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PubMed2001

The Mutant Mouse Behaviour network, a medium to present and discuss methods for the behavioural phenotyping.

The nonprofit international Mutant Mouse Behaviour network "MMB" was founded within the framework of the conference "Behavioural Phenotyping of Mouse Mutants", February 2000, held in Cologne, Germany. It intends to be a forum for presenting and discussing all topics dealing with the behavioural phenotyping of mice. The major aim of the MMB is to support the interdisciplinary finding of a consensus on the methods and techniques used for behavioural phenotyping of mouse mutants. That means that scientist involved in the development of mouse models have to consent to the fact that a consideration of all the parameters that might affect the behaviour is necessary. Finding and establishing a consensus is a fluent process based on a continuous exchange of information. The network will provide a standardised database that includes detailed descriptions of test methods and of the relevant background parameters that might influence the behaviour of mice. Information will range from detailed descriptions of test methods, specifications of the equipment used, housing conditions, and specifications of the animals used according to the international nomenclature. The detailed descriptions will help in making behavioural tests and their results comprehensible and reproducible. A mailing list has been established to provide a platform for the continuous exchange of information between the network members. It will be a forum for discussing all topics related to behavioural phenotyping (see above). Scientists from all research areas involved are free to provide detailed information about their experimental work, and will, in return, get a quick response to their questions. Furthermore, the mailing list will be a useful medium to determine which information should be incorporated.

Animals↗
PubMed2005

Recruitment and communication process for participation in the 2005 AEM Consensus Conference on the Ethical Conduct of Resuscitation Research: methodology, challenges, lessons learned.

The 2005 Academic Emergency Medicine Consensus Conference, "Ethical Conduct of Resuscitation Research," was designed with the goal of developing consensus on important issues for human subjects and researchers surrounding the 1996 federal regulations jointly published by the Department of Health and Human Services and the Food and Drug Administration and known as the Final Rule. These regulations, which guide the conduct of research using the emergency exception from informed consent or waiver of informed consent, have been the subject of much debate in the resuscitation research community. Therefore, the editorial board of Academic Emergency Medicine chose this topic as the subject of their annual consensus conference. This report outlines the methods by which individuals and organizations were recruited to participate, how the conference was advertised, and the way in which participants and nonparticipants were encouraged to communicate before and after the conference. The limitations and potential biases of these methods and activities are also presented.

Committee Membership↗
PubMed2003

The use of the evidence-based approach in a periodontal therapy contemporary science workshop.

BACKGROUND: When appropriately evaluated and carefully managed, the integration of emerging technology into practice can improve health and enhance the quality of life. Since the last American Academy of Periodontology Workshop in 1996, great technological advances in the areas of data access, retrieval, and management have been made. The World Wide Web has "exploded" with great possibilities for gathering data from many sources. Evaluation methods such as meta-analysis and modeling have likewise improved, permitting a more objective and useful assessment of the retrieved information. The purpose of this paper is to demonstrate how the evidence-based (EB) approach was used to plan and implement a consensus conference on periodontal therapy, the Workshop on Contemporary Science in Clinical Periodontics. RATIONALE: The methodologies and philosophies associated with the EB approach provided the ideal framework for assessing the applicability of the newest clinical research to patient therapy. METHODS: Evidence-based systematic reviews on 15 topics associated with contemporary clinical periodontal practice were conducted prior to the Workshop. High standards of scientific rigor and scholarly ideals were stressed throughout the process. At the highly structured conference the reviews served as the basis for development of consensus reports that include implications for practice and research. MATERIAL COVERED: 1. The rationale, design, and implementation of a conference on contemporary clinical periodontics using an evidence-based approach. 2. Data management, clinical versus statistical significance, and the challenges of technology transfer and dissemination. 3. The benefits and limitations of using the EB approach in a consensus conference. CONCLUSIONS: The consensus statements resulting from the conference should serve to augment clinical decision-making, research priorities, education, and reimbursement. The evidence-based approach removed much of the subjectivity traditionally associated with classical reviews of the literature and allowed participants to focus on substantive issues.

Consensus Statements as Topic↗
PubMed2003

[Duplex sonography and ankle-brachial index in lower limb arterial disease: practical approach].

OBJECTIVE: The Société Française de Médecine Vasculaire and Société Française d'Imagerie Cardio-Vasculaire requested that ANAES perform an Health Technology Assessment (HTA) report entitled "Duplex Sonography in Lower Limb Arterial Disease". This report showed a wide variability of practices as well as for diagnostic criteria. The HTA Working Group wished to express that there was a consensual opinion to promote clinical practice harmonization. METHOD: A working document was sent to the HTA Working Group and to a specifically selected Reading Group. A direct draft report was transcribed during the last Working Group meeting. This document was then sent to both Working Group and Reading Group for review and recommendations. The final version takes into account these comments. RESULTS: The consensual practical approach concerns the minimal equipment required to carry out a lower limb arterial Duplex Sonography, examination proceeding and its place according to the clinical situations (asymptomatic patient, claudication, critical ischemia, therapeutic situations support, clinical situations where Duplex Sonography is not justified). CONCLUSION: The document represents a special initiative of the Working Group implemented in the context of an ANAES HTA report. This document should not be considered as ANAES professional guidelines since its working method was not compliant with the ANAES method used to elaborate guidelines. Importantly, it represents the first consensual finalised document regarding this topic in France. It should be considered as a practical guide for professional use, and serve as a basis for the development of recommendations.

Ankle↗
PubMed1998

NIH Consensus Conference. Acupuncture.

OBJECTIVE: To provide clinicians, patients, and the general public with a responsible assessment of the use and effectiveness of acupuncture to treat a variety of conditions. PARTICIPANTS: A nonfederal, nonadvocate, 12-member panel representing the fields of acupuncture, pain, psychology, psychiatry, physical medicine and rehabilitation, drug abuse, family practice, internal medicine, health policy, epidemiology, statistics, physiology, biophysics, and the representatives of the public. In addition, 25 experts from these same fields presented data to the panel and a conference audience of 1200. Presentations and discussions were divided into 3 phases over 2 1/2 days: (1) presentations by investigators working in areas relevant to the consensus questions during a 2-day public session; (2) questions and statements from conference attendees during open discussion periods that were part of the public session; and (3) closed deliberations by the panel during the remainder of the second day and morning of the third. The conference was organized and supported by the Office of Alternative Medicine and the Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md. EVIDENCE: The literature, produced from January 1970 to October 1997, was searched through MEDLINE, Allied and Alternative Medicine, EMBASE, and MANTIS, as well as through a hand search of 9 journals that were not indexed by the National Library of Medicine. An extensive bibliography of 2302 references was provided to the panel and the conference audience. Expert speakers prepared abstracts of their own conference presentations with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. CONSENSUS PROCESS: The panel, answering predefined questions, developed their conclusions based on the scientific evidence presented in the open forum and scientific literature. The panel composed a draft statement, which was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. The draft statement was made available on the World Wide Web immediately following its release at the conference and was updated with the panel's final revisions within a few weeks of the conference. The statement is available at http://consensus.nih.gov. CONCLUSIONS: Acupuncture as a therapeutic intervention is widely practiced in the United States. Although there have been many studies of its potential usefulness, many of these studies provide equivocal results because of design, sample size, and other factors. The issue is further complicated by inherent difficulties in the use of appropriate controls, such as placebos and sham acupuncture groups. However, promising results have emerged, for example, showing efficacy of acupuncture in adult postoperative and chemotherapy nausea and vomiting and in postoperative dental pain. There are other situations, such as addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma, in which acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program. Further research is likely to uncover additional areas where acupuncture interventions will be useful.

Acupuncture Therapy↗
PubMed2000

Use of consensus development to establish national research priorities in critical care.

OBJECTIVES: To test the feasibility of using a nominal group technique to establish clinical and health services research priorities in critical care and to test the representativeness of the group's views. DESIGN: Generation of topics by means of a national survey; a nominal group technique to establish the level of consensus; a survey to test the representativeness of the results. SETTING: United Kingdom and Republic of Ireland. SUBJECTS: Nominal group composed of 10 doctors (8 consultants, 2 trainees) and 2 nurses. MAIN OUTCOME MEASURE: Level of support (median) and level of agreement (mean absolute deviation from the median) derived from a 9 point Likert scale. RESULTS: Of the 325 intensive care units approached, 187 (58%) responded, providing about 1000 suggestions for research. Of the 106 most frequently suggested topics considered by the nominal group, 37 attracted strong support, 48 moderate support and 21 weak support. There was more agreement after the group had met-overall mean of the mean absolute deviations from the median fell from 1.41 to 1.26. The group's views represented the views of the wider community of critical care staff (r=0.73, P<0.01). There was no significant difference in the views of staff from teaching or from non-teaching hospitals. Of the 37 topics that attracted the strongest support, 24 were concerned with organisational aspects of critical care and only 13 with technology assessment or clinical research. CONCLUSIONS: A nominal group technique is feasible and reliable for determining research priorities among clinicians. This approach is more democratic and transparent than the traditional methods used by research funding bodies. The results suggest that clinicians perceive research into the best ways of delivering and organising services as a high priority.

Consensus Statements as Topic↗
PubMed2005

Development of national guidelines for the prevention and control of nosocomial infections.

OBJECTIVE: To develop a national evidence-based guidelines for the prevention and control of nosocomial infection. MATERIAL AND METHOD: Draft guidelines for the prevention and control of nosocomial infection were developed by the researchers and reviewed by a 10 member panel of experts. The guidelines were modified by brainstorming of 55 practitioners in July 2002. The guidelines were tested for their applicability in 20 hospitals across the country in 2002. The participants gave suggestions on the guidelines which were modified accordingly. The guidelines were finalized by brainstorming of the 55 practitioners in August 2003. RESULTS: National guidelines for the prevention and control of nosocomial infections were developed. Twenty-one topics were included. Modifications of the drafted guidelines were made four times according to the opinions of 10 experts, twice by brainstorming of 55 practitioners and by the suggestions of participants from 20 hospitals where they were tested. The practices in hospitals with different facilities were also suggested in the guidelines. CONCLUSION: National guidelines for prevention and control of nosocomial infection were formulated. Their application for use in every hospital and periodic reviews are expected.

Consensus Statements as Topic↗
PubMed2000

Laparoscopic fundoplication for gastro-oesophageal reflux disease - a consensus development conference and the evidence-based benefit.

The aim of this paper is to demonstrate an example of evidence-based medicine for a clinically relevant and frequent disease - gastro-oesophageal reflux disease - for which an increasing number of laparoscopic operations is performed. A consensus development conference was performed on this topic in 1996. During the following 3-year period, increase of knowledge shown by the number of publications was monitored and the consecutive changes of the consensus as well as its consequences and impact were analysed. The six published randomised clinical trials revealed important information about the technique of the laparoscopic operation focussing on the gastric fundic mobilisation and the modification of the anti-reflux wrap. Five consecutive consensus conferences were performed and published. Citations of the 1996 consensus conference could not be found in the major surgical journals - not even by participants of the conference. The responsibility of societies to run such conferences continues.

Consensus Statements as Topic↗
PubMed1996

Short-term impact of the European Consensus Conference on the use of selective decontamination of the digestive tract with antibiotics in ICU patients.

Because it remained controversial, the use of selective digestive decontamination (SDD) in patients in the intensive care unit (ICU) was chosen as the topic of the first European Consensus Conference in Intensive Care Medicine (ECCICM) in December, 1991. The Consensus Bureau decided to assess the impact of this conference 2 years afterwards. For this purpose, a questionnaire was sent to the members of the European Society of Intensive Care Medicine, the Societé de Réanimation de Langue Française and the Societé Française d'Anesthesie et Réanimation before the conference. The recommendations following the conference discouraged the systematic use of SDD in ventilated patients and urged the monitoring of bacterial resistance and adapting antibiotics to epidemiology of the units. Two years after the conference, the same questionnaire was sent to those physicians who had responded to the first one. Eighteen percent used SDD for all ventilated patients and 17% remain users after 2 years. Among the occasional (32%) or continual (17%) users of SDD, the regimens used were mostly intravenous cefotaxime (60% of systemic antibiotics) and a topical combination of polymixin E, tobramycin, and amphotericin B (62% of overall topical combinations). The antibiotics used were unchanged after 2 years in almost all cases. In conclusion, the short-term impact of the Consensus Conference on SDD in ICU patients has been poor. This may be related to the continuing insufficiency of strong, definite data regarding the impact of this technique upon mortality and the theoretical risk of resistance to antibiotics, thus allowing physicians to stick to their policies until there is new evidence.

Anti-Bacterial Agents↗
PubMed1999

[Implication of French general practitioners in the follow-up of patients surgically treated for stage I melanoma].

INTRODUCTION: Our aim was to assess the implication of French general practitioners in the follow up of patients surgically treated for stage I melanoma 2 years after the publication of the 1995 French consensus conference recommendations. MATERIAL AND METHODS: In 1997, we sent a questionnaire to all the general practitioners of Hauts-de-Seine department (n = 1000). In that department, specific training on this topic had been conducted in 1996. RESULTS: The response rate was 12.4 p. 100. Follow up was performed in association with a dermatologist or a oncologist by 97 p. 100. There was a high rate of non-response for questions concerning follow up which reached 30.4 p. 100 for thick melanomas. DISCUSSION: Because of the low response rate, the interpretation of these results must be interpreted with precaution. Dermatologists seem to be the general practitioners' preferred correspondents for patients with melanoma.

Consensus Statements as Topic↗
PubMed1995

Expert ratings of primary care goals and objectives.

OBJECTIVE: To develop consensus on proficiencies internal medicine residents should master in the area of primary and managed care. DESIGN: A draft compendium of primary care educational objectives including important clinical topics was developed at the Sepulveda Veterans Health Administration Medical Center Pilot Ambulatory Care and Education (PACE) Program as part of a local and regional primary care curricular review. Fifty-one experts, including leaders in the Society of General Internal Medicine, the Association of Program Directors in Internal Medicine, the American College of Physicians, general internal medicine division chiefs, and Veterans Affairs (VA) associate chiefs of staff for ambulatory care rated the compendium. MEASUREMENTS AND MAIN RESULTS: Eleven objectives and nine clinical topics were rated "critically important" (4.7 or above on a five-point scale). General internal medicine chiefs and associate chiefs of staff for ambulatory care judged them to be covered adequately in fewer than half of the 17 VA Western Region-affiliated internal medicine programs. Forty-five objectives and 77 clinical topics were considered at least somewhat important to the education of general internal medicine residents in primary care. The VA raters reported that in the prior academic year, their housestaffs had spent between 21% (postgraduate year I) and 33% (postgraduate year III) of their time in ambulatory care settings. CONCLUSION: With the emphasis on primary and managed care, there is a need for national consensus on educational objectives in primary care general internal medicine. This review provides educators with a benchmark to test the adequacy of their institutions' curricula in primary care internal medicine.

Ambulatory Care↗