Context, automated decision support, and clinical practice guidelines: Does the literature apply to the United States practice environment?

2007 ◽  
Vol 76 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Sarah R. Edmonson ◽  
Kimberly A. Smith-Akin ◽  
Elmer V. Bernstam
Keyword(s):  
United States ◽  
Clinical Practice ◽  
Decision Support ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
The United States ◽  
Practice Environment

Gastric Cancer Clinical Practice Guidelines in Oncology

2003 ◽  
Vol 1 (1) ◽  
pp. 28 ◽  
Keyword(s):  
United States ◽  
Gastric Cancer ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
The United States ◽  
Major Health Problem ◽  
Major Health ◽  
Recent Version ◽  
Upper Gastrointestinal

Carcinomas originating in the upper gastrointestinal tract constitute a major health problem around the world. In fact, experts estimate that approximately 34,700 new cases of upper gastrointestinal carcinomas and 25,000 deaths will have occurred in the United States in 2002. This article summarizes the NCCN clinical practice guidelines for managing gastric cancer, which portray uniformity in the systemic approach to cancer in the United States. The article also discusses anticipated future advances in the treatment of gastric carcinoma. For the most recent version of the guidelines, please visit NCCN.org

Impact of Revised Infectious Diseases Society of America and Society for Healthcare Epidemiology of America Clinical Practice Guidelines on the Treatment of Clostridium difficile Infections in the United States

2020 ◽  
Author(s):  
Cornelius J Clancy ◽  
Deanna Buehrle ◽  
Michelle Vu ◽  
Marilyn M Wagener ◽  
M Hong Nguyen
Keyword(s):  
United States ◽  
Clinical Practice ◽  
Clostridium Difficile ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Day Treatment ◽  
The United States ◽  
Prescription Data ◽  
Oral Vancomycin ◽  
Oral Metronidazole

Abstract Background Our objective was to determine if oral vancomycin, fidaxomicin, and oral metronidazole use in the United States changed after publication of revised clinical practice guidelines for Clostridium difficile infection (CDI) in February 2018. Methods We obtained US antibiotic prescription data (IQVIA) from 2006–August 2019 and used guideline-recommended dosing regimens to estimate monthly numbers of 10-day treatment courses of vancomycin, fidaxomicin and metronidazole. Interrupted time-series analyses were performed, adjusted by month. We compared linear trends for monthly numbers of treatment courses in different time periods. Results Cumulative treatment courses of oral vancomycin and fidaxomicin increased by 54% (n = 226 166) and 48% (n = 18 518), respectively, in 18 months following guidelines compared with 18 months before; those of oral metronidazole decreased by 3% (n = 238 372). Monthly vancomycin and fidaxomicin use significantly increased throughout the period following revised guidelines (P < .0001 and P = .0002, respectively), whereas that of metronidazole decreased significantly (P < .0001). Monthly vancomycin use increased and metronidazole use decreased to a significantly greater extent after publication of revised guidelines than after publication of clinical trials establishing superiority of vancomycin over metronidazole (P < .0001). Conclusions Revised practice guidelines have had a significant impact on CDI treatment in the US. Clinical trial data used for the revised guidelines were available since 2007–2014 and 2011–2012 for oral vancomycin and fidaxomicin, respectively. Guidelines or guidance documents for treating CDI and other infections should be updated in more timely fashion.

scholarly journals Utilization of the Sharing Antimicrobial Reports for Pediatric Stewardship (SHARPS) Collaborative electronic mailing list (listserv) by healthcare professionals

2020 ◽  
pp. 1-3
Author(s):  
Christopher C. McPherson ◽  
Zachary A. Vesoulis ◽  
Talene A. Metjian ◽  
Mirela Grabic ◽  
Summer Reyes ◽  
...  
Keyword(s):  
United States ◽  
Clinical Practice ◽  
Retrospective Study ◽  
Clinical Practice Guidelines ◽  
Antimicrobial Stewardship ◽  
Practice Guidelines ◽  
Healthcare Professionals ◽  
The United States ◽  
Mailing List

Abstract Optimizing pediatric antimicrobial stewardship is challenging. In this retrospective study, we evaluated 515 original e-mails to 482 members of the Sharing Antimicrobial Reports for Pediatric Stewardship (SHARPS) Collaborative electronic mailing list ([email protected]). The plurality of threads discussed clinical practice guidelines, and pharmacists were most likely to initiate and respond. Representation was geographically diverse within and outside the United States.

Breast Cancer Clinical Practice Guidelines in Oncology

2003 ◽  
Vol 1 (2) ◽  
pp. 148 ◽  
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Invasive Breast Cancer ◽  
The United States ◽  
Cancer Society ◽  
Nccn Guidelines ◽  
Recent Version

The American Cancer Society estimates that approximately 205,000 new cases of breast cancer were diagnosed in the United States in the year 2002, and approximately 40,000 patients will die of this disease. The NCCN guidelines discuss the complex and varied therapeutic options for patients with noninvasive or invasive breast cancer. For the most recent version of the guidelines, please visit NCCN.org

Hepatobiliary Cancer Clinical Practice Guidelines in Oncology

2003 ◽  
Vol 1 (1) ◽  
pp. 94 ◽  
Keyword(s):  
United States ◽  
Clinical Practice ◽  
Gallbladder Cancer ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
The United States ◽  
Newly Diagnosed ◽  
Nccn Guidelines ◽  
Hepatobiliary Cancer ◽  
Recent Version

Hepatobiliary cancers are both common and highly lethal worldwide. However, in the United States, the incidence of hepatobiliary cancer is relatively low, with approximately 23,700 patients newly diagnosed each year. Gallbladder cancer is the most common of the hepatobiliary malignancies, accounting for approximately 30% of newly diagnosed cases in the United States. Along with summaries of the NCCN guidelines for the 4 subtypes of hepatobiliary cancer, this article includes a brief discussion of the epidemiology, pathology, etiology, staging, diagnosis, and treatment of each subtype. For the most recent version of the guidelines, please visit NCCN.org

scholarly journals Comparing a Mobile Decision Support System Versus the Use of Printed Materials for the Implementation of an Evidence-Based Recommendation: Protocol for a Qualitative Evaluation (Preprint)

2018 ◽  
Author(s):  
Jhon Camacho ◽  
Ana María Medina Ch. ◽  
Zach Landis-Lewis ◽  
Gerald Douglas ◽  
Richard Boyce
Keyword(s):  
Clinical Practice ◽  
Decision Support ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Mobile App ◽  
Second Phase ◽  
Evidence Based ◽  
Clinical Algorithm ◽  
Qualitative Evidence ◽  
Printed Materials

BACKGROUND The distribution of printed materials is the most frequently used strategy to disseminate and implement clinical practice guidelines, although several studies have shown that the effectiveness of this approach is modest at best. Nevertheless, there is insufficient evidence to support the use of other strategies. Recent research has shown that the use of computerized decision support presents a promising approach to address some aspects of this problem. OBJECTIVE The aim of this study is to provide qualitative evidence on the potential effect of mobile decision support systems to facilitate the implementation of evidence-based recommendations included in clinical practice guidelines. METHODS We will conduct a qualitative study with two arms to compare the experience of primary care physicians while they try to implement an evidence-based recommendation in their clinical practice. In the first arm, we will provide participants with a printout of the guideline article containing the recommendation, while in the second arm, we will provide participants with a mobile app developed after formalizing the recommendation text into a clinical algorithm. Data will be collected using semistructured and open interviews to explore aspects of behavioral change and technology acceptance involved in the implementation process. The analysis will be comprised of two phases. During the first phase, we will conduct a template analysis to identify barriers and facilitators in each scenario. Then, during the second phase, we will contrast the findings from each arm to propose hypotheses about the potential impact of the system. RESULTS We have formalized the narrative in the recommendation into a clinical algorithm and have developed a mobile app. Data collection is expected to occur during 2018, with the first phase of analysis running in parallel. The second phase is scheduled to conclude in July 2019. CONCLUSIONS Our study will further the understanding of the role of mobile decision support systems in the implementation of clinical practice guidelines. Furthermore, we will provide qualitative evidence to aid decisions made by low- and middle-income countries’ ministries of health about investments in these technologies.

Sign in / Sign up

Export Citation Format

Share Document