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Results for “Consensus Statements as Topic”

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At least 793 records · Page 44Linked to original sources
PubMed1999

Meat and cancer.

Explore the source record for details and available documents.

Amines↗
PubMed2006

Are the recommendations of the French consensus conference on the management of colon cancer followed up?

The aim of this study was to determine how the guidelines published after this conference have spread. Pretherapeutic evaluation and treatment were assessed for all colon cancers diagnosed in a well-defined French population in 2000. Patients were classified either as managed according to the recommendations, or as undermanaged or overmanaged. Outside the emergency context, pretherapeutic work-up was classified as in conformity with the consensus in 48.0% of the cases, as undervalued in 21.9% and as overvalued in 30.1%. The resection rate at 90% was not far from the optimum. Pathological data allowed us to classify nearly all cases according to the tumour node metastasis classification; however, the number of examined nodes was below the recommendations in 30.8% of cases. Chemotherapy was performed according to the recommendations in 71.4% of cases, 23.1% were undertreated and 5.5% were overtreated. The multivariate analysis indicates that patients aged 75 years or more were less likely to receive chemotherapy than was recommended (P<0.001). This study suggested that the main reasons for not following guideline recommendations were inertia due to previous practices, difficulty to perform a recommended behaviour and lack of familiarity.

Aged↗
PubMed1999

Guidelines for the diagnosis and therapy of diabetes mellitus in cystic fibrosis.

Diabetes is a common complication of cystic fibrosis. Because it is associated with increased morbidity and mortality, prompt diagnosis and aggressive management of cystic fibrosis-related diabetes is important. The Cystic Fibrosis Foundation held a consensus conference in 1998 to define the standards of care for patients with this disease [1[symbol: see text]]. In this article, pathophysiology and management of cystic fibrosis-related diabetes are reviewed.

Consensus Statements as Topic↗
PubMed2002

Acute Dialysis Quality Initiative: methodology.

The area of acute renal failure has lagged behind other areas of critical care medicine such as acute respiratory distress syndrome or sepsis in terms of clinical focus, assimilation and interpretation of currently available evidence, and availability of clinical trials. Furthermore, there has been a lack of attention concerning present therapeutic needs and future clinical research direction. These shortcomings stem, in part, from the fragmentation of acute renal failure care and expertise into the fields of nephrology and critical care medicine. To advance the quality of care, make the evidence base for clinical practice more readily available and suitably interpreted, reduce fragmentation, and refocus the goals of future research in this field, a new quality initiative, the Acute Dialysis Quality Initiative, was launched. This initiative brings together experts from different fields and continents, applying an expert-enhanced evidence analysis to achieve its goals. This brief report details the process of the Acute Dialysis Quality Initiative and its goals and methodology.

Acute Kidney Injury↗
PubMed1999

Refutation and conjecture around consensus breast cancer screening guidelines.

Public health policy making sometimes goes beyond dispassionate scientific review of data and program analysis to reflect the attitudes and promote the interests of various health care constituencies, professional organizations, consumer groups, and governmental bodies. This article recounts events that precipitated the issuance of guidance about the advisability of periodic screening mammography for women 40 to 49 years of age. It illustrates how a pragmatic choice was born from equal parts of data, the community's underlying value system, and political exigencies. Examining the policy making process will provide public health practitioners greater capacity to find workable solutions in their advocacy of better health for all.

Adult↗
PubMed2002

Clinical evaluation of a self blood pressure monitor according to the First International Consensus Conference on Self Blood Pressure Measurement.

BACKGROUND: The Calor TensioSense Bras automatic blood pressure monitor has obtained European Union certification, but the clinical validity of this new oscillometric device when handled by lay subjects has yet to be evaluated. DESIGN: The design employed prospective and blinded blood pressure measurements and a validation procedure according to the criteria set out by the First International Consensus Conference on Self Blood Pressure Measurement (1999). METHODS: Thirty-three subjects were recruited, 11 in each of three strata of systolic blood pressure (<130, 130-160 and >160 mmHg). Blood pressure was measured sequentially seven times, alternating observer and lay measurements. Two certified observers used two mercury columns and a double stethoscope; the subjects used the automatic device. All blood pressure readings and recordings were blinded. Adequate cuff sizes were used, and the subjects' position was standardized. Discrepancy analysis between manual and automatic measurements was carried out using VAPA software. RESULTS: Dispersion of the discrepancies between manual and automatic measurements showed no specific trend. Out of the 99 systolic blood pressure measurements, 53, 76 and 89 discrepancies were less than 5, 10 and 15 mmHg, respectively. Of the 99 diastolic blood pressure measurements, 62, 86 and 97 discrepancies were less than 5, 10 and 15 mmHg, respectively. The mean inter-observer discrepancy was 1 mmHg for both systolic and diastolic blood pressure comparisons. CONCLUSION: This evaluation showed that this device complies with the international validation protocol requirements. Thus, the device can, providing adequate instruction is given in the clinic, be recommended for self-measurement by patients at home, as well as for clinical or epidemiological research.

Blood Pressure Determination↗
PubMedDate not supplied

Incontinence-associated dermatitis: a consensus.

Incontinence-associated dermatitis (IAD) is an inflammation of the skin that occurs when urine or stool comes into contact with perineal or perigenital skin. Little research has focused on IAD, resulting in significant gaps in our understanding of its epidemiology, natural history, etiology, and pathophysiology. A growing number of studies have examined clinical and economic outcomes associated with prevention strategies, but less research exists concerning the efficacy of various treatments. In the clinical and research settings, IAD is often combined with skin damage caused by pressure and shear or related factors, sometimes leading to confusion among clinicians concerning its etiology and diagnosis. This article reviews existing literature related to IAD, outlines strategies for assessing, preventing, and treating IAD, and provides suggestions for additional research needed to enhance our understanding and management of this common but under-reported and understudied skin disorder.

Clinical Protocols↗
PubMed2003

Assessing drinking outcomes in alcohol treatment efficacy studies: selecting a yardstick of success.

BACKGROUND: Although the number of alcohol treatment efficacy trials has mushroomed, there is no consensus on how best to measure outcomes. To advance the goal of establishing cross-trial consistency in measuring outcomes in clinical efficacy studies, the National Institute on Alcohol Abuse and Alcoholism convened a panel of experts and charged them with exploring, debating, and, ultimately, selecting a "sentinel" or "optimal" outcome measure to be used in future alcohol treatment studies. The goal of this article, one in a series of several presented at the National Institute on Alcohol Abuse and Alcoholism conference, is to discuss (1) the rationale underlying selection of an optimal outcome measure, (2) the necessary characteristics of an optimal outcome measure, (3) the utility of selecting an optimal measure, and (4) which drinking assessment methods could be used to collect data to portray the optimal outcome measure. METHODS: At a minimum, the criteria for an "optimal" measure include that it be psychometrically sound. In addition, it should have considerable currency in the field, thereby increasing its prospects for adoption. The measure should also be consistent with the concepts of greatest interest and relevance to the field (e.g., directly reflect the fundamental goal of alcohol treatment). In light of these highly desired features, percent of days heavy drinking was chosen at the conference as a practical and relevant measure of alcohol treatment outcome. CONCLUSIONS: Percent of days heavy drinking should be the optimal measure of alcohol treatment outcome. Currently, daily drinking estimation methods are the most useful for gathering data that can reflect the optimal measure. In addition, data gathered by daily drinking estimation methods can be used to study a variety of other outcome variables of interest to clinical researchers.

Alcohol Drinking↗
PubMed2004

Vasopressor and inotropic support in septic shock: an evidence-based review.

OBJECTIVE: In 2003, critical care and infectious disease experts representing 11 international organizations developed management guidelines for vasopressor and inotropic support in septic shock that would be of practical use for the bedside clinician, under the auspices of the Surviving Sepsis Campaign, an international effort to increase awareness and to improve outcome in severe sepsis. DESIGN: The process included a modified Delphi method, a consensus conference, several subsequent smaller meetings of subgroups and key individuals, teleconferences, and electronic-based discussion among subgroups and among the entire committee. METHODS: The modified Delphi methodology used for grading recommendations built on a 2001 publication sponsored by the International Sepsis Forum. We undertook a systematic review of the literature graded along five levels to create recommendation grades from A to E, with A being the highest grade. Pediatric considerations to contrast adult and pediatric management are in the article by Parker et al. on p. S591. CONCLUSION: An arterial catheter should be placed as soon as possible in patients with septic shock. Vasopressors are indicated to maintain mean arterial pressure of <65 mm Hg, both during and following adequate fluid resuscitation. Norepinephrine or dopamine are the vasopressors of choice in the treatment of septic shock. Norepinephrine may be combined with dobutamine when cardiac output is being measured. Epinephrine, phenylephrine, and vasopressin are not recommended as first-line agents in the treatment of septic shock. Vasopressin may be considered for salvage therapy. Low-dose dopamine is not recommended for the purpose of renal protection. Dobutamine is recommended as the agent of choice to increase cardiac output but should not be used for the purpose of increasing cardiac output above physiologic levels.

Cardiotonic Agents↗