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PubMed1995

[Consensus as the basis of interdisciplinary graduate education curriculum].

Especially in the field of emergency medicine, it is necessary that medical standards are developed in general agreement with all faculty members. Standards should not only be understood as a basis for quality control but also as a helpful guide for the daily routine. The necessary agreement based on scientific discoveries and practical experiences, which find their expression in the general accepted knowledge of the specialty, has to be adapted to the special situation of emergency. Taking the head injury as an example, a special treatment schedule will be developed based on an interdisciplinary consent. The resulting training documents can than be offered to groups at different levels, since the content can be handled in a modular manner. The continuing education course will be available in a set of slides and provides an extensive overview of the topic "head injury" and supports the practical application with an algorithm.

Audiovisual Aids↗
PubMed1997

[Prophylactic antibiotics in acute pancreatitis. Results from a consensus conference].

Pancreatic infection is the leading cause of death from acute pancreatitis. Patients with severe necrotizing pancreatitis are most at risk. Early dynamic computed tomography and percutaneous fine-needle aspiration microbiology of areas of necrosis enable early diagnosis. Several studies has been undertaken in order to investigate the type of bacteria and the concentration reached in pancreatic tissue by different antibiotics. Nevertheless, up to now only three clinical trials of prophylactic antibiotics in acute pancreatitis has been reported. In the IV meeting of the Spanish Association for the Study of the Pancreas, a consensus conference took place with this topic.

Acute Disease↗
PubMed2003

Future directions for the integrated CSFII-NHANES: What We Eat in America-NHANES.

The history of the integration of the dietary data collection from the National Health and Nutrition Examination Survey (NHANES) and the Continuing Survey of Food Intakes by Individuals (CSFII) is reviewed. The purposes and process of the workshop are presented. The three key topics of the workshop are summarized. The key roles of cosponsors and participants are acknowledged.

Consensus Statements as Topic↗
PubMed1995

The American Heart Association Consensus Statement on guidelines for carotid endarterectomy.

The process by which a multidisciplinary, expert panel arrived at a Consensus Statement concerning indications for carotid endarterectomy was reviewed. It is important to point out that this represents an interpretation of currently available data by the individual members of the Committee as it pertains to 96 specific potential indications for carotid endarterectomy. Clearly, as more data become available, it is likely that there will be changes in the opinion of the Committee members. Therefore, this represents a current status that will require a periodic update.

American Heart Association↗
PubMed1996

Duration of antibiotic treatment in surgical infections of the abdomen. Introduction--the different ways to reach consensus.

The many interrelated issues concerning administration of antibiotics following operations for abdominal contamination and infection were a powerful impetus to create this Discussion Forum in The European Journal of Surgery, which focuses on the duration of administration-a previously neglected topic. The guidelines presented herein are not based on previous randomised trials alone, nor are they prescribed by dictatorship of one person. Instead, they are proposed by a steering committee in the form of a table and are confirmed by consensus of many experts. The science of consensus has to be recognized in surgery. The Discussion Forum offers written judgements that provide more details than the usual Consensus Development Conference statements. It can be used for a nominal group process organized by sepsis trial groups and may be of value for a consensus-based treatment of individual patients.

Abdomen↗
PubMed1997

Report of the Northern California Conference for Guidelines on Aid-in-Dying: definitions, differences, convergences, conclusions.

In September 1996, the Stanford University Center for Biomedical Ethics convened a conference entitled "Comprehensive Care of the Terminally Ill: The Northern California Consensus Development Conference for Guidelines on Aid-in-Dying." The regionally based, multidisciplinary conference gathered people from a variety of disciplines and diverse perspectives on physician aid-in-dying. This report documents important points of convergence, disagreement, and uncertainty that emerged from the conference and provides commentary on crucial issues: the definition of terminal illness, ensuring adequate palliative care, psychiatric challenges, coping with family pressures, the doctor-patient relationship, the managed care context, the role of ethics committees, and institutional challenges. Should physician aid-in-dying become a legal practice in California, the report will provide guidance to health care organizations, health professionals, and public policy officials engaged in local or state guideline or policy development.

California↗
PubMed1992

Practice guidelines, a new reality in medicine. II. Methods of developing guidelines.

Current methods for developing practice guidelines include informal consensus development, formal consensus development, evidence-based guideline development, and explicit guideline development. Informal consensus development is the oldest and most common approach, but guidelines produced in this manner are often of poor quality and lack adequate documentation of methods. Formal consensus development uses a systematic approach to assess expert opinion and to reach agreement on recommendations. Evidence-based guideline development links recommendations directly to scientific evidence of effectiveness; rules of evidence are emphasized over expert opinion in making recommendations. Explicit guideline development clarifies the rationale by specifying the potential benefits, harms, and costs of available interventions; estimating the possibility of the outcomes; and comparing the desirability of the outcomes based on patient preferences. Steps in the development of practice guidelines include introductory decisions (selection of topic and panel members, clarification of purpose); assessments of clinical appropriateness (review of scientific evidence and expert opinion); assessment of public policy issues (resource limitations, feasibility issues); and guideline document development and evaluation (drafting of document, peer review, and pretesting).

Clinical Protocols↗
PubMed1993

Advanced epithelial ovarian cancer: 1993 consensus statements.

BACKGROUND: Over the last few days of a 5-day international workshop held in June 1993, a group of specialists in the field of advanced epithelial ovarian cancer tried to reach consensus on a number of issues with implications for standard practice and for research. METHODS: Five groups of experts considered several issues which included: biologic factors, prognostic factors, surgery, management recommendations, dose intensity, supportive care, drug resistance, second-line treatment, investigational drugs, and tumour markers. Discussing the management recommendations, the group attempted to arrive at answers to four questions: Is there in fact a cure rate for advanced ovarian carcinoma? Are there prognostic factors which help to identify patients who will not do well with current therapy? What is the current best therapy for advanced ovarian carcinoma? What directions should research take in advanced ovarian cancer? In a plenary meeting these issues were discussed. RESULTS: Consensus statements were achieved on all topics mentioned above. This article reports on the statements written by the chairmen and approved by the consensus group.

Antineoplastic Agents↗
PubMed2004

The Consensus Conference and Combined-Integrated model of doctoral training in professional psychology--overview of part 1: nature and scope of the Combined-Integrated model.

This special series of articles on the Consensus Conference and Combined-Integrated (C-I) model of doctoral training in professional psychology consists of 13 articles in two successive volumes of the Journal of Clinical Psychology. Six articles are presented in Part 1 (Vol. 60, Issue 9), which collectively describe the "nature and scope" of the C-I model (e.g., historic and definitional issues; the potential advantages of this model; implications for the profession). In Part 2 of this special series (Vol. 60, Issue 10), articles 7 through 12 address the broader implications and potential applications of the C-I model within a range of professional and societal contexts (e.g., for interprofessional collaboration; the health care field; development of a global curriculum; the unified psychology movement; issues of assessment and professional identity; and higher education); article 13 provides a summary of the series as well as a discussion of future directions. As an overview, this paper provides the abstract for each of the articles in Part 1, and describes the various topics of the articles in Part 2. Taken together, the articles in this special series are designed to provide a coherent account of how and why the C-I model is timely and relevant, and therefore warrants serious consideration by the larger education and training community in professional psychology.

Consensus Statements as Topic↗
PubMed1999

Orbital vascular malformations: a consensus statement on terminology and its clinical implications. Orbital Society.

PURPOSE: Orbital venous anomalies and lymphangiomas have been generally classified on morphologic grounds. However, conflicting concepts of these lesions have hampered scientific dialogue and confused clinicians, with occasionally serious consequences for patients. As a step toward uniform nomenclature and better communication, a consensus on the terminology of orbital vascular malformations was sought among the members of the Orbital Society. METHODS: A classification of orbital vascular malformations based on their hemodynamic relationships, as revealed by clinical and imaging features, was presented, discussed, and adopted at the 1998 Annual Meeting of the Orbital Society. A consensus statement was drafted and distributed to all members. The statement was then modified in accordance with members' responses, which included minor stylistic recommendations but no substantive dissent. RESULTS: Orbital vascular malformations may be classified according to their hemodynamic relationships as no flow, venous flow, and arterial flow lesions. Assignment to each group is based on pertinent clinical and imaging criteria. Mixed forms with both venous and no flow components are grouped within the venous flow category to emphasize the clinical importance of that relationship. CONCLUSIONS: A hemodynamic classification of orbital vascular malformations emphasizes features most germane to their management. It should reduce the clinical confusion resulting from purely morphologic differentiation. Widely accepted definitions may allow a better comparison of therapeutic protocols for these troublesome lesions.

Arteries↗