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PubMedDate not supplied

Consensus statement on therapeutic endoscopy and bleeding ulcers. Consensus Development Panel.

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Endoscopy, Gastrointestinal↗

PubMed1990

Changing practice patterns in the management of primary breast cancer: Consensus Development Program.

In the last decade, new knowledge has emerged concerning the efficacy of treatment for breast cancer. For that reason, the National Institutes of Health devoted a consensus conference to this topic. To determine whether the consensus conference had influenced practice patterns, and to evaluate the level of quality of care given to women with breast cancer, the medical records of 573 patients treated in ten hospitals throughout the state of Washington were abstracted and analyzed. Results showed no changes with respect to the consensus conference's recommendations for use of a total mastectomy with axillary dissection or the use of a two-step procedure in which the biopsy is performed first and therapeutic options are discussed before a definitive surgery is undertaken. Analyses of quality of care issues not addressed by the consensus conference revealed that 4 percent of the sample were explicitly staged preoperatively and 29 percent postoperatively and that little changed over time in the use of sentinel laboratory tests. These results also show that consensus recommendations will not necessarily change physicians' behavior even where change is possible, and that quality of care in diagnosis and treatment of breast cancer still needs to be addressed.

Adult↗

PubMedDate not supplied

Intravenous immunoglobulin.

The National Institutes of Health Consensus Development Conference on Intravenous Immunoglobulin: Prevention and Treatment of Disease brought together biomedical scientists in immunology, infectious disease, and pediatrics, as well as health care providers, patients and their families, and the public to address the safe and effective uses of intravenous immunoglobulin (IVIG) preparations. Following 1 1/2 days of presentations by experts and discussion by the audience, a consensus panel weighed the evidence and prepared a consensus statement. Among their findings, the panel concluded that all currently available IVIG preparations are safe and effective in treating the conditions for which they have been licensed; however, their efficacy in treating other conditions remains to be established. Effective regimens have been developed for primary immunodeficiencies and secondary immunodeficiencies, idiopathic thrombocytopenic purpura, and Kawasaki syndrome. However, optimal dosages and treatment schedules still need to be established for patients who may benefit from IVIG therapy. The panel also concluded that the risks of IVIG therapy are minimal, and adverse events, which are rare, can often be alleviated by reducing the rate or volume of infusion. Future research is also important, particularly studies to discern the mechanisms of action of IVIG, to compare the effectiveness of IVIG preparations, and to determine their long-term effectiveness and their effect on quality of life for patients receiving IVIG. The full text of the consensus panel's statement follows.

Humans↗

PubMed1990