behavior. Computer-based guideline implementations, used at the point-of-care, accomplish this integration. Employing object-oriented technologies, we propose a framework of reusable components for the development of guideline implementation systems. We have identified eight information management services that are common to such systems. Our framework integrates these services and their respective reusable components into clinical workflow to promote the development of comprehensive guideline implementation systems, which should ultimately enhance guideline compliance and the overall quality of care.

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Marino, Kaylee K., Kaitlin E. Crowley, Lena K. Tran, Daniel Sylvia, Heather Dell’Orfano, Jeremy R. DeGrado, and Paul M. Szumita. "Intravenous levothyroxine stewardship program at a tertiary academic medical center." American Journal of Health-System Pharmacy 78, no. 13 (April 4, 2021): 1200–1206. http://dx.doi.org/10.1093/ajhp/zxab155.

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Abstract Purpose Based on the pharmacokinetic profile of levothyroxine, a 3-day hold guideline for adult patients ordered for intravenous (IV) levothyroxine was implemented at a tertiary academic medical center. The purpose of this study was to evaluate the impact of the implementation of an IV levothyroxine hold guideline. Methods This single-center, retrospective analysis identified patients ordered for IV levothyroxine during a 13-week period before and after implementation of the guideline. The primary outcome was guideline adherence, defined as full implementation of the 3-day hold. Secondary outcomes included the number of IV levothyroxine administrations avoided in the post-guideline group, extrapolated yearly cost avoidance (EYCA) after guideline implementation, reasons for guideline non-adherence, and number of safety reports involving IV levothyroxine. Results A total of 166 and 134 patients met inclusion criteria for the pre- and post-guideline groups, respectively. Guideline adherence was observed in 94 (70.1%) patients, resulting in 276 vials saved in the 13-week post-guideline period, which translated to an EYCA of $139,877. Forty orders (29.9%) were non-adherent to the guideline, with the most common reason stated as nil per os (NPO). No difference in safety outcomes was seen between the pre- and post-guideline groups, as evidenced by 1 safety report in each group. Conclusion We observed a high rate of adherence to an IV levothyroxine hold guideline. This was associated with a substantial cost savings over the study period with no increase in reported safety events. To our knowledge, this is the first published report of an inpatient IV levothyroxine 3-day hold guideline.

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Kovačević, Tanja, Davorka Vrdoljak, Slavica Jurić Petričević, Ivan Buljan, Dario Sambunjak, Željko Krznarić, Ana Marušić, and Ana Jerončić. "Factors Associated with the Quality and Transparency of National Guidelines: A Mixed-Methods Study." International Journal of Environmental Research and Public Health 19, no. 15 (August 3, 2022): 9515. http://dx.doi.org/10.3390/ijerph19159515.

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We assessed the methodological quality and transparency of all the national clinical practice guidelines that were published in Croatia up until 2017 and explored the factors associated with their quality rating. An in-depth quantitative and qualitative analysis was performed using rigorous methodology. We evaluated the guidelines using a validated AGREE II instrument with four raters; we used multiple linear regressions to identify the predictors of quality; and two focus groups, including guideline developers, to further explore the guideline development process. The majority of the guidelines (N = 74) were developed by medical societies. The guidelines’ quality was rated low: the median standardized AGREE II score was low, 36% (IQR 28–42), and so were the overall-assessments. The aspects of the guidelines that were rated best were the “clarity of presentation” and the “scope and purpose” (median ≥ 59%); however, the other four domains received very low scores (15–33%). Overall, the guideline quality did not improve over time. The guidelines that were developed by medical societies scored significantly worse than those developed by governmental, or unofficial working groups (12–43% per domain). In focus group discussions, inadequate methodology, a lack of implementation systems in place, a lack of awareness about editorial independence, and broader expertise/perspectives in working groups were identified as factors behind the low scores. The factors identified as affecting the quality of the national guidelines may help stakeholders who are developing interventions and education programs aimed at improving guideline quality worldwide.

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Chua, Michael Erlano, Jonathan Mendoza, Manuel See IV, Ednalyn Esmena, Dean Aguila, Jan Michael Silangcruz, Buenaventura Jose Reyes, Saturnino Luna Jr, and Marcelino Morales Jr. "A critical review of recent clinical practice guidelines on the diagnosis and treatment of non-neurogenic male lower urinary tract symptoms." Canadian Urological Association Journal 9, no. 7-8 (July 17, 2015): 463. http://dx.doi.org/10.5489/cuaj.2424.

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Introduction: We provide an overview of the quality of recent clinical clinical practice guidelines (CPGs) for non-neurogenic male lower urinary tract symptoms (LUTS) and summarize the recommendations for their diagnosis, assessment, and treatment.Methods: We systematically searched recent (2008–2013) CPGs for non-neurogenic male LUTS. Eligible CPGs were assessed and appraised using Appraisal of Guidelines, Research and Evaluation II (AGREE II) tool by a CPG-appraisal group. The appraisal scores for each guideline were summarized according to each domain and in total. A recommendation summary was made across the guidelines for diagnostics, conservative management, medical, minimally invasive therapy, and surgical management.Results: A total of 8 guidelines were considered. According to AGREE II appraisal of guidelines, the National Institute for Health and Clinical Excellence (NICE), American Urological Association (AUA) and European Association of Urology (EAU) consistently scored high on the guideline domains assessed. Recommendations on diagnostics, conservative management, medical, and surgical management were consistent among the top 3 guidelines. However, we noted a discrepancy in recommending minimally invasive therapy as an alternative management of moderate to severe or bothersome non-neurogenic male LUTS secondary to benign prostatic enlargement (BPE); the NICE guideline, in particular, does not recommend using minimally invasive therapy.Conclusion: The quality of recent CPGs on non-neurogenic male LUTS was appraised and summarized. The guidelines from NICE, AUA and EAU were considered highly compliant to the AGREE II proposition for guideline formation and development.

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&NA;. "Guideline 9C: Guidelines on Short-Latency Auditory Evoked Potentials." Journal of Clinical Neurophysiology 23, no. 2 (April 2006): 157–67. http://dx.doi.org/10.1097/00004691-200604000-00012.

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&NA;. "Guideline 9D: Guidelines on Short-Latency Somatosensory Evoked Potentials." Journal of Clinical Neurophysiology 23, no. 2 (April 2006): 168–79. http://dx.doi.org/10.1097/00004691-200604000-00013.

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&NA;. "Guideline Twelve: Guidelines for Long-Term Monitoring for Epilepsy." Journal of Clinical Neurophysiology 25, no. 3 (June 2008): 170–80. http://dx.doi.org/10.1097/wnp.0b013e318175d472.

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He, Na, Shan Su, Zhikang Ye, Guanhua Du, Bei He, Dakui Li, Youning Liu, et al. "Evidence-based Guideline for Therapeutic Drug Monitoring of Vancomycin: 2020 Update by the Division of Therapeutic Drug Monitoring, Chinese Pharmacological Society." Clinical Infectious Diseases 71, Supplement_4 (November 15, 2020): S363—S371. http://dx.doi.org/10.1093/cid/ciaa1536.

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Abstract Background Clinical practice guidelines or recommendations often require timely and regular updating as new evidence emerges, because this can alter the risk-benefit trade-off. The scientific process of developing and updating guidelines accompanied by adequate implementation can improve outcomes. To promote better management of patients receiving vancomycin therapy, we updated the guideline for the therapeutic drug monitoring (TDM) of vancomycin published in 2015. Methods Our updated recommendations complied with standards for developing trustworthy guidelines, including timeliness and rigor of the updating process, as well as the use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. We also followed the methodology handbook published by the National Institute for Health and Clinical Excellence and the Spanish National Health System. Results We partially updated the 2015 guideline. Apart from adults, the updated guideline also focuses on pediatric patients and neonates requiring intravenous vancomycin therapy. The guideline recommendations involve a broadened range of patients requiring TDM, modified index of TDM (both 24-hour area under the curve and trough concentration), addition regarding the necessity and timing of repeated TDM, and initial dose for specific subpopulations. Overall, 1 recommendation was deleted and 3 recommendations were modified. Eleven new recommendations were added, and no recommendation was made for 2 clinical questions. Conclusions We updated an evidence-based guideline regarding the TDM of vancomycin using a rigorous and multidisciplinary approach. The updated guideline provides more comprehensive recommendations to inform rational and optimized vancomycin use and is thus of greater applicability.

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Steeb, Theresa, Markus Follmann, Ralf Matthias Hagen, Carola Berking, and Markus Vincent Heppt. "Implications of the COVID-19 Pandemic for the Development and Update of Clinical Practice Guidelines: Viewpoint." Journal of Medical Internet Research 22, no. 12 (December 29, 2020): e20064. http://dx.doi.org/10.2196/20064.

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Following the rapid spread of a new type of coronavirus (SARS-CoV-2), nearly all countries have introduced temporary restrictions affecting daily life, with “social distancing” as a key intervention for slowing the spread of the virus. Despite the pandemic, the development or actualization of medical guidelines, especially in the rapidly changing field of oncology, needs to be continued to provide up-to-date evidence- and consensus-based recommendations for shared decision making and maintaining the treatment quality for patients. In this viewpoint, we describe the potential strengths and limitations of online conferences for medical guideline development. This viewpoint will assist guideline developers in evaluating whether online conferences are an appropriate tool for their guideline conference and audience.

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Spreckelsen, C., C. Weßel, and L. Ißler. "Implementing Software Development Guidelines in a Medical Informatics Research Project." Methods of Information in Medicine 46, no. 06 (2007): 641–45. http://dx.doi.org/10.1055/s-0038-1625422.

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Summary Objectives : Due to the non-commercial, researchoriented context, software in medical informatics research projects is often developed by researchers as a proof-of-concept without applying structured software development process models. A guideline for software development can bring sufficient structure to the development process while avoiding the complexity of industry-standard methods. Methods : We adapted the common evidence-based guideline development process from medicine to build a guideline for software development in our medical informatics teaching and research project. Results : Our guideline development used the six steps of problem identification, first proposal, review, revision, gaining consensus and periodic guideline review. Since the developers had taken part in guideline development, our guideline clearly states the consensus of the development team over critical topics. The guideline improved the quality of our source code in structure and understandability. Conclusions : A software development guideline that is developed following a consensus panel approach is a good instrument for basic software quality assurance in domains where complex, industry-standard software development methods cannot be applied. This is especially the case in non-commercial, research- oriented medical informatics projectswhere mainly non-software engineers like students do the development work.

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Blume, Louise H. K., Nico J. H. W. Van Weert, Jamiu O. Busari, and Diana Delnoij. "Guideline adherence: How do boards of directors deal with it? A survey in Dutch hospitals." Journal of Hospital Administration 5, no. 5 (July 5, 2016): 21. http://dx.doi.org/10.5430/jha.v5n5p21.

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Objective: Adherence to guidelines is often low, as multiple barriers exist for guideline implementation. To tackle the implementation problem, awareness of the existence of guidelines is necessary for the health care process and setting as a whole.Purpose: Despite the importance of guidelines adherence, problems have been reported from hospitals in achieving this. This study gives insight into how boards of directors of general and specialist hospitals arrange the responsibilities for guideline adherence within their organisation, how they deal with guidelines for medical specialists and what opportunities exist for improvement.Methods: A survey was sent to 116 Dutch hospitals in 2015. Thirty-nine responses were included in the study for further analysis (net response rate of 36%). All data other than the open questions were analysed in SPSS using descriptives to answer the research question.Results: The findings demonstrated that the distribution of responsibility concerning guideline implementation is problematic. The boards of directors used a variety of information sources to keep informed about the status of implementation of the guidelines for medical specialists, mostly through medical specialists’ peer reviews (visits) and internal audits. The study revealed several opportunities for improvements, for example, that a national database is necessary with all up-to-date guidelines, whereby changes and news are distributed directly to hospitals and other stakeholders.Conclusions: This paper offers recommendations for a thoughtful shift in distribution of responsibility, as in a more desired situation the ultimate responsibility of the board of directors would decrease and the responsibility of the medical specialists would increase.

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DRY, LAURENCE R. "Expert Testimony." Pediatrics 84, no. 3 (September 1, 1989): 590. http://dx.doi.org/10.1542/peds.84.3.590.

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I wish to comment on the American Academy of Pediatrics' guidelines for expert testimony (Pediatrics. 1989; 83:312-313). Although I applaud the efforts of the Committee on Medical Liability and believe that there should be a tightening of the definition of what constitutes an expert medical witness, guideline 6 goes too far: "The physician should be willing to submit transcripts of depositions and/or courtroom testimony for peer review." This guideline attempts to place sanctions on opinion testimony and thus limits free speech.

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Resmark, Gaby, Stephan Herpertz, Beate Herpertz-Dahlmann, and Almut Zeeck. "Treatment of Anorexia Nervosa—New Evidence-Based Guidelines." Journal of Clinical Medicine 8, no. 2 (January 29, 2019): 153. http://dx.doi.org/10.3390/jcm8020153.

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Anorexia nervosa is the most severe eating disorder; it has a protracted course of illness and the highest mortality rate among all psychiatric illnesses. It is characterised by a restriction of energy intake followed by substantial weight loss, which can culminate in cachexia and related medical consequences. Anorexia nervosa is associated with high personal and economic costs for sufferers, their relatives and society. Evidence-based practice guidelines aim to support all groups involved in the care of patients with anorexia nervosa by providing them with scientifically sound recommendations regarding diagnosis and treatment. The German S3-guideline for eating disorders has been recently revised. In this paper, the new guideline is presented and changes, in comparison with the original guideline published in 2011, are discussed. Further, the German guideline is compared to current international evidence-based guidelines for eating disorders. Many of the treatment recommendations made in the revised German guideline are consistent with existing international treatment guidelines. Although the available evidence has significantly improved in quality and amount since the original German guideline publication in 2011, further research investigating eating disorders in general, and specifically anorexia nervosa, is still needed.

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