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Results for “Consensus Statements as Topic”

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At least 937 records · Page 52Linked to original sources
PubMed2002

Guidelines and algorithms for the use of methylphenidate in children with Attention-Deficit/ Hyperactivity Disorder.

OBJECTIVE: To review published algorithms for guiding the use of methylphenidate (MPH) in the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in children and adolescents. METHODS: A consensus roundtable of 12 experts was convened to review the evidence for the safety and efficacy of MPH in the treatment of ADHD, as well as the published algorithms and practice guidelines for using MPH. The experts reviewed the algorithms for practicality and acceptability by clinicians. RESULTS: Algorithms that included MPH commonly selected it as the initial medication to be employed in the treatment of children with ADHD. Factors involved included its high efficacy, good safety record, and the ubiquitous nature of its appearance in the ADHD treatment literature. CONCLUSIONS: MPH should be considered as the first medication to be used in a treatment algorithm for children and adolescents with ADHD.

Adolescent↗
PubMedDate not supplied

A critique of the ACCP consensus conference on mechanical ventilation. American College of Chest Physicians.

The American College of Chest Physicians recently published a statement summarizing the results of the Consensus Conference on Mechanical Ventilation (Chest 1993; 104:1833-1859). In this statement, the physiology of mechanical ventilation was extensively reviewed, and 5 principles and 38 guidelines or recommendations on which consensus was reached were presented. The following critique (1) summarizes the findings of the conference; (2) comments on selected principles, recommendations, and physiological concepts presented in the statement; and (3) discusses the strengths and the limitations of the consensus conference format, as well as the errors and biases inherent in the policy-making process. The Consensus Conference statement is one of the clearest, most complete reviews of physiology and techniques of mechanical ventilation I have yet encountered. The suggested guidelines and recommendations clearly follow from the physiological principles discussed. Unfortunately, numerous problems with the consensus conference format and the almost total lack of controlled randomized studies limit the confidence with which these suggestions can be accepted. Our experts in respiratory care are remiss for not providing outcome-based or preference-based data, and the pulmonary and critical care community is remiss for not demanding that they do so before changing our approaches on the basis of their suggestions.

Bias↗
PubMed1994

Cariogenicity tests.

An American Dental Association Scientific Consensus Conference on Methods for the Assessment of the Cariogenic Potential (CP) of Foods was held in San Antonio, Texas, in 1985. The aim was to establish a scientific consensus regarding methods to assess the CP of foods. As a result, a sequential food-testing program was proposed involving Animal Caries, Human Plaque Acidity, and Demineralization/Remineralization Models. Two categories of CP--namely, no CP and low CP--were included. The test protocol has hardly been followed since, primarily because the category of low CP was not considered useful in dietary counseling. It is advocated that research into possible caries-preventive factors of food will be more beneficial for improvements of the oral health of the general population than assessments of low CP.

Animals↗
PubMed2000

Promoting good research practice.

Embarking on a new millennium provides the stimulus both to take stock and also to look forward. In the field of medical statistics there is much to make us feel proud and excited. Rapid methodological developments together with parallel developments in computer technology have enormously expanded our statistical repertoire. At the same time, the high profile attained by the evidence-based medicine movement means that the importance of our discipline is recognized more widely then ever before. However, any medical statistician who is involved in medical publishing, or who is even a regular reader of the medical literature, must be aware of the yawning chasm between what is recognized as good statistical practice and what is actually published. Poor study design, inappropriate analysis and selective reporting are commonplace. In my opinion the most important challenge currently facing our profession is the task of bridging this chasm.

Consensus Statements as Topic↗
PubMed1998

Expert panel assessment of appropriateness of abdominal aortic aneurysm surgery: global judgement versus probability estimation.

OBJECTIVE: To compare an expert panel's global assessment of appropriateness of elective surgery for abdominal aortic aneurysms (AAA) with their assessment of the effect of surgery on the probability of 5-year mortality. METHODS: Nine expert panel members rated the appropriateness of 120 scenarios for elective AAA repair on a nine-point scale, and also estimated the 5-year probability of AAA-related death and of non-AAA related death among 30-day survivors of AAA surgery and among patients with unoperated AAA. These probabilities were used to determine differences in 5-year probability of mortality of surgery vs. no surgery for each scenario. Three categories of appropriateness were defined based on these differences: inappropriate (< 0%), equivocal (0-5%), and appropriate (> 5%). RESULTS: The distribution of scenarios was inappropriate (39%), equivocal (12%), and appropriate (49%) based on probability estimates and inappropriate (43%), equivocal (22%), and appropriate (36%) based on global assessment. There was poor agreement between the two methods, with a Kappa coefficient = 0.28 (95% CI: 0.23 to 0.32). Although a higher proportion of scenarios were rated as appropriate using probability estimation rather than global judgment, the level of agreement among members of the panel was similar, Kappa coefficient = 0.07 (95% CI: -0.07 to 0.72). CONCLUSIONS: Experts disagree about the appropriate indications for elective surgery for AAA. Explicit estimates used in a decision analysis may provide a better assessment of appropriate indications than the global judgment of experts. Global assessment of the appropriateness of AAA surgery based on panel members' review of research evidence for increased survival appears to include implicitly their valuation of outcomes.

Aortic Aneurysm, Abdominal↗
PubMed2001

Hematology grants workshop-2001.

This year the Hematology Grants Workshop, chaired by Dr. Todd, includes a comprehensive listing of available National Institutes of Health, Department of Veterans Affairs, and non-federal grants applicable to fellows and junior faculty as well as to established investigators. In Section II, Dr. Miller discusses the essential principles of successful grant writing with a special emphasis on the young investigator. He highlights the best strategies to take and the common mistakes to avoid. In Section III, Dr. Silverstein outlines the structure of the current NIH Integrated Review Group (IRG) system and the study sections of the most relevance to hematology. He traces the path that a grant takes from review to funding including the way in which grants are reviewed at NIH Study Section Meetings and provides advice in the preparation of revised applications.

Consensus Statements as Topic↗
PubMed2003

Hematology grants workshop.

Uppermost among the many concerns of young researchers is acquiring funding for beginning a career as a clinician-scientist. This chapter is targeted specifically at those individuals considering an academic physician-scientist career and those on the verge of becoming independent researchers. In Section I, Drs. Poncz and Iannone discuss the Mentored Career Development Award (K08). They summarize the application process, highlighting the critical components of a successful application and what the review process entails. In Section II, Dr. Werner discusses what applicants need to know about the NIH Institutes' program, review, and grants management function; the different NIH staff whom applicants should contact during the various stages of the grants process; and the important sections and key phrases in NIH Program Announcements for career development awards.

Consensus Statements as Topic↗
PubMed2005

Stability of response characteristics of a Delphi panel: application of bootstrap data expansion.

BACKGROUND: Delphi surveys with panels of experts in a particular area of interest have been widely utilized in the fields of clinical medicine, nursing practice, medical education and healthcare services. Despite this wide applicability of the Delphi methodology, there is no clear identification of what constitutes a sufficient number of Delphi survey participants to ensure stability of results. METHODS: The study analyzed the response characteristics from the first round of a Delphi survey conducted with 23 experts in healthcare quality and patient safety. The panel members had similar training and subject matter understanding of the Malcolm Baldrige Criteria for Performance Excellence in Healthcare. The raw data from the first round sampling, which usually contains the largest diversity of responses, were augmented via bootstrap sampling to obtain computer-generated results for two larger samples obtained by sampling with replacement. Response characteristics (mean, trimmed mean, standard deviation and 95% confidence intervals) for 54 survey items were compared for the responses of the 23 actual study participants and two computer-generated samples of 1000 and 2000 resampling iterations. RESULTS: The results from this study indicate that the response characteristics of a small expert panel in a well-defined knowledge area are stable in light of augmented sampling. CONCLUSION: Panels of similarly trained experts (who possess a general understanding in the field of interest) provide effective and reliable utilization of a small sample from a limited number of experts in a field of study to develop reliable criteria that inform judgment and support effective decision-making.

Consensus Statements as Topic↗
PubMed2006

Gaining insight into the Clinical Practice Guideline development processes: qualitative study in a workshop to implement the GRADE proposal in Spain.

BACKGROUND: The GRADE method represents a new approach to grading the quality of evidence and strength of recommendations in the preparation of Clinical Practice Guidelines (CPG). In the context of a pilot study to assess the implementability of the system in Spain, we considered it relevant to gain an insight into the significance of the perceptions and attitudes expressed by the actual experts participating in the system try-out. METHODS: Qualitative research with an ethnographic approach, through non-participant observation and focus groups within the context of a consensus workshop in which 19 CPG experts participated to evaluate the GRADE proposal using 12 evidence tables taken from hypertension, asthma and arthritis CPGs. The interventions were recorded, under a guarantee of confidentiality. The transcriptions and field notes were analyzed, based on a sociological discourse analysis model, and the provisional findings were re-sent to participants in order to improve their validity. RESULTS: 1) Certain problems over procedure and terminology hindered the acceptance of this new method as a common reference system for the preparation of CPGs. 2) A greater closeness to clinical practice was accompanied by concerns over value judgments and subjectivity, with a demand for greater explicitness in the consensus process. 3) The type of "evidence" on which the guidelines are based, how and by whom the evidence is prepared, and what the role of the different actors should be, all constitute unresolved concerns in the CPG preparation and implementation processes. 4) The grading process is not neutral: professional background, prior experience and the degree of leadership all condition the participants' input and interactions. CONCLUSION: The findings obtained allow the quantitative evaluation to be better interpreted and, in turn, go beyond the particularities of the GRADE method. Adaptation to the complexities of clinical practice, the need for carefully designed multi-disciplinary work and the reflexivity present in the CPG preparation process, all represent lines of debate that are necessary to improve the CPG quality in the Spanish health care sector.

Anthropology, Cultural↗