Since the publication of the first EFNS task force reports in 1997, a total of 20 evidence-based guidelines for the treatment and management of neurological diseases have been published by the EFNS (http://www.efns.org/guidelines). In 2001, recommendations for the preparation of neurological guidelines were issued by the EFNS Scientific Committee (Eur ...

Guidelines for the management of chemotherapy-induced emesis are necessary to help clinicians match the emetogenicity of antineoplastic agents with the abundance of antiemetic agents now available. Numerous guidelines for antiemetic therapy currently exist, but compliance with them is inconsistent, in part because optimal antiemetic protection is not yet possible, even ...

Problems with tracheal intubation are infrequent but are the most common cause of anaesthetic death or brain damage. The clinical situation is not always managed well. The Difficult Airway Society (DAS) has developed guidelines for management of the unanticipated difficult tracheal intubation in the non-obstetric adult patient without upper airway ...

OBJECTIVE: To identify clinical practice guidelines from prominent US organizations for the initial management of urinary incontinence (UI) in women and compare them with recommendations from the International Consultation on Incontinence (ICI). The challenge of implementing guidelines in the US was also identified. METHODS: The medical literature was reviewed to ...

Little is known about how recent ISTSS practice guidelines (E. B. Foa, T. M. Keane, & M. J. Friedman, 2000) compare with prevailing PTSD treatment practices for veterans. Prior to guideline dissemination, clinicians in 6 VA medical centers were surveyed in 1999 (n = 321) and in 2001 (n = ...

The use of clinical practice guidelines (CPGs) to guide rational treatment of patients is hardly novel to most areas of medicine or pharmacy but is a relatively new concept in nephrology where practice patterns have been dictated predominantly by opinion. This situation has undergone significant and dramatic change in the ...

OBJECTIVE: To describe the Veterans Affairs (VA)/Department of Defense (DoD) Clinical Practice Guidelines for diabetes and contrast selected recommendations with those of the American Diabetes Association (ADA). RESEARCH DESIGN AND METHODS: We summarize the general structure of the VA/DoD Guidelines and describe the rationale for recommendations issued in 2003 for ...

A postal survey was undertaken to assess otolaryngologists' awareness, implementation and perceived weaknesses of the Scottish Intercollegiate Guidelines Network (SIGN) clinical guideline for the Management of Sore Throat and Indications for Tonsillectomy. The reply rate was 77 per cent. There was high awareness of the guideline and while 84 per ...

The NIH guidelines recommends hat practitioners give asthmatics written action plans with instructions on management of home (yellow zone) exacerbations. There is ambiguity regarding the definition of the yellow zone in patient-appropriate terms, and paucity of data on the efficacy of the different pharmacological interventions that can be used. This ...

To establish to what extent neurosurgeons subscribe to the lumbosacral radicular syndrome (LRS) guideline, and to evaluate their current management of patients with LRS against the guideline. All active neurosurgeons in the Netherlands (n=92) were mailed a questionnaire about the guideline and data from 66 responders were analysed. Patients were ...

The 2003 American Urological Association (AUA) guideline on management of benign prostatic hyperplasia (BPH) was released at the AUA annual meeting in Chicago, April 2003 and the diagnosis and treatment recommendations were published later in 2003. It is likely that the 2003 AUA guideline on the management of BPH will ...

OBJECTIVES: In mid-1997 the American College of Gastroenterology (ACG) published guidelines for the management of varices. The aim of this study is to assess the change in regional practice patterns between early 1997 (preguidelines) and 2000 (postguidelines). METHODS: Gastroenterologists in Oregon and Southwestern Washington state were sent a self-reporting questionnaire ...

The EDTNA/ERCA European Practice Database (EPD) questionnaire was piloted in the Czech Republic (CZ), Northern Italy and Northern England (N-ENG) in early 2003. The questionnaire used in the CZ and N-ENG featured additional questions on the use of erythropoetin (EPO) and intravenous (IV) iron. There were significant differences in the ...

OBJECTIVE: The study was undertaken to provide consensus guidelines for the management of women with a cytologic interpretation of high-grade squamous intraepithelial lesion (HSIL) on cytologic examination. This review article presents relevant literature supporting the proposed guidelines. PARTICIPANTS: An independent panel of 121 experts in various aspects of the diagnosis ...

Guidelines for the pharmacological treatment of heart failure (HF) are based on results from large clinical trials demonstrating benefit. State of the art pharmacological management of HF assumes that target doses should be the same as those used in trials. Thus equal doses are recommended for all in practical guidelines, ...

An audit against standards and guidelines of a representative sample of syphilis cases managed in genitourinary medicine clinics in Yorkshire was carried out. Satisfactory serological endpoints could be determined for about two-thirds of treated early and less than one-third of treated late syphilis cases. HIV antibody testing was obtained for ...

BACKGROUND: Although managed care organizations (MCOs) may be optimal settings for implementing tobacco use cessation clinical guidelines, such guidelines remain poorly implemented in many MCO settings. PURPOSE: We examined issues related to the implementation of guidelines in MCOs, to provide examples of studies that have addressed issues related to guideline ...

This Brief Report presents results of preliminary testing of a tool, "Attitudes Regarding Practice Guidelines," adapted from previous work by Cabana et al to examine barriers to adherence to practice guidelines. In a small sample of 21 clinicians (10 infectious disease physicians and 11 clinical nurses), the test-retest reliability was.86 ...

Clinical studies are among the most important literature published in the area of cardiovascular pharmacotherapy and are the basis of many of the standards of practice today. We compiled a list of these clinical trials, as well as well-written, up-to-date review articles and important treatment guidelines, that focus on pharmacotherapeutic ...

Clinical practice guidelines have emerged as a reality for medical practitioners over the past 20 years. Although virtually all groups interested in the development of practice guidelines hope for improvements in patient care, secondary expectations vary widely among those using them. Their use in daily practice by physicians has met ...

Obstructive sleep apnea syndrome (OSAS) is a common, under-recognized condition in childhood with significant morbidities if undiagnosed and untreated. The American Academy of Pediatrics recently issued a clinical practice guideline for the diagnosis and management of childhood OSAS. It was accompanied by a comprehensive evidence-based technical report that summarized the ...

OBJECTIVE: To determine whether consultant rheumatologists monitor the ocular toxicity of hydroxychloroquine according to standards set by national guidelines. METHOD: An observational cross-sectional questionnaire study of all consultant rheumatologists in the UK was undertaken. The main outcome measure was the proportion of rheumatologists who practise in compliance with nationally set ...

The causal relationship between dyslipidemia and atherosclerosis is well-documented. Screening and appropriate management of dyslipidemia by health care providers is imperative in both primary and secondary prevention of coronary artery disease, peripheral vascular disease, and stroke. In response to the release of new research data, clinical practice guidelines for the ...

It should be emphasized that these treatment practice guidelines are guidelines, not absolute recommendations for treatment. They represent an effort to distill and simplify an enormous body of knowledge and experience into fairly simple management algorithms. In general, treatment recommendations for primary tumors are based on better data than the ...

Clinical protocols and guidelines are widely used in the medi-cal domain to improve disease management techniques. Different software systems are in development to support the de-sign and the execution of such guidelines. The bottleneck in the guideline software developing process is the transformation of the text-based clinical guidelines into a ...

In A Theory of Justice, John Rawls demands from citizens who decide upon principles of justice and the rules derived from such principles that they abstract from all particularities that constitute their identity as unique individuals. This demand is unrealistic in policy settings where actual policy-makers convene to provide guidance, ...

This paper describes the architecture of NewGuide, a guide-line management system for handling the whole life cycle of a computerized clinical practice guideline. NewGuide components are organized in a distributed architecture: an editor to formalize guidelines, a repository to store them, an inference engine to implement guidelines instances in a ...

While clinical practice guidelines (CPGs) were designed as a tool to improve patient outcomes, decrease practice variation, and optimize resource utilization, providers often encounter significant barriers to integrating these into clinical practice. A study was conducted at six spinal cord injury (SCI) centers in the Department of Veterans Affairs (VA) ...

The Conference on Guideline Standardization (COGS) was convened to create a standardized documentation checklist for clinical practice guidelines in an effort to promote guideline quality and facilitate implementation. The statement was created by a multidisciplinary panel using a rigorous consensus development methodology. The Guideline Elements Model (GEM) provides a standardized ...

Presenting guidelines relating to cardiovascular disease (CVD) in a clinical decision support system (CDSS) is viewed as a mechanism for introducing evidence based practice in to daily practice. Analysis of guidelines on consistency is needed before constructing such a system. We analyzed 74 electronically available Dutch general practice guidelines for ...

Evidence-based medicine relies on the execution of clinical practice guidelines and protocols. A great deal of effort has been invested in the development of tools which can automate the representation and execution of the recommendations contained within such guidelines, by creating Computer Interpretable Guideline Models (CIGMs). Context-based task ontologies (CTOs), ...

OBJECTIVES: Promoting the adoption of clinical practice guidelines is a challenging task. Research shows that adopters' beliefs about guidelines and the process of their development are important predictors of guideline use. Our objective is to report on the development and refinement of an instrument designed to measure oncologists' assessments of ...

Part II of the guidelines contains a description of epidemiology, histopathology, clinical presentation, diagnostic procedure, treatment, and survival for each type of neuroendocrine tumour. We are not only including gastroenteropancreatic tumours but also bronchopulmonary and thymic neuroendocrine tumours. These guidelines essentially cover basic knowledge in the diagnosis and management of ...

BACKGROUND: Clinical practice guidelines are systematically developed statements designed to assist in patient and physician clinical decision making for specific clinical circumstances. In order to establish which guideline topics are priorities, practitioners were surveyed regarding their current practice. METHODS: One hundred ninety-seven practitioners in Ontario, Canada were mailed a survey ...

This paper presents two main questions that need to be answered before deciding to revise dietary guidelines: Is there really a need to revise existing guidelines? and How is dietary risk management to be integrated into dietary guidelines? Any group assigned the task of evaluating and possibly revising existing guides ...

PURPOSE: To determine whether patients with hypercholesterolemia were being treated according to the updated 2001 National Cholesterol Education Program (NCEP) clinical guidelines and whether a difference existed between internists and cardiologists in the implementation of these guidelines. DATA SOURCES: This retrospective study used data obtained from a review of 200 ...

A written document was developed to clarify the District's adult mosquito-management tactics to other interested individuals and agencies. The program described consists of 7 discrete components: 1) initiation criteria, 2) treatment area delineation, 3) agricultural and land-use practices, 4) meteorological conditions, 5) continuance criteria, 6) termination criteria, and 7) factors ...

Incident investigation standards and performance criteria continue to improve. In recognition, the Center for Chemical Process Safety (CCPS) undertook a major project to upgrade and update the Incident Investigation Guidelines originally published in 1992. These significantly expanded guidelines provide a practical resource for effective investigation of process-related incidents, and reflect ...

These guidelines for management of pemphigus vulgaris have been prepared for dermatologists on behalf of the British Association of Dermatologists. They present evidence-based guidance for treatment, with identification of the strength of evidence available at the time of preparation of the guidelines, and a brief overview of epidemiological aspects, diagnosis ...

This is one of a series of statements discussing the utilization of GI endoscopy in common clinical situations. The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy prepared this text. In preparing this guideline, a MEDLINE literature search was performed, and additional references were obtained from the ...

BACKGROUND: The production of clinical guidelines is increasing and will continue to do so with the introduction of clinical governance. In 1997, the British Orthopaedic Association (BOA) and the British Association of Plastic Surgeons (BAPS) published joint guidelines on the management of open tibial fractures. It is not known whether ...

OBJECTIVES: To assess physician awareness and reported use of medical guidelines for community-acquired pneumonia (CAP), and to identify factors associated with variations in awareness and use of these guidelines. DESIGN: A questionnaire was administered during the preintervention phase of a randomized clinical trial of a pneumonia guideline implementation strategy. PARTICIPANTS: ...

PURPOSE: To discuss the newest 2001 changes in The Bethesda System of cervical cytology classification and management guidelines for abnormal Pap smears. DATA SOURCES: Extensive review of scientific literature and consensus guidelines. CONCLUSIONS: Decision making about abnormal cervical cytology can be frustrating and controversial. It is imperative that nurse practitioners ...

The guidelines recommended in the literature for the convergence angle of a crown preparation vary from 3 to 24 degrees. There is a lack of guidelines on techniques to achieve a specific axial inclination. The purpose of this article was to present a practical technique, with a diamond rotary cutting ...

These suggested practice guidelines extensively evaluate reviewed risk-based data and indicate useful current approaches for managing MDS. Given the limited number of studies comparing different therapies in MDS, most of the therapeutic drugs used to treat this disease should be assessed in the context of clinical trials. A number of ...

Despite enormous energies invested in authoring clinical practice guidelines, the quality of individual guidelines varies considerably. The Conference on Guideline Standardization (COGS) was convened in April 2002 to define a standard for guideline reporting that would promote guideline quality and facilitate implementation. Twenty-three people with expertise and experience in guideline ...

Clinical practice guidelines are a tool to assist with clinical decision making. They provide information about the care for a condition and make recommendations based on research evidence, which can be adapted locally. A focus group within the Allied Health Interest Group of the Australian and New Zealand Burn Association ...

OBJECTIVES: To perform a process evaluation of a multifaceted intervention to improve cardiovascular and diabetes care in general practice. METHODS: The feasibility of the intervention, carried out by outreach visitors in 62 practices, was addressed by evaluating whether the intervention programme was performed as planned and the extent to which ...

This paper describes a prospective audit of all induced abortions performed between May and July 2000, in a Buckinghamshire district general hospital, to evaluate practice compared to the Royal College of Obstetricians and Gynaecologists Guidelines (RCOG Evidence-Based Guideline No. 7, 2000). Areas for improvement were identified and department guidelines were ...

Although clinical practice guidelines (CPGs) have been suggested as a means of encapsulating best practice in evidence-based medical treatment, their usage in clinical environments has been disappointing. Criticisms of guideline representations have been that they are predominantly narrative and are difficult to incorporate into clinical information systems.