scholarly journals Are Evidence-Based Guidelines Reflected in Clinical Practice? An Analysis of Prospectively Collected Data of the Italian Thyroid Cancer Observatory

Thyroid ◽  
2017 ◽  
Vol 27 (12) ◽  
pp. 1490-1497 ◽  
Author(s):  
Livia Lamartina ◽  
Cosimo Durante ◽  
Giuseppe Lucisano ◽  
Giorgio Grani ◽  
Rocco Bellantone ◽  
...  
Sarcoma ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
S. J. Neuhaus ◽  
D. Thomas ◽  
J. Desai ◽  
C. Vuletich ◽  
J. von Dincklage ◽  
...  

In 2013 Australia introduced Wiki-based Clinical Practice Guidelines for the Management of Adult Onset Sarcoma. These guidelines utilized a customized MediaWiki software application for guideline development and are the first evidence-based guidelines for clinical management of sarcoma. This paper presents our experience with developing and implementing web-based interactive guidelines and reviews some of the challenges and lessons from adopting an evidence-based (rather than consensus-based) approach to clinical sarcoma guidelines. Digital guidelines can be easily updated with new evidence, continuously reviewed and widely disseminated. They provide an accessible method of enabling clinicians and consumers to access evidence-based clinical practice recommendations and, as evidenced by over 2000 views in the first four months after release, with 49% of those visits being from countries outside of Australia. The lessons learned have relevance to other rare cancers in addition to the international sarcoma community.


2016 ◽  
Vol 102 (2) ◽  
pp. 152-156 ◽  
Author(s):  
Janis Armstrong ◽  
Elaine Buchanan ◽  
Hazel Duncan ◽  
Kathleen Ross ◽  
Konstantinos Gerasimidis

ObjectiveThere is an emerging interest in the use of blenderised food for tube-feeding (BFTF). This survey explored paediatric dietitians' perceptions and experiences of BFTF use.DesignA web-based questionnaire was distributed to the Paediatric group of the British Dietetic Association. The survey captured dietitians' personal opinions and experience supporting children on BFTF, and the perceptions of carers.ResultsOf the 77 respondents, 19 were aware of professional guidelines and 63 had never received training on BFTF. Thirty-four would not recommend BFTF and 11 would advise against its use; yet 43 would recommend it to supplement commercial feeds. Fifty-seven would change their perception about BFTF if there were evidence-based guidelines. Forty-four would feel confident to support a patient using BFTF. Forty-three had previous experience supporting a patient with BFTF. The main concerns perceived by dietitians, pertinent to the use of BFTF, were nutritional inadequacy (n=71), tube blockages (n=64) and increased infection risk (n=59) but these were significantly higher than those experienced by themselves in clinical practice (p<0.001 for all three). A reduction in reflux and vomiting and increased carer involvement were the main perceived and observed benefits by both dietitians and carers.ConclusionsThe use of these feeds for tube-fed children is increasingly being seen as a viable choice. Dietitians experienced significantly fewer issues with the use of BFTF in clinical practice compared with their self-reported apprehensions in the survey. Well-controlled studies are now needed to objectively assess the benefits, risks, costs and practicality of BFTF.


Author(s):  
James G. Anderson ◽  
Linda L Casebeer ◽  
Robert E. Kristofco ◽  
Angela S. Carillo

The rapid expansion of scientific knowledge brings increased physician uncertainty in clinical decisionmaking. Clinical practice guidelines have been developed to reduce physician uncertainty. The broad movement to develop and disseminate clinical practice guidelines is rooted in evidence-based medicine. Although the development and dissemination of evidence-based guidelines has increased dramatically over the past decade, studies indicate serious deficiencies in the adoption of guidelines into practice. Developments such as client/server networks, the Internet, and the World Wide Web are rapidly expanding potential educational applications for information and communications technologies and the capacity for introducing strategies to promote guideline adoption. Web-enabled computer technology can enhance the capability of healthcare information systems to reduce variation in clinical decisionmaking.


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