Conflicts of interest among authors of the ESC guidelines for the management of atrial fibrillation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
B Schneider ◽  
C Stoellberger
Keyword(s):  
Atrial Fibrillation ◽  
Conflicts Of Interest ◽  
Task Force ◽  
Guideline Development ◽  
Decision Makers ◽  
Institute Of Medicine ◽  
Guideline Development Group ◽  
Group Members ◽  
Esc Guidelines ◽  
Development Group

Abstract Background In 2011, the Institute of Medicine (IOM) published standards for developing trustworthy clinical practice guidelines. It is recommended that “Whenever possible guideline development group members should not have conflicts of interest (COIs). In some circumstances, a guideline development group may not be able to perform its work without members who have COIs, such as relevant clinical specialists. Members with COIs should represent not more than a minority of the guideline development group members. The chair or cochairs should not be a person with COIs.” Aim Aim of the present study was to assess if the ESC guidelines for the management of atrial fibrillation are in accordance with the standards proposed by the IOM. Methods The declaration of COIs from task force members (TFM) and reviewers of the 2010 and 2016 ESC atrial fibrillation guidelines were retrieved from the ESC homepage. The number and the type of COIs were assessed for each guideline and compared. Results Regarding the 2010 guidelines, 8 of the 25 TFM (32%) reported no COI. In the remaining 17 TFM, 148 COIs were reported (8.7±10.2 per member, range 1–44). The chairperson declared 11 COIs. Consulting and advising was reported by 15 and research contacts by 13 TFM. Among the guideline reviewers, 12/26 (46%) reported no COI, and 14 reviewers declared 72 COIs (5.1±3.3 per reviewer, range 2–14). Regarding the 2016 guidelines, 3 of the 17 TFM (18%) reported no COI. The remaining 14 TFM declared 182 COIs (13.0±10.4 per member, range 1–32). The chairperson of the task force had the second most COIs (n=30). Direct personal payment was reported by 14 and research funding of the department by 10 TFM. Among the guideline reviewers, 16/79 (20%) reported no COI, and 63 reviewers declared 473 COIs (7.5±6.8 per reviewer, range 1–34). Comparing the 2010 and the 2016 guidelines, there was an increase of TFM with COIs (from 68% to 82%), of the number of COIs per TFM (from 8.7±10.2 to 13.0±10.4) and the COIs of the chairperson (from 11 to 30). Moreover, the proportion of TFM receiving personal payment (60% vs 82%) and the number of COIs due to personal payment (5.9±7.3 vs 7.7±7.4) were higher in the 2016 guidelines. In addition, more guideline reviewers had COIs in 2016 (54% vs 80%). Conclusion The high and increasing rate of TFM and reviewers with COIs is not in accordance with the recommendations of the IOM. Since COIs can influence healthcare decision makers and may consciously or unconsciously influence choices made throughout the guideline development process, the ESC should follow the standards of the IOM. Funding Acknowledgement Type of funding source: None

scholarly journals Guidelines for the investigation of chronic diarrhoea in adults: British Society of Gastroenterology, 3rd edition

Gut ◽  
2018 ◽  
Vol 67 (8) ◽  
pp. 1380-1399 ◽  
Author(s):  
Ramesh P Arasaradnam ◽  
Steven Brown ◽  
Alastair Forbes ◽  
Mark R Fox ◽  
Pali Hungin ◽  
...  
Keyword(s):  
Guideline Development ◽  
Grade System ◽  
British Society ◽  
Chronic Diarrhoea ◽  
Clinical Services ◽  
Quality Of Evidence ◽  
Guideline Development Group ◽  
Development Group

Chronic diarrhoea is a common problem, hence clear guidance on investigations is required. This is an updated guideline from 2003 for the investigations of chronic diarrhoea commissioned by the Clinical Services and Standards Committee of the British Society of Gastroenterology (BSG). This document has undergone significant revision in content through input by 13 members of the Guideline Development Group (GDG) representing various institutions. The GRADE system was used to appraise the quality of evidence and grading of recommendations.

scholarly journals Clinical Practice Guideline: Improving Nasal Form and Function after Rhinoplasty

2017 ◽  
Vol 156 (2_suppl) ◽  
pp. S1-S30 ◽  
Author(s):  
Lisa E. Ishii ◽  
Travis T. Tollefson ◽  
Gregory J. Basura ◽  
Richard M. Rosenfeld ◽  
Peter J. Abramson ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Guideline Development ◽  
Evidence Based ◽  
Nasal Airway ◽  
Form And Function ◽  
Guideline Development Group ◽  
Obstructive Sleep ◽  
And Function ◽  
Development Group

Objective Rhinoplasty, a surgical procedure that alters the shape or appearance of the nose while preserving or enhancing the nasal airway, ranks among the most commonly performed cosmetic procedures in the United States, with >200,000 procedures reported in 2014. While it is difficult to calculate the exact economic burden incurred by rhinoplasty patients following surgery with or without complications, the average rhinoplasty procedure typically exceeds $4000. The costs incurred due to complications, infections, or revision surgery may include the cost of long-term antibiotics, hospitalization, or lost revenue from hours/days of missed work. The resultant psychological impact of rhinoplasty can also be significant. Furthermore, the health care burden from psychological pressures of nasal deformities/aesthetic shortcomings, surgical infections, surgical pain, side effects from antibiotics, and nasal packing materials must also be considered for these patients. Prior to this guideline, limited literature existed on standard care considerations for pre- and postsurgical management and for standard surgical practice to ensure optimal outcomes for patients undergoing rhinoplasty. The impetus for this guideline is to utilize current evidence-based medicine practices and data to build unanimity regarding the peri- and postoperative strategies to maximize patient safety and to optimize surgical results for patients. Purpose The primary purpose of this guideline is to provide evidence-based recommendations for clinicians who either perform rhinoplasty or are involved in the care of a rhinoplasty candidate, as well as to optimize patient care, promote effective diagnosis and therapy, and reduce harmful or unnecessary variations in care. The target audience is any clinician or individual, in any setting, involved in the management of these patients. The target patient population is all patients aged ≥15 years. The guideline is intended to focus on knowledge gaps, practice variations, and clinical concerns associated with this surgical procedure; it is not intended to be a comprehensive reference for improving nasal form and function after rhinoplasty. Recommendations in this guideline concerning education and counseling to the patient are also intended to include the caregiver if the patient is <18 years of age. Action Statements The Guideline Development Group made the following recommendations: (1) Clinicians should ask all patients seeking rhinoplasty about their motivations for surgery and their expectations for outcomes, should provide feedback on whether those expectations are a realistic goal of surgery, and should document this discussion in the medical record. (2) Clinicians should assess rhinoplasty candidates for comorbid conditions that could modify or contraindicate surgery, including obstructive sleep apnea, body dysmorphic disorder, bleeding disorders, or chronic use of topical vasoconstrictive intranasal drugs. (3) The surgeon, or the surgeon’s designee, should evaluate the rhinoplasty candidate for nasal airway obstruction during the preoperative assessment. (4) The surgeon, or the surgeon’s designee, should educate rhinoplasty candidates regarding what to expect after surgery, how surgery might affect the ability to breathe through the nose, potential complications of surgery, and the possible need for future nasal surgery. (5) The clinician, or the clinician’s designee, should counsel rhinoplasty candidates with documented obstructive sleep apnea about the impact of surgery on nasal airway obstruction and how obstructive sleep apnea might affect perioperative management. (6) The surgeon, or the surgeon’s designee, should educate rhinoplasty patients before surgery about strategies to manage discomfort after surgery. (7) Clinicians should document patients’ satisfaction with their nasal appearance and with their nasal function at a minimum of 12 months after rhinoplasty. The Guideline Development Group made recommendations against certain actions: (1) When a surgeon, or the surgeon’s designee, chooses to administer perioperative antibiotics for rhinoplasty, he or she should not routinely prescribe antibiotic therapy for a duration >24 hours after surgery. (2) Surgeons should not routinely place packing in the nasal cavity of rhinoplasty patients (with or without septoplasty) at the conclusion of surgery. The panel group made the following statement an option: (1) The surgeon, or the surgeon’s designee, may administer perioperative systemic steroids to the rhinoplasty patient.

scholarly journals Physical Therapist Management of Total Knee Arthroplasty

2020 ◽  
Vol 100 (9) ◽  
pp. 1603-1631 ◽  
Author(s):  
Diane U Jette ◽  
Stephen J Hunter ◽  
Lynn Burkett ◽  
Bud Langham ◽  
David S Logerstedt ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Guideline Development ◽  
Clinical Information ◽  
Guideline Development Group ◽  
Total Knee ◽  
American Physical ◽  
Development Group

Abstract A clinical practice guideline on total knee arthroplasty was developed by an American Physical Therapy (APTA) volunteer guideline development group that consisted of physical therapists, an orthopedic surgeon, a nurse, and a consumer. The guideline was based on systematic reviews of current scientific and clinical information and accepted approaches to management of total knee arthroplasty.

Nice Guideline on Osteoarthritis: Is it Fair to Acupuncture? Yes

2009 ◽  
Vol 27 (2) ◽  
pp. 72-75 ◽  
Author(s):  
Nicholas Latimer
Keyword(s):  
Cost Effectiveness ◽  
Economic Analysis ◽  
Clinical Guideline ◽  
Guideline Development ◽  
Nice Guideline ◽  
Guideline Development Group ◽  
The Cost ◽  
Development Group ◽  
Nice Clinical Guideline

The NICE Osteoarthritis Guideline Development Group (GDG) has been challenged for not using the available acupuncture evidence in the most appropriate manner in three crucial areas. This response explains the methods used by the GDG with particular reference to the economic analysis, and illustrates that the methods used were those most appropriate for developing a NICE clinical guideline. The cost-effectiveness conclusions made by the GDG are supported by the currently available evidence.

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