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PubMed2000

American Thyroid Association guidelines for detection of thyroid dysfunction.

OBJECTIVE: To define the optimal approach to identify patients with thyroid dysfunction. PARTICIPANTS: The 8-member Standards of Care Committee of the American Thyroid Association prepared a draft, which was reviewed by the association's 780 members, 50 of whom responded with suggested revisions. EVIDENCE: Relevant published studies were identified through MEDLINE and the association membership's personal resources. CONSENSUS PROCESS: Consensus was reached at group meetings. The first draft was prepared by a single author (P.W.L.) after group discussion. Suggested revisions were incorporated after consideration by the committee. CONCLUSIONS: The American Thyroid Association recommends that adults be screened for thyroid dysfunction by measurement of the serum thyrotropin concentration, beginning at age 35 years and every 5 years thereafter. The indication for screening is particularly compelling in women, but it can also be justified in men as a relatively cost-effective measure in the context of the periodic health examination. Individuals with symptoms and signs potentially attributable to thyroid dysfunction and those with risk factors for its development may require more frequent serum thyrotropin testing.

Adult↗
PubMed2006

The cancer and leukemia group B oncology nursing committee (1983-2006): a history of passion, commitment, challenge, and accomplishment.

The Cancer and Leukemia Group B (CALGB) Oncology Nursing Committee (ONC) was initially established in 1983 as a working group with the specific aim of promoting protocol compliance through collaboration, communication, and education to enhance the scientific goals of the Group. Due to the efforts of its members, the committee gained full committee status. ONC members now serve as principal investigators and coinvestigators on research studies, continue to sponsor biannual educational sessions individually and in concert with other CALGB committees, and continue to develop tools to enlighten patients about their disease and the clinical trial process. The ONC, an administrative group of 12 members, provides leadership within CALGB. Although ONC members have always acted as liaisons to the disease and modality committees, three positions have recently been designated specifically for doctorally prepared nurse scientists. Since its inception, general nurse membership within the group has more than doubled to a total of more than 500 members.

Antineoplastic Agents↗
PubMed1983

Impact of network organization on head and neck cancer control.

Prior to the Northern California Head and Neck Cancer Network, there had been no organized community effort regarding detection, management, and rehabilitation of head and neck cancers. Organization depended upon endorsement by the newly formed Northern California Cancer Program (NCCP) and membership of major treatment centers. Important developmental steps included financial support, a principal investigator, a representative multidisciplinary Steering Committee and By-laws. The organization established a support staff and subcommittees of volunteer professionals for the following areas: standards of care (state-of-the-art); patient management guidelines; epidemiology and evaluation; pre-treatment conferences; screening programs and dental hygienist training; demonstration of rehabilitation techniques; and professional education. Assessment of the contract period with a baseline year indicated beneficial and progressive standards of care, improved referral patterns, and areas of weakness useful in guiding future educational efforts. Utilizing a large target population of almost 9 million and 72 institutions responsible for more than 80% of the cancer patients yielded data on 1,790 patients that was meaningful and realistic regarding cancer control. The pre-treatment conferences in four different geographic locations are continuing, as well as rehabilitation programs in each area. The cooperative multidisciplinary, multi-institutional efforts developed during the contract are continuing in educational and research programs. Screening programs were shown not to be cost effective.

California↗
PubMed1993

In the path of Daedalus: middle-class Australians' attitudes to embryo research.

In the Australian debate over the permissability of embryo experimentation, four lobby groups are equally divided into supporting and opposing parties, although for differing reasons. The scientific and the infertile women's lobbies support experimentation while the pro-life and feminist lobbies oppose it, and the recommendations of committees of enquiry as to a proper legal position tend to reflect representation of these groups in their memberships. Community opinion is often invoked as a way out of this stalemate, but little is yet known of levels of community support for the opposing views. The present survey elicited the views of middle-class Australians (345 respondents) on the acceptability of in vitro fertilization (IVF) and embryo experimentation, and on the humanity of the embryo. It was found that while there was almost consensus support for IVF (90 per cent approval in principle), little more than half the respondents approved of embryo experimentation on the just-fertilized one-cell embryo, and this fell to only a third for the fourteen day embryo. This was despite the fact that more respondents regarded the embryo of a few days old as 'object/tissue' than as 'human/a baby'. Disapproval of embryo experimentation was more strongly associated with female sex, younger age, and fertility than with male sex, older age and infertility. Implications for the ethics of research policy are discussed.

Attitude↗
PubMed1998

Canadian guidelines for intravenous thrombolytic treatment in acute stroke. A consensus statement of the Canadian Stroke Consortium.

BACKGROUND: The thromobolytic drug, tissue plasminogen activator (tPA) has been approved in the United States for the treatment of acute ischemic stroke amid controversy and concern about the balance of risk and benefit. The Canadian Stroke Consortium (CSC), a national network of neurologists who collaborate on joint projects in stroke medicine, including clinical trials and consensus statements, has developed guidelines for the use of tPA in Canada. METHODS AND RESULTS: The CSC Board of Directors wrote a preliminary report based on existing publications, including randomized drug trials and the report of a special committee struck by the Stroke Council of the American Heart Association. This draft was circulated to the CSC membership-at-large for suggestions or amendments, to produce this final draft. CONCLUSIONS: The present guidelines have been devised to represent a Canadian viewpoint of management. The Health Protection Branch of the Ministry of Health of Canada has not yet produced an evaluation. Further modification of these guidelines may be necessary when more data from clinical trials and experience with the drug become available.

Acute Disease↗
PubMed1993

Informatics in medical practice: billing systems survey by the Hawaii Medical Association.

The Information Age has arrived! Our offices are quickly integrating information machines for the business part of our profession, just as the stethoscope and scalpel are requisites for the practice of medicine and surgery. The mission of the HMA Computer Committee is to provide guidance in the direction of medical informatics for its members. We hope to assist the membership in the selection, evaluation and use of the products relating to the processing of information in the modern practice of medicine.

Accounting↗
PubMed1990

SGNA standards for practice for gastroenterology nurses and associates.

Since 1986 the SGNA Board of Directors has been working toward a new set of standards that would recognize the changes that had occurred within the profession and the Society, as well as look toward the future. With the assistance of a facilitator, an innovative set of qualitative outcome standards were recently developed by the Standards of Practice Committee and approved by the SGNA Board of Directors. Several plans are being made to introduce the Standards to the membership. This article introduces the concept, the Standards and makes suggestions for their practical application in the work place.

Clinical Competence↗
PubMed1993

Interprofessional code. Kentucky Medical Association and Kentucky Bar Association.

The Physician-Attorney Liaison Committee, composed of members of the Kentucky Medical Association and the Kentucky Bar Association, met in January at KMA. The Committee reviewed the Interprofessional Code, last revised in October 1984, and agreed to publish the Code in this issue of The KMA Journal and the spring issue of KBA's Bench and Bar, soliciting comments and suggestions from members of each profession on how the Code might be revised to more effectively deal with specific problems or concerns physicians and attorneys might have in their dealings with each other. Suggestions for revisions to the Code and comments should be addressed to the Kentucky Medical Association, 301 N Hurstbourne Parkway, #200, Louisville, KY 40222, Attention: Physician-Attorney Liaison Committee. The Committee is also exploring ways to further improve the relationship between attorneys and physicians. Suggestions made at the meeting included encouraging joint informal meetings of local bar and medical associations, participation by members of one profession in seminars on subjects of interest to the other profession, and guest articles in each association's professional publication. Anyone interested in pursuing such opportunities or suggesting others is also encouraged to contact KMA. The Committee plans to meet again in May to consider revisions to the Interprofessional Code and suggestions from each association's membership.

Clinical Medicine↗
PubMed2001

ICRP and UNSCEAR: some distant memories. International Commission on Radiological Protection. United Nations Scientific Committee on the Effects of Atomic Radiation.

The operations of ICRP and UNSCEAR have been partly complementary during the past half century, and there has been considerable overlapping of membership of the two bodies. From its inception in 1955 UNSCEAR collected imformation upon which estimates of radiation risk have been based; these have been used by ICRP as a background to its recommendations during recent decades. Over the years there have been many interesting incidents connected with the work of these two bodies, in which a number of memorable characters participated. Some of these are recalled.

Health Physics↗
PubMedDate not supplied

Regional metrology organisations and the JCRB.

In 1999, National Metrology Institutes (NMIs) from some 39 countries signed the International Committee of Weights and Measures (CIPM) Mutual Recognition Arrangement (MRA) in Paris. The MRA, drawn up by the CIPM, under the authority given to it in the Metre Convention, was in response to requirements of Governments and Regulators to provide a sound technical foundation for trade agreements. Core objectives of the MRA are to allow for the establishment of the degree of equivalence of national measurement standards and to provide for mutual recognition of calibration certificates issued by NMIs. This presentation will detail the evolution of the MRA. Globally, NMIs are affiliated to Regional Metrology Organisations (RMOs). The key role of the RMOs in the MRA process will be discussed along with the structure and objectives of the various RMOs worldwide. The Joint Committee of the RMOs and the BIPM (JCRB) plays a central part in the effective operation of the MRA. Its tasks, membership and output will also be described.

Government Regulation↗
PubMedDate not supplied

Medical Group Management Association strategic plan executive summary.

In order to assure that MGMA and its affiliates CRAHCA and ACMGA continue to provide programs and services that are responsive to the changing needs of members and the field, the MGMA Board of Directors voted to initiate the development of a strategic plan in 1981. Guided by the appointed Strategic Planning Committee and utilizing the services of an outside consultant to facilitate the planning process, the project was set forth. A detailed membership survey was used as one component of the planning process. This executive summary highlights the key process and content elements as set forth in the complete plan document.

Group Practice↗
PubMed1982

[Subregional system of training as a means of satisfying institutional training needs].

The document traces the developments that led to the inception of the Committee of Managers and Directors of Water Supply and Sanitation Institutions of Central America and Panama, and furnishes data on its membership, responsibilities and operating procedures. It describes how needs and priorities in this field have been defined and the formulation of a system for the training of nonprofessional technical staff. It reviews the negotiations entered into with national and international agencies to obtain financial support for a project for such training, designed to set up training units and units for the detection of water losses in the seven countries of the Central American area, and the Dominican Republic, and to train 630 technicians in 19 months in courses to be conducted in those countries. Also, it supplies information on the strategic, managerial and operational planning of the project, including a functional scheme and the mechanism for evaluating the project's operations.

Central America↗
PubMed1990

Five-year results of the peer assessment program of the College of Physicians and Surgeons of Ontario.

The office practices of 918 physicians selected through stratified random sampling from the College of Physicians and Surgeons of Ontario (CPSO) registry were assessed by peers and the Peer Assessment Committee of the CPSO from 1981 to 1985. The sample comprised 662 general practitioners (GPs) and family physicians (FPs) and 256 specialists in 11 fields. Of the physicians 749 (82%) had neither deficient records nor an unsatisfactory level of patient care. Of the GPs and FPs 97 (15%) had serious deficiencies in one or both areas, as compared with 4 (2%) of the specialists (p2 less than 0.00001). The proportions of certificants of the Royal College of Physicians and Surgeons of Canada and of the College of Family Physicians of Canada (CFPC) with serious deficiencies were low (2% and 3% respectively). Three statistically significant predictors of physician performance were found among the GPs and FPs: age, CFPC membership status and type of practice. Of the 56 physicians who were reassessed 6 to 12 months later 29 (52%) had made the improvements recommended by the committee. Our findings demonstrate the need, feasibility and acceptance of a peer assessment program of office practices in Ontario.

Age Factors↗
PubMed1984

Construction of the annual meeting program of the Academy.

Six hundred of 912 papers submitted were accepted for presentation at the 1983 Annual Meeting of the AAN. A statistical study of scoring by individual members of the Committee showed significant mean score differences. A normalization procedure for scoring was compared with the actual meeting scores and selections. A substantial difference in 3 of 19 program categories and lesser changes in 14 others occurred. It is no longer feasible for each submission to be evaluated by all committee members. Four readers per paper and normalization of scores will result in a program reflecting the broad interests of the Academy membership.

Abstracting and Indexing↗
PubMed2002

The Surgical Infection Society guidelines on antimicrobial therapy for intra-abdominal infections: evidence for the recommendations.

Revised guidelines for the use of antimicrobial therapy in patients with intra-abdominal infections were recently developed by the Therapeutic Agents Committee of the Surgical Infection Society (Mazuski et al., Surg Infect 2002;3:161-173). These were based, insofar as possible, on evidence published over the past decade. The objective of this document is to describe the process by which the Committee identified and reviewed the published literature utilized to develop the recommendations and to summarize the results of those reviews. English-language articles published between 1990 and 2000 related to antimicrobial therapy for intra-abdominal infections were identified by a systematic MEDLINE search and an examination of references included in recent review articles. If current literature with regard to a specific issue was lacking, relevant articles published prior to 1990 were identified. All prospective randomized controlled trials, as well as other articles selected by the Committee, were evaluated individually and collectively. Data with regard to patient numbers, types of infections, and results of interventions were abstracted. Studies were categorized according to their design, and all included trials were graded according to quality. On the basis of this evidence, the Committee formulated recommendations for antimicrobial therapy for intra-abdominal infections and graded those recommendations. After receiving comments from invited reviewers and the general membership of the Society, the guidelines were finalized and submitted to the Council of the Surgical Infection Society for approval. The final recommendations related to the selection of patients needing therapeutic antimicrobials, acceptable antimicrobial regimens, duration of antimicrobial use, and the identification and treatment of higher-risk patients. Although numerous publications pertaining to these topics were identified, but nearly all of the prospective randomized controlled trials represented comparisons of different antimicrobial regimens for the treatment of intra-abdominal infections. A few prospective trials evaluated the need for therapeutic antimicrobial therapy in patients with peritoneal contamination following abdominal trauma. The quality of these prospective trials was highly variable. Many did not limit enrollment to patients with complicated intra-abdominal infections, lacked blinding of treatment assignment, did not provide a complete description of the criteria used to determine therapeutic success or failure, failed to identify the reasons why patients were excluded from analysis, or did not include an intention-to-treat analysis. For many issues, no prospective randomized controlled trials were encountered, and guidelines had to be formulated using evidence from studies with historical controls or uncontrolled data, or on the basis of expert opinion

Abdominal Abscess↗
PubMed1987

Scientists' attitudes toward Animal Care and Use Committees.

The major results of this survey of scientists' attitudes toward institutional oversight Committees are: overwhelming support that ACUCs be charged with review of experimental protocols and ensuring compliance with national standards governing humane use of animals. Virtually unanimous agreement that both veterinarians and investigators serve on ACUCs as members. Other types of persons most favored for membership include nonscientists, noninstitutional affiliated people, and laboratory animal technicians. Majority support for ACUC review of student projects involving animals.

Animal Welfare↗
PubMed1986

Regulation of animal experimentation: Canada's program of voluntary control.

The Canadian Council on Animal Care (CCAC), is an autonomous advisory and supervisory body responsible for surveillance of experimental animal care and use in Canada's universities, government laboratories and pharmaceutical houses. Its 20-organization membership includes representatives of government, industry, academia and the humane movement. CCAC's voluntary peer review program depends heavily on institutional animal care committees who evaluate the ethical aspects of animal study protocols, and provide day-to-day surveillance of animal care. Its scientific teams, each of which also includes an appointee of the Canadian Federation of Humane Societies (CFHS), conduct assessments based on CCAC's "Guide to the Care and Use of Experimental Animals" (Volume 1, 1980; Volume 2, 1984). Canada's two major funding agencies, the Medical Research Council (MRC) and the Natural Sciences and Engineering Research Council (NSERC), have recently stated that, in the event of an institution's continued non-compliance with CCAC requirements, sanctions may include the "freezing or withdrawal of any or all research programs funded by either or both Research Councils in an institution". This presentation describes the CCAC program of voluntary peer review and examines historic aspects of animal issues in Canada, from that country's early reliance on the fur trade, to today's almost defunct harp seal fishery, from Banting and Best's discovery of insulin, to development of the pacemaker.

Animal Testing Alternatives↗