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PubMed1997

Effects of communication, information overlap, and behavioral consistency on consensus in social perception.

Three experiments (N = 69, 162, and 201, respectively) were conducted to test the mathematically derived predictions of the Weighted Average Model (D. A. Kenny, 1991) of consensus in interpersonal perception. Study 1 estimated the effect of perceiver communication. Study 2 estimated the effects of communication and stimulus overlap, and Study 3 estimated the effects of communication, overlap, and target consistency on consensus. The strongest consensus was found when perceivers communicated about highly overlapping information about targets who were cross-situationally consistent. Conversely, the lowest level of consensus was observed when perceivers did not communicate and had nonoverlapping information about targets who were cross-situationally inconsistent. Both stimulus variables (overlap and consistency) and an interpersonal variable (communication) affected consensus as predicted by the Weighted Average Model.

Adolescent↗
PubMed1987

GTP-binding domain: three consensus sequence elements with distinct spacing.

A sequence comparison of nine functionally different GTP-binding protein families has yielded further information on the general characterization of the conservation and importance of amino acid sequences in the GTP-binding domain, including a consensus sequence composed of three consensus elements GXXXXGK, DXXG, and NKXD with consensus spacings of either 40-80 or approximately equal to 130-170 amino acid residues between the first and second elements and approximately 40-80 amino acid residues between the second and third sequence elements; the sequence NKXW in place of NKXD in the sequence element responsible for base specificity allows the use of ITP as well as GTP; dGTP can be used with essentially the same efficiency as GTP; signal transducing proteins and enzymes have been identified in the nine families; and family conservations allow the identification of the most probable consensus sequence element when more than one is present. Employing these features we have screened the protein sequence data base of the Protein Identification Resource and have identified only known GTP-binding proteins with the exception of protein 2C from foot-and-mouth disease virus as matching the consensus sequence. Based on this finding we predict that foot-and-mouth disease virus protein 2C binds GTP and, by analogy, that protein 2C from several related viruses (polio, rhino, encephalomyocarditis, and cowpea mosaic) will bind a nucleotide as part of its biologic activity.

Amino Acid Sequence↗
PubMed1992

Tn10 insertion specificity is strongly dependent upon sequences immediately adjacent to the target-site consensus sequence.

Transposon Tn10 inserts preferentially into particular "hotspots" that have been shown by sequence analysis to contain the symmetrical consensus sequence 5'-GCTNAGC-3'. This consensus is necessary but not sufficient to determine insertion specificity. We have mutagenized a known hotspot to identify other determinants for insertion into this site. This genetic dissection of the sequence context of a protein binding site shows that a second major determinant for Tn10 insertion specificity is contributed by the 6-9 base pairs that flank each end of the consensus sequence. Variations in these context base pairs can confer variations of at least 1000-fold in insertion frequency. There is no discernible consensus sequence for the context determinant, suggesting that sequence-specific protein-DNA contacts are not playing a major role. Taken together with previous work, the observations presented suggest a model for the interaction of transposase with the insertion site: symmetrically disposed subunits bind with specific contacts to the major groove of consensus-sequence base pairs, while flanking sequences influence the interaction through effects on DNA helix structure. We also show that the determinants important for insertion into a site are not important for transposition out of that site.

Base Sequence↗
PubMed2003

Definitions for public health nutrition: a developing consensus.

OBJECTIVES: To assess the level of agreement amongst a panel of public health nutrition leaders regarding the key descriptors used to define the field of public health nutrition. DESIGN: Cross-sectional survey requiring quantitative and qualitative responses representing the first round of a consensus development Delphi technique. SETTING: International. SUBJECTS: Expert panel of 24 public health nutrition leaders from nine countries in the European Union, the USA and Australia. RESULTS: All but one of the panel agreed it was important to have a consensus definition for public health nutrition to describe the field consistently. Opinion about the length and complexity of this definition tended to vary depending on the intended use of the definition. The large majority (18/24) supported the inclusion of specific reference to physical activity in a definition of public health nutrition, although there was not consensus (> 83% agreement as criterion) on this point. Consensus descriptors regarded as important in a definition of public health nutrition included: population-based, focus on health promotion, food and nutrition systems focus, wellness maintenance, primary prevention, applies public health principles, education, environmental and political descriptors. Treatment as a descriptor was rated as unimportant by a majority (14/24) of panellists, delineating public health nutrition from clinical practice. CONCLUSIONS: There is strong international agreement amongst public health nutrition leaders in Europe, the USA and Australia about a range of descriptors that can be used to define public health nutrition. The limitations of using word-for-word definitions between and within countries may be overcome by explicit use of the consensus descriptors identified in this process.

Cross-Sectional Studies↗
PubMed1999

Clinical utility of anticardiolipin antibody assays: high inter-laboratory variation and limited consensus by participants of external quality assurance programs signals a cautious approach.

Antibodies that bind phospholipid (anti-phospholipid antibodies [APA]) are a focus of major interest to both clinical and laboratory personnel across a variety of disciplines because of the assortment of disorders with which they are reportedly associated. A solid phase assay using cardiolipin as the test phospholipid (anti-cardiolipin antibody assay [ACA]) has now become a laboratory standard for the detection of APA. In the current report, data from two separate external quality assurance programs (QAP) and collected over the past four years, have been evaluated to assess the utility of the ACA. Despite attempted standardizations, exceedingly high inter-laboratory variation and a general lack of test result consensus would signal the adoption of a cautious clinical approach towards laboratory findings. For example, for a total of 21 cross-laboratory tested serum samples (tested for both IgG and IgM for 41 quantitative estimations), inter-laboratory variation for both ACA-IgG and ACA-IgM was higher than 50% in 20 of 41 testing cases (48.8%). The situation with regard to testing consensus was equally concerning. Total consensus (i.e., 100% of participating laboratories agreed that a given serum sample gave an ACA result of either negative or positive) occurred in less than 20% of cases for ACA-IgG. More importantly, in about 50% of serum testing occasions there was no general consensus in returned laboratory data (i.e., more than 80% of labs could not agree on whether a serum sample tested was either ACA-positive or ACA-negative). Thus, despite attempted international standardizations, exceedingly high inter-laboratory variation and a general lack of test result consensus would argue that the assay has limited utility. We conclude that single point laboratory results must be used with considerable caution before accepting that ACA activity is present in patient serum or not. We agree with recommendations indicating that laboratory tests should be repeated at least once prior to making a clinical diagnosis of any APS-like disorder.

Antibodies, Anticardiolipin↗
PubMed2005

Visualizing conflicting evolutionary hypotheses in large collections of trees: using consensus networks to study the origins of placentals and hexapods.

Many phylogenetic methods produce large collections of trees as opposed to a single tree, which allows the exploration of support for various evolutionary hypotheses. However, to be useful, the information contained in large collections of trees should be summarized; frequently this is achieved by constructing a consensus tree. Consensus trees display only those signals that are present in a large proportion of the trees. However, by their very nature consensus trees require that any conflicts between the trees are necessarily disregarded. We present a method that extends the notion of consensus trees to allow the visualization of conflicting hypotheses in a consensus network. We demonstrate the utility of this method in highlighting differences amongst maximum likelihood bootstrap values and Bayesian posterior probabilities in the placental mammal phylogeny, and also in comparing the phylogenetic signal contained in amino acid versus nucleotide characters for hexapod monophyly.

Algorithms↗
PubMed2005

Pcons5: combining consensus, structural evaluation and fold recognition scores.

MOTIVATION: The success of the consensus approach to the protein structure prediction problem has led to development of several different consensus methods. Most of them only rely on a structural comparison of a number of different models. However, there are other types of information that might be useful such as the score from the server and structural evaluation. RESULTS: Pcons5 is a new and improved version of the consensus predictor Pcons. Pcons5 integrates information from three different sources: the consensus analysis, structural evaluation and the score from the fold recognition servers. We show that Pcons5 is better than the previous version of Pcons and that it performs better than using only the consensus analysis. In addition, we also present a version of Pmodeller based on Pcons5, which performs significantly better than Pcons5. AVAILABILITY: Pcons5 is the first Pcons version available as a standalone program from http://www.sbc.su.se/~bjorn/Pcons5. It should be easy to implement in local meta-servers.

Algorithms↗
PubMed1999

Assessing the effectiveness and optimal structure of trauma systems: a consensus among experts.

OBJECTIVE: To determine whether a consensus exists among experts regarding the effect of organized trauma systems on patient outcomes based on peer-reviewed, published evidence. Second, to ascertain whether experts agree on the optimal structure of trauma systems. METHODS: A multistage, longitudinal survey was administered to trauma system experts participating in a national symposium designed to assess the published evidence regarding trauma system effectiveness. Survey questions assessed published evidence by evaluating study designs, potential biases, and sample case mix. Trauma system structure was assessed by asking participants to rate the merit of previously identified key trauma system characteristics. Analyses were conducted using consensus theory. RESULTS: Ninety symposium participants (99%) completed all five surveys. Respondents considered the evidence to be "moderately supportive" of trauma system effectiveness when considering severely injured patients in urban settings. Several key trauma system characteristics were identified as mandatory or highly desirable components of trauma system implementation and maintenance. Experts currently favor exclusive rather than inclusive trauma systems. CONCLUSION: A consensus does exist among trauma system experts regarding the effectiveness of trauma systems and the optimal structure of trauma systems. Additional research is needed to determine whether trauma system benefits extend to other patient subgroups in other geographic regions. Consensus theory provides an impressive model for assessing rater agreement by controlling for response bias and providing a probability measure to determine whether a true consensus exists.

Canada↗
PubMed1998

Changing preoperative fasting policies. Impact of a national consensus.

BACKGROUND: Liberalisation of preoperative fasting rules has been discussed and recommended in the anaesthesia literature in recent years. In Norway, a national consensus on this issue was reached in 1993. The aim of the present study was to investigate whether a national consensus on fasting recommendations led to a change in fasting policies in Norwegian anaesthesia departments. METHODS: A questionnaire on preoperative fasting routines was sent to all Norwegian anaesthesia departments in 1993 and repeated in 1996. RESULTS: Written local guidelines for preoperative fasting were present in 85% of the institutions in both surveys. Of the hospitals, 69% had changed their local guidelines after the national consensus. In 1996 more hospitals allowed less than 6 h fasting for clear liquids in children (93% versus 71% in 1993; P < 0.005). A similar tendency was noted in adults (79% versus 63% in 1993; P = 0.1). In contradiction to the national guidelines, 31% of the departments reported that they allowed less than 6 h fasting after a light breakfast in the morning of surgery in 1996. The corresponding number for 1993 was 21% (ns). CONCLUSION: The new, consensus-based national fasting guidelines have been associated with a change towards more liberal fasting policies in Norwegian departments of anaesthesia. However, as not all local changes were supported by the national consensus, other sources of information were used when local policies were decided.

Adult↗
PubMed1997

The "golden section" and bias in perceptions of social consensus.

Meta-analytic examination of I28 false consensus effect issues supports the hypothesis that the "Golden Section" (61.8% group size) approximates the level of actual consensus that separates overestimation of consensus (group size < 61.8%) from underestimation (group size > 61.8%). Overestimation of the actual percentage of others who endorse one's own view increases as actual consensus decreases from 61.8%, and underestimation increases as it exceeds 61.8%. The form of the response (viz, a yes or no answer to a question) moderates this conclusion. The Golden Section holds for majorities and minorities defined by agreement with an issue. For majority and minority groups defined by disagreement, the inflection point is higher. Contrary to Mullen and Hu (1988), for agreeing majorities, the slope for consensus underestimation as a function of increased majority size does not differ from that of minority overestimation.

Journal Article↗
PubMed2000

The primacy of self-referent information in perceptions of social consensus.

People's own responses to a social stimulus (i.e. whether they endorse it or reject it) predict how they expect other people to respond (consensus estimates). This correlation has long been accepted as evidence for social projection. There has been little direct evidence, however, for the assumption that self-referent judgments shape judgments about others. Supporting the projection model, Expt 1 shows that self-referent information is more accessible than consensus estimates. Once they have been made, people's own endorsements and rejections of a stimulus facilitate consensus estimates. In turn, consensus estimates facilitate endorsements (but less so). Judgments about the physical properties of the stimulus facilitate neither type of social judgment. Supporting the view that projection is egocentric, Expt 2 shows that, when making consensus estimates, people rely more on their own endorsements than on the endorsements made by another individual. This self-other difference does not depend on whose endorsements are revealed first or on whether the other person is anonymous or individual.

Adolescent↗
PubMed1993

Comparison of L1 consensus primers with E6 type specific primers for detection of human papillomaviruses in paraffin sections of cervical neoplasia.

In our comparative study of L1 consensus primers with E6 type-specific primers for detection of human papillomavirus (HPVs) by polymerase chain reaction (PCR) in 35 cases of cervical neoplasia, the detection rate by E6 primers (54%; 19/35) was significantly higher than that by L1 primers (25%; 9/35) (p < 0.01). And all specimens HPV-positive with L1 primers were also positive by E6 primers. HPV DNA could be amplified in 36% (9 of 25) of tissue by L1 consensus primers from which beta-globin gene was amplified as compared with 64% (16 of 25) of tissue by E6 type-specific primers. With the L1 consensus primers, 8 cases were positive for HPV-16 and 1 case was positive for HPV-33. These results show that the L1 consensus primers have inferior sensitivity to the E6 type-specific primers for the detection of HPV by PCR. But the L1 consensus primers have great value in making simultaneous detection of various HPV types in a single tube reaction, thus they permit reduction of time and the economic burden of the experiment.

Base Sequence↗
PubMed2002

[Surgery and referral for subsequent 131I therapy for patients with differentiated thyroid carcinoma in the south-east of the Netherlands, 1983-1996, compared to the consensus guidelines from 1987].

OBJECTIVE: To evaluate the treatment of patients with differentiated (papillary or follicular) thyroid cancer in general hospitals in the south-east of the Netherlands during the period 1983-1996, in relation to the 1987 national consensus recommendations. DESIGN: Population-based, retrospective, descriptive. METHOD: For the period 1 January 1983-31 December 1996, data on the histology, TNM-stage and treatment (hospital, specialist, type of operation, referral for 131I therapy) of all 236 patients with differentiated thyroid cancer were obtained from the cancer registry of the Comprehensive Cancer Centre South, Eindhoven, the Netherlands. The treatment was compared with the recommendations from the consensus meeting in 1987. RESULTS: Data on 219 patients (137 papillary, 82 follicular thyroid carcinoma) treated in the general hospitals in the region were studied; the 17 remaining patients had been referred from outside the region. Patients were treated at all hospitals in the region; the number of specialists per hospital able to treat thyroid carcinoma (internist and/or surgeon) was limited. In total 79% of the patients underwent a (near-)total thyroidectomy, half of them in two phases, and in 12% of the cases combined with regional lymph node dissection. In the majority of cases, surgical treatment was in accordance with the consensus recommendations: 65-100% of the cases per hospital. The proportion of patients referred for 131I therapy varied from 17% to 90%; referral was more frequent in the case of larger tumours and/or metastases. Of the 24 patients with a small papillary carcinoma without metastases, 79% were not referred for 131I therapy. CONCLUSIONS: The recommendations laid down in the consensus meeting in 1987 were known and appeared to be followed for surgical treatment but for subsequent 131I therapy they appeared to be interpreted differently. A review of the consensus guidelines seems to be worthwhile.

Carcinoma↗
PubMed2005

Treating morphologic and metabolic complications in HIV-infected patients on antiretroviral therapy. A consensus statement of an advisory committee of the International Association of Physicians in AIDS Care.

OBJECTIVE: Clinicians are increasingly challenged by presentation of morphologic and metabolic complications in HIV-infected patients. These complications are associated with HIV infection and/or combination antiretroviral therapy. This Consensus Statement is intended to offer guidance to clinicians actively involved in HIV/AIDS care. PARTICIPANTS: Seven clinicians with expertise in HIV medicine were invited by the International Association of Physicians in AIDS Care (IAPAC) to serve on an ad hoc Advisory Committee. CONSENSUS PROCESS: IAPAC convened the Advisory Committee to develop a draft Consensus Statement. Each clinician was tasked with drafting a specific section of the Consensus Statement corresponding with his or her expertise around a morphologic and/or metabolic complication. Scientific and clinical research, and other data in published literature and abstracts from scientific conferences were considered by strength of evidence. This document represents the consensus agreement of the Advisory Committee.

Anti-HIV Agents↗
PubMed2006

Daily consensus interferon (CIFN) monotherapy in non-responders or relapsers to a previous interferon regime: one year follow-up after 48 weeks of treatment.

BACKGROUND/AIMS: Data suggests on the basis of thrice a week therapy, efficacy of mono consensus interferon is comparable to other alpha interferons. One-year follow-up after 12-month daily consensus interferon monotherapy for chronic hepatitis C among non-responders or relapsers to previous consensus interferon monotherapy is investigated. METHODS: Between February and August 1998, 11 non-cirrhotic patients with previous consensus interferon failure were treated. Six were relapsers and five non-responders. Serum HCV-RNA was tested at the 12th and 48th weeks of treatment and followed for one year thereafter. RESULTS: Eight (72%) were HCV-RNA negative at both 12th and 48th weeks. Of these, 60% (3/5) were among previous non-responders and 83% (5/6) were among previous relapsers. One year sustained virological response was 55%. Of this, 40% (2/5) were among non-responders and 66% (4/6) previous relapsers. CONCLUSIONS: These findings suggest that daily consensus interferon needs to be further investigated as an alternative to pegylated formulations, especially with the addition of ribavirin.

Adult↗
PubMed1995

[Compliance with consensus 'Diagnosis pulmonary embolism' in clinical practice].

OBJECTIVE: Evaluation of clinical management in patients suspected of pulmonary embolism as compared with the Dutch consensus for diagnosing pulmonary embolism. DESIGN: Retrospective. SETTING: Medical Centre Alkmaar. METHOD: Retrospective analysis of clinical management in patients subjected to ventilation-perfusion scintigraphy on suspicion of pulmonary embolism. RESULTS: In 55 (24%) of the 225 patients included a high-probability scan was found, in 68 (30%) a non-high-probability scan and in 102 (45%) a normal scan. The clinical management in all patients with a normal or high-probability scan was according to the consensus. In the 68 patients with a non-high-probability scan the consensus was completely followed in 16%, partially in 18% and not at all in 66%. CONCLUSION: Clinical management of patients with a non-high-probability scan in the vast majority of cases was not according to the consensus. The consensus was followed in all patients with a normal or high-probability scan.

Anticoagulants↗
PubMed1996

Consensus minimum standards for use in a trainer's report for summative assessment in general practice.

BACKGROUND: Summative assessment of general practitioner registrars is to be introduced in September 1996, one component of which will be a report by the trainer. Standards must be set and guidance provided as to the most appropriate ways of obtaining evidence for the trainer's assessment. AIM: The first aim of this study was to set consensus minimum standards for 30 items that are likely to form the content of a trainer's report; the second aim was to provide a consensus view on the most appropriate methods of assessment to be used by trainers. METHOD: A consensus conference was held in March 1995 during which the 30 items were discussed by a group of 30 general practitioners, of whom 27 were experienced trainers. This resulted in a draft document that was circulated to the conference attenders and other experts for consultation. RESULTS: Draft minimum standards were produced for all 30 items after the consensus conference with a mean of 2.5 standards for each item. Of those involved in the consultation exercise, 82% replied. Most of the revisions suggested at this stage were of a minor nature; the only major revision was to divide one item into two, resulting in a final total of 31 items. All but one of the 80 standards could be assessed by direct observation; 41 (51%) could be assessed by tutorial-based discussion and 61 (76%) by methods specific to that standard. Trainers or their practice partners were viewed as acceptable sources of evidence for all items and hospital consultants and primary health care team members were viewed as acceptable for just over half of the items. CONCLUSION: Standards for use by trainers when providing a general practitioner report for the summative assessment of registrars have been developed by consensus conference and have been subjected to review by consultation. Acceptable methods by which registrars could be assessed against these standards, and suitable personnel who could provide evidence, have also been suggested.

Education, Medical, Graduate↗
PubMed1996

[Costs of diagnosis and treatment for pulmonary embolism lower due to application of consensus strategy].

OBJECTIVE: To compare the costs of diagnosis and treatment of patients clinically suspected of pulmonary embolism, before and after the adoption of the Dutch consensus for the diagnosis of pulmonary embolism. DESIGN: Study of the records, followed by a prospective study with a follow-up lasting 6 months. SETTING: Academic Medical Centre and Slotervaart Hospital, Amsterdam, the Netherlands. METHOD: Data were collected on 120 patients from the preconsensus period and on 452 patients examined according to the consensus strategy. This established the average patterns of medical consumption of patients before and after adoption of consensus. The mean costs per patient were then estimated. RESULTS: Diagnosis and treatment of a patient according to the consensus strategy on the basis of our estimates were considerably less expensive than non-protocolled diagnosis and treatment (Dfl. 4,413 as against Dfl. 5,115 per patient). This difference mainly resulted from shorter hospital stays owing to more rapid completion of the diagnosis. Considering the large number of annual hospital admissions in the Netherlands in connection with this diagnosis, savings of up to Dfl. 26 million would appear possible if the consensus were followed nationwide. CONCLUSION: Considerable amounts are involved in the diagnosis and treatment of pulmonary embolism in the Netherlands. Accordingly, further research into possibilities to make these more efficient would appear advisable.

Clinical Protocols↗