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PubMed1991

The false consensus bias as applied to psychologically disturbed adolescents.

In order to examine whether the false consensus bias applied to psychologically disturbed adolescents, outpatients at a rural mental health center who described themselves as very depressed or suicidal, and nondisturbed teenagers (who had no history of psychological treatment and were not at that time seeking psychological treatment), were asked to read a newspaper article about either a child's suicidal or viral illness death. Both groups of adolescents, like adults in previous research, viewed the suicidal child and the surviving family more negatively than they did the child and survivors of a viral illness death. Further, consistent with the false consensus hypothesis, adolescent clients viewed either child as more psychologically disturbed than did nonclients. Also, clients, as compared to nonclients, viewed both parents as more psychologically disturbed prior to either child's death. Results somewhat support the hypothesis of a false consensus bias which operates for depressed, suicidal adolescents when they view the tragedy of a child's death, but not when they are making recommendations about psychological help for the surviving family. Results are interpreted as suggesting that adolescent outpatients either view therapy as not particularly beneficial or as not particularly appropriate for bereaved individuals.

Adolescent↗

PubMed1990

Two mutations of the factor IX gene including a donor splice consensus deletion and a point mutation in a Dutch patient with severe hemophilia B.

The abnormal factor IX gene of a patient with severe hemophilia B (hemophilia B Ursem) was selected for study. All of the coding and their flanking regions and parts of the 5'- and 3'-untranslated regions of the factor IX gene were amplified from the patient's genomic DNA by using the polymerase chain reaction (PCR). By analyzing the nucleotide sequence of the PCR products we have identified two mutations in the patient's factor IX gene, viz. a tetranucleotide deletion (GAGT, nt 6492 to 6495) or (TGAG, nt 6491 to 6494) in the 5'-donor splice site consensus at the exon 2-intron B boundary, and a point mutation at nucleotide 31103 in the catalytic domain (exon 8) of factor IXa, which changes the codon for valine 328 (GTT) to one for isoleucine (ATT). PCR-amplified exon 8 from 45 normal males and 55 normal females had the codon for valine-328. We propose that the deletion within the donor splice-site consensus is the cause of the disease in this individual, whereas the substitution of valine-328 by isoleucine may be a neutral variant which is, at least, very rare in the normal population. In a family study the DNA sequence of the patient's mother shows both the G to A transition in exon 8 and the 5'-donor splice consensus deletion in intron B in one allele.

Amino Acid Sequence↗

PubMed1985

Consensus symmetry pattern in E. coli promoter sequences.

A computer method was used to select two subgroups in 172 Escherichia coli promoter nucleotide sequences characterized by "standard" 17 bp and "non-standard" 17 +/- 2 bp spacing between the Pribnow box and -35 region. The conservation of the two-fold rotational (2f) and true palindrome (tp) symmetry relations was determined between nucleotide doublets in both promoter subgroups which represent consensus symmetry patterns. Statistically significant symmetries were primarily distinguished from those established by the nucleotide sequence conservation. The consensus symmetry pattern of standard promoters involves 45 of the 60 promoter nucleotide positions at which less strongly conserved and non-conserved sequences were mostly occupied (per se). They also show a high level of symmetry centre conservation. The conservation of the statistically significant 2f symmetry centres at positions -4.5 and -31.5 suggests partial conservation of the Pribnow box and -35 pentamer in the codogenic strand in an opposite orientation, respectively. The non-standard promoters differ from the standard ones by the consensus symmetry pattern and by the 2f and tp symmetry centre distribution with an overall lower degree of symmetry conservation in the -35 region. It has been suggested that the conserved symmetry relations provide an additional condition necessary for the specific interaction of RNA polymerase with the promoter sequence to initiate transcription.

Base Sequence↗

PubMed1985

Health implications of obesity: an NIH Consensus Development Conference.

In February 1985, in Bethesda, MD, the National Institutes of Health held a Consensus Development Conference on the Health Implications of Obesity. Nineteen experts in pertinent subject areas presented the current state of the art to a panel of 15 senior-level professionals. On the basis of the scientific evidence presented and its discussion by the audience, the panel formulated a "consensus statement" of findings and recommendations in the form of a narrative reply to six key questions focused on the health implications of obesity. This article summarizes the results of the consensus conference and discusses the conclusions and recommendations of the panel and their implications for the dietetic profession. Also provided, as a practical tool for the dietitian, are two nomograms indicating body mass index and desirable weight and 20% and 40% overweight levels for men and women of different heights and weights.

Adult↗

PubMedDate not supplied

Consensus guidelines for product sterilization.

Sterilization requires a thorough understanding of both technical and regulatory requirements. The development of consensus guidelines has proven to be an effective method of establishing sterilization practices that can meet both regulatory and technical requirements. Regulatory rules prepared without industry participation have proven to be more costly and less effective than consensus guidelines. The AAMI recommended practice, Guideline for Industrial Ethylene Oxide Sterilization of Medical Devices, exemplifies the value of the consensus approach.

Equipment and Supplies↗

PubMed1994

World health organization (WHO) consensus questionnaire on validity of methods for assessment of carcinogenicity of man-made fibers.

In May 1992, the WHO European Office held an expert consultation on the assessment of carcinogenicity of man-made fibers. WHO decided to determine whether the conclusions of such an expert consultation would be supported by scientific opinion internationally. For this experiment, WHO sent the 28 conclusions of the consultation, as a Consensus Questionnaire, to scientists worldwide seeking agreement, or otherwise, with the conclusions. Two hundred scientists responded. For every conclusion, at least 70% of respondents agreed, and for over half the conclusions more than 90% agreed. For some conclusions there were significant differences by country of respondent and/or by work environment. Respondents from the U.S.A., or in Government employ, tended to agree with the questions less often, and those from Germany, or from Industry, most often. The disagreements were most often related to questions concerned with the models for assessing carcinogenicity, but in every case the disagreements were expressed by fewer than one in three of respondents. There was minority opinion that the inhalation model was not adequately sensitive for assessing human hazards and that the intraperitoneal test could give validated answers on the carcinogenicity of fibers. Three questions demonstrated significant variability in response rate both from country to country and by work environment group. Each of the original WHO conclusions was concerned with shortcomings of the intraperitoneal test, when used for carcinogenicity classification. For these questions, the overall agreement rates were 85 to 91%. Respondents from U.S.A. and from Government disagreed with the WHO conclusions more often than others. Those from Germany and in Research agreed most often. This experiment has shown that the Consensus Questionnaire approach can be used to seek international scientific opinion. It has also shown that the conclusions of future expert consultations need to be formulated in a manner suitable for the Consensus Questionnaire approach, to avoid the ambiguities that can arise if too many concepts are included within a single conclusion.

Air Pollutants, Occupational↗

PubMed1995

Enhancing physician adoption of practice guidelines. Dissemination of influenza vaccination guideline using a small-group consensus process.

BACKGROUND: A dissemination intervention to facilitate adoption of a preventive practice guideline (influenza vaccination for older adults) in group practices was developed and evaluated. The intervention, small-group consensus process, started with a physician expert presenting the guideline and followed with the group participating in a structured discussion of ways to implement the guideline that culminated in a public commitment (ie, "buy in") to adopt the guideline. METHODS: Thirteen group practices and their primary care physicians (mean size, 5) were assigned randomly to intervention or control arms. In each group practice, physicians in the intervention arm met for 1 hour. Control physicians participated in an unrelated discussion (non-steroidal drug use). Guideline adoption was determined by changes in physicians' vaccination rates that were obtained through prechart and postchart reviews of 51 physicians. Prequestionnaires and postquestionnaires measured influenza knowledge and prevention attitudes. RESULTS: Using analysis of covariance, the small-group consensus process was found to increase physician vaccination rates by 34% compared with the control arm (F (1,48) = 19.49). All intervention arm physicians increased vaccination rates from before to after compared with 54% of control arm physicians. Attitudes and knowledge did not change and were unrelated to increased vaccination rates. CONCLUSIONS: A case is made for the small-group consensus process as an effective utilization-focused dissemination method. Interventions based on group dynamics and sensitive to local practice contexts can be useful in facilitating adoption of guidelines by physicians in group practices.

Decision Making↗

PubMed1994

[Reestimation of aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio based on JSCC consensus method--changes of criteria for a differential diagnosis of hepatic disorders following the alteration from Karmen method to JSCC method].

We estimated clinical criteria of aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio that is measured by the consensus method of JSCC (Japan Society of Clinical Chemistry) for serum AST and ALT. The JSCC consensus method is closely correlated with both IFCC (International Federation of Clinical Chemistry) recommended method without pyridoxal phosphate and Karmen method recommended by the expert panel of liver function tests in Japanese Society of Gastroenterology. The slopes of the regression line is estimated to be 1.00 and 0.87 respectively. We propose that the decision making value of AST/ALT ratio to differentiate several types of liver diseases should be set to 0.87 measured by JSCC consensus method, instead of 1.0 measured by Karmen method.

Alanine Transaminase↗

PubMed1993

Consensus AP-1 and CRE motifs upstream from the human cytotoxic serine protease B (CSP-B/CGL-1) gene synergize to activate transcription.

The human CGL-1/cytotoxic serine protease B gene (CSP-B; also known as granzyme B) is transcriptionally activated during cytotoxic T-lymphocyte maturation. Activation can be mimicked in the PEER T-cell leukemia cell line by treatment with 12-O-tetradecanoylphorbol-13-acetate (TPA) and N6-2'-O-dibutyryladenosine 3',5'-cyclic monophosphate (bt2cAMP). In this report, we show that a consensus AP-1 element and a consensus cAMP response element (CRE) located 5' to the CSP-B transcriptional start site are both required for transcriptional activation of the CPS-B promoter in TPA + bt2cAMP-stimulated PEER cells. A 94-bp fragment containing both elements activates a heterologous promoter in an orientation-independent fashion. Several single nucleotide substitutions in the AP-1 site abolish activity of the 94-bp fragment. Several point mutations in the consensus CRE substantially reduce promoter activity, but one CRE mutation increases activity fourfold. Replacement of the CRE with a second copy of the AP-1 site results in a level of transcriptional activity comparable with that of the wild-type sequence, but replacement of the AP-1 site with a CRE abolishes activity. Neither the AP-1 site nor the CRE can be effectively replaced with an SP-1 site. Deletions between the AP-1 site and the CRE retain full activity only if helical spacing is preserved, suggesting that synergism between these two elements is either the result of cooperative binding of factors to the DNA or of cooperative binding of DNA-bound factors to another protein.

Base Sequence↗

PubMed1996

Development of consensus guidelines for conditions commonly managed in general practice. Royal Australian College of General Practitioners.

OBJECTIVE: Initially, the project objective was to develop audit protocols for commonly managed conditions in general practice. However, as the nature of the project evolved these objectives changed to developing consensus guidelines. METHOD: An iterative process was undertaken using mail-outs to gain items for potential inclusion in an audit protocol. This resulted in a change of direction to management guidelines. Consensus, as to the validity of inclusion of items in each guideline, was then achieved by continuing to use an iterative process. RESULTS: Guidelines for 30 presenting complaints were developed. Because a number of differential diagnoses were possible for each complaint, a total of 105 guidelines were developed. A total of 263 general practitioners participated. CONCLUSION: The concept of discriminant actions was developed. It was agreed that this described the clinical decision making that occurs in the general practices of participating practitioners. It is feasible to use an iterative method undertaken by mail to develop consensus guidelines for conditions that are commonly managed by general practitioners.

Australia↗

PubMedDate not supplied

Awareness of consensus preventive medicine practice guidelines among primary care physicians.

INTRODUCTION: Since documented low use of preventive medicine practices may be due to lack of acquaintance with recommended practices, we measured the level of awareness of specific consensus recommendations and assessed factors that might influence awareness. METHODS: We surveyed 326 randomly selected Kansas primary care physicians stratified by urban-rural location and medical specialty (family practice, internal medicine, obstetrics-gynecology, and pediatrics) using a structured computer-assisted interview or questionnaire composed of 11 specialty-specific multiple choice knowledge questions based on selected published consensus recommendations. RESULTS: With a 90% response rate to our survey, chi 2 testing and analysis of variance (ANOVA) showed (1) correct response rates ranging from 27% (hypertension treatment threshold) to 99% (follow-up mammography) with a correct response rate of at least 70% for seven of the 11 questions; (2) no consistent differences for overall correct response rates among medical specialties and between practice location, gender, years in practice, preventive medicine exposure during residency or through continuing medical education courses, or acquaintance with source publications; and (3) higher correct response rates for six of 11 questions among physicians with board certification. CONCLUSIONS: Our results suggest that low use of prevention practices by physicians is likely due to factors other than lack of physician knowledge of published consensus recommendations.

Analysis of Variance↗

PubMed1995

Informed consent in emergency research. Consensus statement from the Coalition Conference of Acute Resuscitation and Critical Care Researchers.

OBJECTIVE: A coalition conference of acute resuscitation researchers was held to discuss the feasibility of applying current federal research regulations regarding informed consent to the emergency setting. This article presents consensus recommendations for regulatory changes for consent in emergency research. PARTICIPANTS: Representatives from the Society for Academic Emergency Medicine and the American Heart Association identified several professional organizations as stakeholders in this issue, including research, clinical, bioethics, legal, and patient advocacy groups. The Office for Protection From Research Risks (OPRR), the Food And Drug Administration (FDA), and staff from specific legislative offices were also invited to observe. Forty-three participants attended, including representatives from 12 professional organizations, five medical institutions, and the FDA and OPRR. This was a closed meeting. Participants were self-funded or sponsored by their professional organizations. EVIDENCE: Before the meeting, a draft of a position statement was developed by the conference organizers based on the current literature and discussions with experts in the field. This draft, copies of the current federal research regulations, and supporting articles were distributed before the conference. CONSENSUS PROCESS: Participants rotated through moderated discussion sessions to comment on subsections of the draft. Following discussion, a working draft was developed and distributed to each participant and represented organizational board for final review. All comments were considered in the final version of the document. CONCLUSIONS: We believe there are circumstances when it is not feasible to obtain prospective or proxy consent for enrollment into an emergency research protocol. In these circumstances, patients are vulnerable, not only to research risks, but also to being denied potentially beneficial therapy when there is no known effective treatment for their life-threatening condition. We offer recommendations that should be met when the critical nature of the illness or injury or the need to apply an investigational therapy rapidly precludes prospective consent for participation in emergency research.

Consensus↗

PubMed2006

Report on the second Latin American consensus conference for flow cytometric immunophenotyping of hematological malignancies.

On May 3 and 4, 2005, the Second Latin American Consensus Conference for the Immunophenotyping of Hematological Malignancies took place in Queretaro, México, with representatives from 10 countries of the region and two external consultants. This document summarizes the major conclusions for which consensus were achieved. Major differences regarding the recommendations from the first conference, which took place 9 years ago, concern the medical indications and the antibody panels for immunophenotyping. The aim of disseminating these guidelines to the international community is based on the potential interest for other countries with similar socioeconomic conditions.

Antibodies, Monoclonal↗

PubMed2005

Abnormal uterine bleeding and underlying hemostatic disorders: report of a consensus process.

An ad hoc consensus group determined that the prevalence of von Willebrand's disease in females with heavy menstrual bleeding is approximately 13%, but the severity of the disorder varies and, consequently, the overall clinical impact remains unknown. Consensus recommendations are presented, which include [1] a structured history for screening females with heavy menstrual bleeding; [2] a collaborative, multidisciplinary evaluation, and [3] a strategy for future basic science and clinical investigation.

Blood Coagulation Disorders↗

PubMed2005

Proceedings of a consensus conference: towards an understanding of TRALI.

Transfusion-related acute lung injury is a relatively uncommon transfusion-associated adverse effect occurring during or soon after an allogeneic blood transfusion. Transfusion-related acute lung injury is a complex syndrome that has many manifestations and has only recently been identified to be an important cause of transfusion-associated morbidity and mortality. But despite its increasing recognition, much about the pathogenesis, treatment, and prevention is poorly understood and often controversial. The purpose of this consensus conference was to bring together international experts in an effort to try to standardize a case definition, which could be used to enhance future understanding of transfusion-related acute lung injury including its epidemiology, pathogenesis, management, prevention, and research. These proceedings are being provided with a view to making available to the transfusion medicine community the considerable amount of important information presented at this consensus conference by the invited international panel of experts.

Adult↗

PubMed2026

Chinese expert consensus on precision testing and molecular diagnosis of pancreatic cancer (2025).

This consensus by the CSCO Pancreatic Cancer Expert Committee establishes evidence-based guidelines for molecular testing in pancreatic ductal adenocarcinoma. It details recommendations for biomarkers (e.g., KRAS, BRCA, MSI), liquid biopsy, and precision imaging to direct targeted therapies and immunotherapy, aiming to standardize diagnosis and optimize individualized patient care. Pancreatic ductal adenocarcinoma (PDAC) is the most common pathological type of primary pancreatic malignancy, accounting for ~95% of cases and generally referred to as pancreatic cancer [1]. Its prognosis is extremely poor and its incidence continues to rise [2]. According to the most recent global cancer statistics, the incidence of pancreatic cancer ranks 12th among all cancers, and its mortality ranks 6th, making it one of the deadliest malignancies worldwide [3]. Approximately 57% of patients have metastatic disease at diagnosis and require systemic therapy, for which chemotherapy remains the standard first-line option [1]. However, the overall response rate to currently available systemic regimens is low, and the 5-year survival rate for patients with metastatic disease remains below 5% [3]. Although most pancreatic cancers harbor canonical driver mutations, they exhibit marked heterogeneity at the molecular level. Whole-genome sequencing (WGS) and integrative genomic analyses have identified molecular subtypes of PDAC with potential clinical relevance [4-9]. With the increasing implementation of precision oncology, the Chinese Society of Clinical Oncology (CSCO) Guidelines for the Diagnosis and Treatment of Pancreatic Cancer give a level 1 recommendation to perform genetic and other molecular testing on tissue or cytologic specimens as part of the pathological diagnostic work-up, in order to guide individualized treatment, including targeted therapy and immunotherapy [10]. To further promote the use of genetic and molecular testing in the precision treatment of pancreatic cancer, the CSCO Pancreatic Cancer Expert Committee convened a multidisciplinary panel to develop the present Chinese Expert Consensus on Precision Testing and Molecular Diagnosis of Pancreatic Cancer (2025), aiming to provide clinicians with an authoritative reference for precision diagnostics and treatment decision-making.

Humans↗

PubMed2002

Diagnosis of gastrointestinal stromal tumors: A consensus approach.

As a result of major recent advances in understanding the biology of gastrointestinal stromal tumors (GISTs), specifically recognition of the central role of activating KIT mutations and associated KIT protein expression in these lesions, and the development of novel and effective therapy for GISTs using the receptor tyrosine kinase inhibitor STI-571, these tumors have become the focus of considerable attention by pathologists, clinicians, and patients. Stromal/mesenchymal tumors of the gastrointestinal tract have long been a source of confusion and controversy with regard to classification, line(s) of differentiation, and prognostication. Characterization of the KIT pathway and its phenotypic implications has helped to resolve some but not all of these issues. Given the now critical role of accurate and reproducible pathologic diagnosis in ensuring appropriate treatment for patients with GIST, the National Institutes of Health convened a GIST workshop in April 2001 with the goal of developing a consensus approach to diagnosis and morphologic prognostication. Key elements of the consensus, as described herein, are the defining role of KIT immunopositivity in diagnosis and a proposed scheme for estimating metastatic risk in these lesions, based on tumor size and mitotic count, recognizing that it is probably unwise to use the definitive term "benign" for any GIST, at least at the present time.

Antineoplastic Agents↗

PubMed2002

The Italian gynecological consensus statement on the use of epoetin alfa in the management of anemia.

A Consensus Conference on the use of recombinant human erythropoietin (rHuEPO, epoetin alfa) in gynecologic tumors was held in Rome in March 1999, and an associated consensus paper has been published in Italian. The current paper updates several discussions that took place at the 1999 meeting concerning epoetin alfa treatment in breast, ovarian, and cervical cancers; the role of epoetin alfa in mobilizing progenitor hematopoietic cells; administration of epoetin alfa in combination with granulocyte colony-stimulating factor; and the effect of hemoglobin levels on outcome of radiation or chemoradiation treatment.

Anemia↗