scholarly journals LO24: Is prehospital care supported by evidence-based guidelines? An environmental scan and quality appraisal using AGREE II

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S35-S36
Author(s):  
S. Turner ◽  
E. Lang ◽  
K. Brown ◽  
C. Leyton ◽  
E. Bulger ◽  
...  
Keyword(s):  
Life Support ◽  
Guideline Development ◽  
Prehospital Care ◽  
Evidence Based ◽  
High Quality ◽  
Agree Ii ◽  
Level Of Evidence ◽  
High Quality Evidence ◽  
Evidence Based Guidelines ◽  
Quality Evidence

Introduction: The Institute of Medicine (IOM) has recommended that high-quality, evidence-based guidelines be developed for emergency medical services (EMS). The National Association of EMS Physicians (NAEMSP) has outlined a strategy that will see this task fulfilled, consisting of multiple working groups focused on all aspects of guideline development and implementation. A first step, and our objective, was a cataloguing and appraisal of the current guidelines targeting EMS providers. Methods: A systematic search of the literature was conducted in MEDLINE (1175), EMBASE (519), PubMed (14), Trip (416), and guidelines.gov (64) through May 1, 2016. Two independent reviewers screened titles for relevance to prehospital care, and then abstracts for essential guideline features, including a systematic review, a grading system, and an association between level of evidence and strength of recommendation. All disagreements were moderated by a third party. Citations meeting inclusion criteria were appraised with the AGREE II tool, which looks at six different domains of guideline quality, containing a total of 23 items rated from 1 to 7. Each guideline was appraised by three separate reviewers, and composite scores were calculated by averaging the scaled domain totals. Results: After primary (kappa 97%) and secondary (kappa 93%) screening, 49 guidelines were retained for full review. Only three guidelines obtained a score of >90%, the topics of which included aeromedical transport, analgesia in trauma, and resuscitation of avalanche victims. Only two guidelines scored between 80% and 90%, the topics of which included stroke and pediatric seizure management. One guideline, splinting in an austere environment, scored between 70% and 80%. Nine guidelines scored between 60% and 70%, the topics of which included ischemic stroke, cardiovascular life support, hemorrhage control, intubation, triage, hypothermia, and fibrinolytic use. Of the remaining guidelines, 14 scored between 50% and 60%, and 20 obtained a score of <50%. Conclusion: There are few high-quality, evidence-based guidelines in EMS. Of those that are published, the majority fail to meet established quality measures. Although a lack of randomized controlled trials (RCTs) conducted in the prehospital field continues to limit guideline development, suboptimal methodology is also commonplace within the existing literature.

Organizing and delivering treatment for ADHD

2018 ◽  
Author(s):  
David Coghill ◽  
Marina Danckaerts
Keyword(s):  
Treatment Initiation ◽  
Careful Consideration ◽  
Routine Clinical Practice ◽  
Evidence Based ◽  
High Quality ◽  
Children With Adhd ◽  
High Quality Evidence ◽  
Ongoing Care ◽  
Evidence Based Guidelines ◽  
Quality Evidence

Following diagnosis, all children with ADHD will require some form of intervention, and most will require treatment over a relatively prolonged period of time. Whilst there are now several high-quality evidence-based guidelines for the management of ADHD, these are often difficult to operationalize into routine clinical practice and as a consequence studies report considerable variations in care at local, national, and international levels. We describe a structured, but flexible, approach to the organization and delivery of ADHD treatments that aims to optimize care and reduce variation in practice. This pathway pays particular attention to optimizing care through careful consideration of the initial targets for treatment and choice of first treatment, initiation and titration of medication treatments, monitoring ongoing care and identifying adverse events, and the adjustment and switching of treatments when outcomes are not optimal.

scholarly journals Society of Vascular and Interventional Neurology Standards and Parameters for Guideline Development and Publication

2021 ◽  
Author(s):  
Alicia C. Castonguay ◽  
Adam de Havenon ◽  
Thabele M. Leslie‐Mazwi ◽  
Cynthia Kenmuir ◽  
Sunil A. Sheth ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
American Heart ◽  
Guideline Development ◽  
Heart Association ◽  
Standardize Patient ◽  
Evidence Based ◽  
Level Of Evidence ◽  
High Quality Evidence ◽  
Practice Parameters ◽  
Quality Evidence

Abstract BACKGROUND As much of the scope of neurointerventional practice falls outside data covered by existing randomized clinical trials, and, as a result, may have failed to enter into existing guidelines, an evidence‐based framework for guideline and standards development is needed. We establish an evidence‐based framework to guide all subsequent guidelines and brief practice updates produced by the Society of Vascular and Interventional Neurology (SVIN). METHODS The SVIN formed the Guidelines and Practice Parameters committee to develop the structure and procedures for guidelines and brief practice updates. RESULTS In this article, the Guidelines and Practice Parameters committee has outlined the process by which the guidelines will be created and approved by the SVIN. Additionally, the Guidelines and Practice Parameters committee has adopted the American College of Cardiology/American Heart Association framework of Class of Recommendation and Level of Evidence. A unique, additional separation of the Expert Opinion endorsement category has been developed when high‐quality evidence does not exist at the time of the publication. CONCLUSIONS The SVIN has developed an evidence‐based framework for all guideline statements and brief practice updates. The SVIN guidelines and brief practice updates will guide clinicians in the field of interventional neurology to improve and standardize patient care.

scholarly journals TRADE-OFFS BETWEEN EPISTEMIC AND MORAL VALUES IN EVIDENCE-BASED POLICY

2018 ◽  
Vol 35 (1) ◽  
pp. 49-78 ◽  
Author(s):  
Donal Khosrowi
Keyword(s):  
Controlled Trials ◽  
Evidence Based ◽  
Epistemic Values ◽  
High Quality ◽  
Political Values ◽  
Randomized Controlled ◽  
High Quality Evidence ◽  
Evidence Based Policy ◽  
Trade Offs ◽  
Quality Evidence

Abstract:Proponents of evidence-based policy (EBP) call for public policy to be informed by high-quality evidence from randomized controlled trials. This methodological preference aims to promote several epistemic values, e.g. rigour, unbiasedness, precision, and the ability to obtain causal conclusions. I argue that there is a trade-off between these epistemic values and several non-epistemic, moral and political values. This is because the evidence afforded by standard EBP methods is differentially useful for pursuing different moral and political values. I expand on how this challenges ideals of value-freedom and -neutrality in EBP, and offer suggestions for how EBP methodology might be revised.

Clinical studies of incidental intracranial meningiomas—towards high-quality evidence-based practice

2020 ◽  
Vol 162 (3) ◽  
pp. 673-674
Author(s):  
Abdurrahman I. Islim ◽  
Christopher P. Millward ◽  
Kirsty J. Martin-McGill ◽  
Ruwanthi Kolamunnage-Dona ◽  
Thomas Santarius ◽  
...  
Keyword(s):  
Clinical Studies ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
High Quality ◽  
High Quality Evidence ◽  
Intracranial Meningiomas ◽  
Quality Evidence

Addressing the information needs of older patients

2002 ◽  
Vol 12 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Matthew Harris ◽  
Antony Bayer ◽  
Win Tadd
Keyword(s):  
Therapeutic Intervention ◽  
Older Patients ◽  
Information Needs ◽  
Clinical Governance ◽  
Reliable Information ◽  
Evidence Based ◽  
High Quality ◽  
High Quality Evidence ◽  
Risk Framework ◽  
Quality Evidence

The availability of high-quality, evidence-based, clearly communicated, user-focused information is central to the new NHS. Reliable information empowers patients and their families and enables them to become more knowledgeable about their care and condition following consultation and diagnosis or before a therapeutic intervention. It is an integral part of clinical governance and the clinical risk framework.

Asthma guidelines: which is the best of three?

2020 ◽  
Vol 31 (8) ◽  
pp. 344-351
Author(s):  
Andrew Booth
Keyword(s):  
Health Professional ◽  
Evidence Based ◽  
High Quality ◽  
Pharmacological Management ◽  
International Guidelines ◽  
Diagnosis And Management ◽  
Asthma Guideline ◽  
High Quality Evidence ◽  
The Uk ◽  
Quality Evidence

Andrew Booth offers a comprehensive look into national and international guidelines surrounding the diagnosis and management of asthma National and international guidelines provide evidence-based advice on the diagnosis and management of asthma. There are now three potential asthma guidelines to follow, each taking its own unique, and sometimes conflicting direction, creating a total of over 700 pages of high-quality evidence. A puzzle is thus presented to the busy health professional: which guideline do I follow? This article compares and contrasts two national and one international asthma guideline, focusing particularly on diagnosis and pharmacological management. Mortality from asthma is increasing in the UK, making the need for a conjoined guideline more urgent than ever.

scholarly journals Evidence-Based Comparison of Robotic and Open Radical Prostatectomy

2010 ◽  
Vol 10 ◽  
pp. 2228-2237 ◽  
Author(s):  
William T. Lowrance ◽  
Tatum V. Tarin ◽  
Shahrokh F. Shariat
Keyword(s):  
Cost Effectiveness ◽  
Radical Prostatectomy ◽  
Radical Retropubic Prostatectomy ◽  
Evidence Based ◽  
High Quality ◽  
Robotic Assisted ◽  
Retropubic Prostatectomy ◽  
Open Radical Prostatectomy ◽  
High Quality Evidence ◽  
Quality Evidence

The rapid adoption of robotic-assisted laparoscopic radical prostatectomy (RALP) has occurred despite a lack of high-quality evidence demonstrating its oncologic advantages, safety, or cost effectiveness compared with open radical retropubic prostatectomy (ORP). This review examines the current literature comparing ORP and RALP, focusing on perioperative, oncologic, functional, and economic outcomes.

Formative Evaluation of a Framework for High Quality, Evidence-Based Services in School Mental Health

2009 ◽  
Vol 1 (4) ◽  
pp. 196-211 ◽  
Author(s):  
Mark Weist ◽  
Nancy Lever ◽  
Sharon Stephan ◽  
Eric Youngstrom ◽  
Elizabeth Moore ◽  
...  
Keyword(s):  
Mental Health ◽  
Formative Evaluation ◽  
School Mental Health ◽  
Evidence Based ◽  
High Quality ◽  
High Quality Evidence ◽  
Quality Evidence

scholarly journals Ankyloglossia and Its Management- Need for Standardised Guidelines

2020 ◽  
pp. 36-41
Author(s):  
Hemanth Kowdley Subrahmanyam
Keyword(s):  
Decision Making ◽  
Diagnostic Criteria ◽  
Breast Feeding ◽  
Healthcare Providers ◽  
Treatment Decisions ◽  
Evidence Based ◽  
High Quality ◽  
High Quality Evidence ◽  
Quality Evidence

With increasing diagnosis of ankyloglossia, the need for uniformity in diagnostic criteria and treatment decisions like frenotomy or frenuloplasty has come to the fore. Involvement of multidisciplinary healthcare providers who use various non-standardised resources and tools in the assessment and decision making is debatable. Effects of ankyloglossia on breast feeding, speech and sleep are discussed in this article following review of available high quality evidence based literature.

scholarly journals Autologous conditioned serum applications in the treatment of musculoskeletal diseases: a narrative review

2022 ◽  
Vol 8 (2) ◽  
Author(s):  
Seyed Ahmad Raeissadat ◽  
Seyed Mansoor Rayegani ◽  
Nafisseh Jafarian ◽  
Mina Heidari
Keyword(s):  
Musculoskeletal Diseases ◽  
Current Data ◽  
Major Focus ◽  
High Quality ◽  
Level Of Evidence ◽  
Safety And Efficacy ◽  
High Quality Evidence ◽  
Autologous Conditioned Serum ◽  
Positive Results ◽  
Quality Evidence

Aim: Autologous conditioned serum has been studied as a treatment option in musculoskeletal disorders and resulted in varying outcomes. This study aims to pool the current data on this matter. Materials & methods: Major databases were searched for the topics, and after screening the results, the final 21 papers (level of evidence I or II) were included. Results & conclusion: This study showed a major focus of the literature on the effectiveness of autologous conditioned serum in osteoarthritis, in which there is much high-quality evidence suggesting its safety and efficacy. Also, some of the available experiments are assessing its application in tendinopathies and radiculopathies which, despite positive results, recommend further evaluations on this topic.

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