Reliability of the ASA physical status scale in clinical practice: methodological issues

Historically, doctors have not entertained a broad enough view of the total human life cycle. While much attention has been focused on infancy, childhood, adolescence and adulthood as times of growth and change, we have all but ignored the later years and the often marvelous characteristics of “the survivors.” The use of standardized methods for evaluating the mental and physical status of old people has deprived both practitioners and patients of the richness of life-long experiences. By taking the time to attentively listen to their patients' reflections of the past, physicians can help advance our growing understanding of human aging and expand the repertoire of mechanisms that are useful in clinical practice.

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High-dose antipsychotic medication

Psychiatric Bulletin ◽

10.1192/pb.20.11.676 ◽

1996 ◽

Vol 20 (11) ◽

pp. 676-680 ◽

Cited By ~ 13

Author(s):

Peter L. Cornwall ◽

Fuad Hassanyeh ◽

Caprice Horn

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Clinical Practice ◽

Antipsychotic Medication ◽

Antipsychotic Drugs ◽

Maximum Dose ◽

High Dose ◽

National Formulary ◽

Physical Status ◽

High Dose Treatment

We audited the use of high-dose antipsychotic drugs in patients admitted to a special (intensive) care unit over two periods. Five out of 57 patients in the first sample and three out of 62 in the second were treated with a single antipsychotic drug above the British National Formulary maximum dose. The proportion of patients treated with antipsychotic drugs such that the total dose in chlorpromazine equivalents was greater than 1000 mg, fed. The audit showed improvements in clinical practice, particularly with respect to the onset of, indication for and outcome of high-dose treatment and in monitoring the patients' physical status.

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Reliability of the American Society of Anesthesiologists Physical Status Scale in Clinical Practice

Survey of Anesthesiology ◽

10.1097/01.sa.0000466634.00085.fe ◽

2015 ◽

Vol 59 (4) ◽

pp. 202-203 ◽

Cited By ~ 1

Author(s):

A. Sankar ◽

S. R. Johnson ◽

W. S. Beattie ◽

G. Tait ◽

D. N. Wijeysundera

Keyword(s):

Clinical Practice ◽

Physical Status ◽

American Society ◽

American Society Of Anesthesiologists

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Whole Medical Systems versus the System of Conventional Biomedicine: A Critical, Narrative Review of Similarities, Differences, and Factors That Promote the Integration Process

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2017/4904930 ◽

2017 ◽

Vol 2017 ◽

pp. 1-13 ◽

Cited By ~ 7

Author(s):

Erik W. Baars ◽

Harald J. Hamre

Keyword(s):

Clinical Practice ◽

Conventional Medicine ◽

Narrative Review ◽

Future Research ◽

Integration Process ◽

Medical Systems ◽

Methodological Issues ◽

High Quality Research ◽

Safety And Efficacy ◽

Legal Frameworks

Background. There is an increasing need for a worldwide professional integration of conventional medicine and traditional/complementary whole medical systems (WMSs). However, the integration is perceived by conventional medicine as problematic or unacceptable, because of a supposed lack of evidence for specific effects of WMSs therapies and supposed prescientific or unscientific paradigms of WMSs. Objectives. To review the literature on the features of WMSs, similarities and differences between conventional medicine and WMSs, and scientific and clinical practice issues that should be dealt with in order to promote the integration process. Methods. A critical, narrative review of the literature on six WMSs. Results and Conclusions. Key factors for the integration of WMSs and conventional medicine are as follows: legal frameworks, quality standards, high-quality research on safety and efficacy of WMS interventions, infrastructure, and financial resources. For scientific assessment of WMSs, there are unresolved ontological, epistemological, and methodological issues and issues of diagnostics, therapy delivery, and outcome assessment in clinical practice. Future research not only should be directed at quality assurance and generating the necessary data on safety and efficacy/effectiveness but also should address more fundamental (ontological, epistemological, and methodological) issues, in order to overcome the differences between WMSs and conventional medicine.

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Predicting the Progression of Mild Cognitive Impairment Using Machine Learning: A Systematic, Quantitative and Critical Review

10.1101/2020.09.01.20185959 ◽

2020 ◽

Author(s):

Manon Ansart ◽

Stephane Epelbaum ◽

Giulia Bassignana ◽

Alexandre Bone ◽

Simona Bottani ◽

...

Keyword(s):

Machine Learning ◽

Cognitive Impairment ◽

Clinical Practice ◽

Mild Cognitive Impairment ◽

Parameter Tuning ◽

Methodological Issues ◽

Cognitive Assessments ◽

Data Set ◽

Mixed Effect ◽

The Impact

We performed a systematic review of studies focusing on the automatic prediction of the progression of mild cognitive impairment to Alzheimer's disease (AD) dementia, and a quantitative analysis of the methodological choices impacting performance. This review included 172 articles, from which 234 experiments were extracted. For each of them, we reported the used data set, the feature types, the algorithm type, performance and potential methodological issues. The impact of these characteristics on the performance was evaluated using a multivariate mixed effect linear regressions. We found that using cognitive, fluorodeoxyglucose-positron emission tomography or potentially electroencephalography and magnetoencephalography variables significantly improved predictive performance compared to not including them, whereas including other modalities, in particular T1 magnetic resonance imaging, did not show a significant effect. The good performance of cognitive assessments questions the wide use of imaging for predicting the progression to AD and advocates for exploring further fine domain-specific cognitive assessments. We also identified several methodological issues, including the absence of a test set, or its use for feature selection or parameter tuning in nearly a fourth of the papers. Other issues, found in 15% of the studies, cast doubts on the relevance of the method to clinical practice. We also highlight that short-term predictions are likely not to be better than predicting that subjects stay stable over time. These issues highlight the importance of adhering to good practices for the use of machine learning as a decision support system for the clinical practice.

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Deep Brain Stimulation in Persistent Vegetative States: Ethical Issues Governing Decision Making

Behavioural Neurology ◽

10.1155/2014/641213 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Sara Patuzzo ◽

Paolo Manganotti

Keyword(s):

Decision Making ◽

Clinical Practice ◽

Deep Brain Stimulation ◽

Brain Stimulation ◽

Ethical Issues ◽

Vegetative State ◽

Persistent Vegetative State ◽

Future Perspectives ◽

Methodological Issues ◽

Deep Brain

The aim of the present paper was to investigate the fundamental ethical issues of Deep Brain Stimulation (DBS) on patients remaining in Persistent Vegetative State (PVS). First, the purpose of this analysis was to discuss the nature of this intervention in order to classify it such as an ordinary clinical practice, or otherwise as an extraordinary clinical practice or as experimental research. Second, ethical issues, criticisms, and methodological issues of this intervention, also in the future perspectives, are discussed, attempting to identify who could give informed consent for a patient in PVS.

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The Inference Generation Strategy may be effective for some adults with high functioning autism spectrum disorder, but methodological issues limit its relevance to clinical practice

Evidence-Based Communication Assessment and Intervention ◽

10.1080/17489539.2015.1012778 ◽

2014 ◽

Vol 8 (3) ◽

pp. 142-146

Author(s):

Devender R. Banda ◽

Nouf M. Alzrayer

Keyword(s):

Autism Spectrum Disorder ◽

Clinical Practice ◽

High Functioning Autism ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Methodological Issues ◽

Inference Generation ◽

High Functioning

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Chloroquine, Hydroxychloroquine and Covid-19: a systematic review of literature

InterAmerican Journal of Medicine and Health ◽

10.31005/iajmh.v3i0.79 ◽

2020 ◽

Vol 3 ◽

pp. 1-10 ◽

Cited By ~ 2

Author(s):

Jose Paulo Guida

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Clinical Practice ◽

Viral Load ◽

Side Effects ◽

Clinical Findings ◽

Current Evidence ◽

Review Of Literature ◽

Inclusion Criteria ◽

Methodological Issues

Objective: to assess effectiveness and safety of hydroxychloroquine and chloroquine on the treatment of COVID-19. Study desing: a systematic review of literature was performed in two databases; studies were included if they had as intervention use of chloroquine or hydroxychloroquine and reported outcomes on laboratorial or clinical findings or description of side effects. Results: 38 studies were included; of those, only one fulfilled inclusion criteria and were included in this review. This study has important methodological issues and only reported viral load, but any clinical outcomes. Conclusions: Many ongoing clinical trials will provide new evidences about the use of hydroxychloroquine and chloroquine to the treatment of COVID-19. Current evidence do not support its use on clinical practice.

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Reliability of the American Society of Anesthesiologists physical status scale in clinical practice

British Journal of Anaesthesia ◽

10.1093/bja/aeu100 ◽

2014 ◽

Vol 113 (3) ◽

pp. 424-432 ◽

Cited By ~ 216

Author(s):

A. Sankar ◽

S.R. Johnson ◽

W.S. Beattie ◽

G. Tait ◽

D.N. Wijeysundera

Keyword(s):

Clinical Practice ◽

Physical Status ◽

American Society ◽

American Society Of Anesthesiologists

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Guidelines for the Assessment of Efficacy of Clinical Hypnosis Applications

10.31234/osf.io/2cqaw ◽

2021 ◽

Author(s):

Zoltan Kekecs ◽

Donald Moss ◽

Gary Elkins ◽

Giuseppe De Benedittis ◽

Olafur Pallson ◽

...

Keyword(s):

Clinical Practice ◽

Scientific Knowledge ◽

Best Practice ◽

Task Force ◽

The Other ◽

International Survey ◽

Methodological Issues ◽

Practice Recommendations ◽

Efficacy Research ◽

Clinical Hypnosis

The research on the efficacy of hypnosis applications continues to grow, yet there is frequently a chasm between scientific knowledge and clinical practice. One challenge has been a lack of a unified standard for efficacy research in hypnosis. In 2018, six major hypnosis organizations collaborated to form a Task Force for Establishing Efficacy Standards for Clinical Hypnosis. The present paper reports the Guidelines for the Assessment of Efficacy of Clinical Hypnosis Applications created by the Task Force listing ten specific recommendations. These recommendations are intended to guide researchers who want to assess the accumulated evidence in existing research about the efficacy of applications of clinical hypnosis. The paper also discusses methodological issues in the interpretation and implementation of these guidelines. Future papers will report on the other products of the Hypnosis Efficacy Task Force, such as best practice recommendations for outcomes research in hypnosis, and an international survey of researchers and clinicians on current practices and views of hypnosis.

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