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PubMed2005

A model of ambiguity and vagueness in clinical practice guideline recommendations.

Ambiguity and vagueness in clinical practice guidelines reduce the likelihood of clinician adherence. They lead to inconsistent interpretation and, in turn, to inappropriate practice variation and medical errors. Resolving ambiguity and vagueness is an essential step in the computerized implementation of clinical practice guidelines. Successful resolution of ambiguity and vagueness requires an understanding of their characteristics, yet ambiguity and vagueness have not been differentiated, classified and described in medical context. In this paper, we propose a tri-axial model to describe ambiguity and vagueness in clinical practice guidelines: differentiation of true ambiguity from vagueness, classification of ambiguity and vagueness, intentionality and components involved. Our goals in introducing this model are: (a) to provide guidance to guideline authors to enable them to reduce inadvertent use of ambiguous or vague language, (b) to improve transparency when vague language is used deliberately and (c) to create a framework for the development of tools to apply the model during authoring and implementation of clinical practice guidelines.

Decision Making, Computer-Assisted↗

PubMed1991

[Evaluation of the effectiveness of antibacterial therapy].

It is recommended to estimate the clinical effect of antibacterial therapy in patients with different purulent inflammatory complications with an account of the data on both the clinical and bacteriological examinations. The full affect consisted in disappearance of the clinical signs and complete bacteriological sanation of the purulent inflammatory foci. The partial effect was shown by a marked decrease in the clinical manifestations without complete bacteriological sanation of the foci. The ill effect was evidenced by clinical picture having no time course and no favourable time course in bacteriological tests. No effect was indicated by deterioration of the clinical picture and no favourable time course in the bacteriological tests.

Anti-Bacterial Agents↗

PubMed1990

[Frequency with which semiquantitative expressions are used in Mexican medical literature].

OBJECTIVE: To describe the frequency with which semiquantitative expressions are used in Mexican medical journals. STUDY DESIGN: [corrected] Comparative survey. Frame of reference. Four Mexican medical journals considered representative of the medical literature in Mexico were studied (Revista de Investigación Clínica, Archivos de Investigación Médica, Revista Médica del IMSS and the Boletín Médico del Hospital Infantil de México). STUDY UNITS: Ten articles randomly selected and considered as original research material published in 1987 from each journal were used. MEASUREMENTS: Eight terms were identified in each text of the selected articles: almost always, very probably, probable, probably, frequent, possible, improbable and almost never. MAIN RESULTS: One hundred and fifty three expressions were identified, for a global average of 3.8 expressions per article. No statistical significant differences were found between the journals in relation to the frequency with which the expressions were used (P = 0.76). When comparing the chapters of each article, significant statistical differences were found which disappeared when the comparison was rated. In 89% of the cases, the expressions did not have a referral which therefore did not allow for their quantification. Finally, those articles defined as "clinical" had a greater frequency of semiquantitative expressions than those considered as "biomedical" (4.2 vs 1.3 on the average, respectively). CONCLUSIONS: On the average, semiquantitative expressions are used four times per article, 75% of the times without a referral which would allow to quantify them, which could condition for a wide variety of interpretations on behalf of the readers.

Mexico↗

PubMed1990

A comparison of drug products available in Germany and the United States.

Health-care professionals practicing with the U.S. European Command frequently encounter drug products of their host nation. Confusion about the identity or use of these medications can slow emergency treatment or mislead the medical management of patients. This article compares drug products available in the Federal Republic of Germany (FRG) with those of the United States of America. Differences in nomenclature used for generic drug names are described, as well as prescription practices unique to the FRG, such as unusual drug combinations, additional dosage forms, and divergent labeling practices. Military pharmacies are effective resources for translation of host nation drug products.

Dosage Forms↗

PubMedDate not supplied

The cure for lazy eye.

The use of the term lazy eye blurs the distinction between amblyopia and strabismus, often causing parents to confuse the two problems. Parents often infer a causal explanation from the descriptive term, lazy eye. This misunderstanding causes parents to believe the child may outgrow the disorder. Therefore, an opportunity for early treatment during the important formative years may be lost. The correctly informed and knowledgeable parent will be more active and responsible in making sure that the child, especially the noncompliant child, follows the advised treatment.

Amblyopia↗

PubMed1989