Management of conflicts of interests of ESC guideline authors

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Seggewiss ◽  
N Schurig ◽  
T Lempert
Keyword(s):  
Quality Criteria ◽  
Standard Of Care ◽  
International Standards ◽  
Active Management ◽  
National Standard ◽  
Conflicts Of Interests ◽  
Cancer Society ◽  
European Guidelines ◽  
Esc Guidelines ◽  
Medical Guidelines

Abstract Introduction According to WHO definition medical guidelines are systematically developed statements to support the decisions of clinicians and patients about appropriate health care for specific clinical situations. Guidelines should be based on on results of randomized trials and independence from economic interests. Therefore, not only detailed declaration but also active management of conflicts of interests (COI) of guideline committee members should be declared. The public database LeitlinienWatch (GuidelineWatch) analyzes German and European guidelines with respect to COI declaration and management. Methods Between 2015 and 2019 nine German National Standard of Care guidelines (NVL), 10 German Cancer Society (DKG) guidelines, and 10 ESC guidelines were compared according to five criteria. Each criterion was scored 0–3 points (Table). Furthermore, up to 3 extra points could be awarded for methodological quality. Results Overall, guidelines of NVL (11.3±3.5) and DKG (9.8±3.3) achieved more points than ESC guidelines (2.8±0.4; p<0.00001). ESC-guidelines scored points only by documentation of COI and sometimes an extra bonuspoint for an internal review process. In all ESC guidelines >50% of the authors had COI. These conflicts did not lead to an exclusion of lead authors or abstentions from voting. A public accessible review was standard practice in NVL-guidelines and more often performed in DKG-guidelines but was lacking in ESC guideline process. Overall, NVL- and DKG-guidelines showed better handling of COI (Table). Conclusion Declaration and management of COI are quality criteria for medical guidelines. Current ESC guidelines do not meet international standards for COI management. Therefore, the rules for the ESC guideline process need to be revised. Funding Acknowledgement Type of funding source: None

The tactics of managing children and adolescents when twisting the uterine appendages from the position of international standards

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. 39-41
Author(s):  
Zalina K. Batyrova ◽  
Zaira K. Kumykova ◽  
Elena V. Uvarova ◽  
Vladimir D. Chuprynin ◽  
Natalya A. Buralkina ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Ovarian Tissue ◽  
Standard Of Care ◽  
Lymphatic Drainage ◽  
International Standards ◽  
Delivery Of Care ◽  
National Medical ◽  
Treatment Standard ◽  
Common Causes ◽  
Adolescent Gynecology

Background. Adnexal torsion (AT) takes fifth place among all emergency gynecological conditions. Suspicion of AT requires immediate diagnosis and urgent surgical treatment. The most common causes of AT are various volumetric formations, such as functional or dermoid ovarian cysts, contributing to an increase in its volume and/or anomalies in the development of the ligamentous apparatus. Timely diagnosis and detorsion contributes to the full restoration of impaired venous outflow and lymphatic drainage of the ovarian tissue, preventing the development of severe ischemia and necrosis. Over the past few decades, a surgical organ-preserving approach in managing patients with AT has been the gold standard of care. Materials and methods. The article describes the results of a retrospective study of cases of AT in children and adolescents treated at the Department of Pediatric and adolescent gynecology Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology with an assessment of the clinical and anamnestic features of this cohort of patients and the choice of therapeutic tactics. Conclusion. A multidisciplinary approach is critical to optimizing the delivery of care in cases of AT, including minimally invasive detorsion and preserving the functionality of the ovary as a treatment standard that should be used in the management of children and adolescents.

Discussion on Determination of Non-Methane Hydrocarbons

2014 ◽  
Vol 1073-1076 ◽  
pp. 562-566
Author(s):  
Zhe Min Li
Keyword(s):  
International Standards ◽  
National Standards ◽  
National Standard ◽  
Measure Methods

This paper summarized the measure methods which include both Chinese national standards and international standards of how to determine the concentration of Non-methane Hydrocarbons (NMHC).Some problems and suggestions were discussed in this paper to improve the level of the measure methods and prompt the establishment of relative Chinese national standard.

Image evaluation and breast density categories as a function of mammary positioning in full-field digital mammography

2019 ◽  
Vol 61 (7) ◽  
pp. 868-874
Author(s):  
Irene Tomoko Nakano ◽  
Gabriel Lucca de Oliveira Salvador ◽  
Hugo Reuters Schelin ◽  
Valeriy Denyak ◽  
Helen Jamil Khoury ◽  
...  
Keyword(s):  
Breast Density ◽  
Area Under The Curve ◽  
Quality Criteria ◽  
Roc Curves ◽  
Full Field ◽  
European Guidelines ◽  
Full Field Digital Mammography ◽  
Definition Of ◽  
The Individual ◽  
The Right

Background Appropriate mammary positioning is an important factor in optimizing image quality in mammography (MMG). Purpose To study the correlation of quality criteria and breast density classification proposed by the American College of Radiology (ACR) and European Guidelines and its influence to achieve a proper positioning, therefore an adequate MMG. Material and methods A total of 128 routine MMG examinations were reviewed for the definition of breast composition parenchyma and assessment of several quality criteria proposed by the ACR and European Guidelines to achieve an adequate MMG. Adequate MMG was defined as a difference between the posterior nipple line (PNL), difference of the mediolateral oblique (MLO) and craniocaudal (CC) incidences > 1 cm. The quality criteria were analyzed as a function of correlation coefficient in order to evaluate the individual impact of each factor and analysis of variance (ANOVA) for all criteria. Receiver operating characteristic (ROC) curves were plotted to evaluate the performance of the criteria on each type of parenchyma. Results Negative correlation of fatty breasts and visibility of the mammary angle, a greater number of skin folds and PNL > 1 cm (r < 0). Dense MMG presented less visibility of the lateral tissue compared with other categories. Area under the curve of ROC analysis revealed values of 53.1% and 54.7% for the right and left breasts, respectively. Conclusion Several factors influenced in the MMG process, but we find that breast parenchyma has a substantial role in affecting these criteria and therefore a correct position for diagnosis, which could compromise MMG diagnostic performance.

scholarly journals Population impact of the 2017 ACC/AHA guidelines compared with the 2013 ESH/ESC guidelines for hypertension management

2018 ◽  
Vol 25 (10) ◽  
pp. 1111-1113 ◽  
Author(s):  
Julien Vaucher ◽  
Pedro Marques-Vidal ◽  
Gérard Waeber ◽  
Peter Vollenweider
Keyword(s):  
Cost Reduction ◽  
Antihypertensive Treatment ◽  
Hypertension Management ◽  
Related Condition ◽  
European Guidelines ◽  
Swiss Population ◽  
Esc Guidelines ◽  
Stage 1 ◽  
Antihypertensive Treatments ◽  
Number Of Individuals

Background The 2017 ACC/AHA guidelines on hypertension management recommend the introduction of antihypertensive treatment for patients with new stage 1 hypertension thresholds (130–139/80–89 mm Hg) and with a cardiovascular disease or related condition. We compared the Swiss population and economic impact of antihypertensive treatment of the 2017 ACC/AHA guidelines with the 2013 European guidelines. Methods Analyses were based on 4438 participants (aged 45–85 years; 2448 women) of the CoLaus|PsyCoLaus study recruited between 2014-2017. Participants eligible for antihypertensive treatment according to the 2017 ACC/AHA and 2013 European guidelines were sex and age standardised using the Swiss population for 2016. In addition, we estimated the population-wide annual costs of antihypertensive treatment. Results Individuals eligible for antihypertensive treatment were 40.3% (95% confidence interval 38.5–42.1) and 31.3% (29.7–32.9) according to the 2017 ACC/AHA and 2013 European guidelines, respectively. That difference would translate into approximately 250,000 additional individuals eligible for antihypertensive treatment, corresponding to an additional annual cost of 72.5 million CHF (63.0 million EUR). Conclusion The 2017 ACC/AHA guidelines on the management of hypertension substantially increase the number of individuals eligible for antihypertensive treatment compared to the 2013 European guidelines. While implementation of the 2017 ACC/AHA guidelines is expected to lead to cost reduction by preventing cardiovascular diseases, that reduction might be mitigated by the costs incurred by antihypertensive treatments in a larger proportion of the population.

scholarly journals Cost Savings Analysis of Individualized Exercise Oncology Programs

2019 ◽  
Vol 18 ◽  
pp. 153473541983946 ◽  
Author(s):  
Karen Y. Wonders ◽  
Rob Wise ◽  
Danielle Ondreka ◽  
Josh Gratsch
Keyword(s):  
Cancer Care ◽  
Cost Savings ◽  
Length Of Hospital Stay ◽  
Standard Of Care ◽  
National Standard ◽  
Cost Burden ◽  
Post Intervention ◽  
Before And After ◽  
The Impact ◽  
Exercise Oncology

Background: The physical and economic toll of cancer make it a high health priority. The rising cost of cancer care is now a primary focus for patients, payers, and providers. Escalating costs of clinical trials and national drug regulations have led the median monthly costs of cancer drugs to rise from less than $100 in 1965 to 1969, to more than $5000 in 2005 to 2009, stressing the importance of finding innovative ways to reduce cost burden. In the present study, we report the economic evaluation of an individualized exercise oncology program beginning early after diagnosis. Methods: An independent research group, ASCEND Innovations, retrospectively analyzed patient records to statistically demonstrate the impact of exercise oncology during cancer treatment. All patients completed 12 weeks of prescribed, individualized exercise that included cardiovascular, strength training, and flexibility components. The 3 primary hospital measures leveraged for statistical comparison before and after supportive care enrollment were number of encounters, number of readmissions, and average total charges, as well as emergency room visits and length of hospital stay ( P < .05). Results: The resulting dataset consisted of 1493 total hospital encounters for 147 unique patients. The results statistically demonstrate a positive effect of exercise oncology during cancer care, in terms of reductions in overall cost per patient pre- to post-intervention. Conclusions: Individualized exercise oncology programs should be employed as part of the national standard of care for individuals battling cancer, in order to improve patient outcome and reduce cost burden.

Examining the cost of community-based tuberculosis treatment in South Africa

2020 ◽  
Vol 24 (6) ◽  
pp. 612-618
Author(s):  
A. Moran ◽  
N. Kula ◽  
G. Jagwer ◽  
E. Broughton ◽  
Y. Pillay ◽  
...  
Keyword(s):  
South Africa ◽  
Treatment Success ◽  
Standard Of Care ◽  
Multidrug Resistant ◽  
National Standard ◽  
Eastern Cape ◽  
Community Based ◽  
Tb Treatment ◽  
Adherence Support ◽  
The Cost

SETTING: While South Africa has improved access to tuberculosis (TB) treatment and care, the 2015 treatment success rate for multidrug-resistant TB (MDR-TB) remains low, at 55%. Community-based TB treatment and care improves patient retention compared to the standard of care alone.OBJECTIVE: To assess the cost of a USAID-funded community-based TB model in Nelson Mandela Bay Health District (NMBHD), Eastern Cape Province, South Africa compared to the national standard of care alone.DESIGN: We estimated the cost of community-based DR-TB treatment and adherence support compared to the standard of care alone.RESULTS: Average overall costs were US$2827 lower per patient on the community-based model than the standard of care alone.CONCLUSION: The per-patient cost of the community-based model is lower than the standard of care alone. Assuming the costs and effects of a community-based model implemented in NMBHD were observed at a larger scale, implementing the model could reduce overall health system costs.

Impact of Intraoperative Stimulation Brain Mapping on Glioma Surgery Outcome: A Meta-Analysis

2012 ◽  
Vol 30 (20) ◽  
pp. 2559-2565 ◽  
Author(s):  
Philip C. De Witt Hamer ◽  
Santiago Gil Robles ◽  
Aeilko H. Zwinderman ◽  
Hugues Duffau ◽  
Mitchel S. Berger
Keyword(s):  
Meta Analysis ◽  
Quality Criteria ◽  
Standard Of Care ◽  
Glioma Surgery ◽  
Extensive Resection ◽  
Surgery Outcome ◽  
Neurologic Deficits ◽  
Meta Regression Analysis ◽  
Event Rates

Purpose Surgery for infiltrative gliomas aims to balance tumor removal with preservation of functional integrity. The usefulness of intraoperative stimulation mapping (ISM) has not been addressed in randomized trials. This study addresses glioma surgery outcome on the basis of a meta-analysis of observational studies. Methods A systematic search retrieved 90 reports published between 1990 and 2010 with 8,091 adult patients who had resective surgery for supratentorial infiltrative glioma, with or without ISM. Quality criteria consisted of postoperative neurologic examination details and follow-up timing. New postoperative neurologic deficits were categorized on the basis of timing and severity. Meta-analysis with a Bayesian random effects model determined summary event rates of deficits as well as gross total resection rate and eloquent locations. Meta-regression analysis explored heterogeneity among studies. Results Late severe neurologic deficits were observed in 3.4% (95% CI, 2.3% to 4.8%) of patients after resections with ISM, and in 8.2% (95% CI, 5.7% to 11.4%) of patients after resections without ISM (adjusted odds ratio, 0.39; 95% CI, 0.23 to 0.64). The percentages of radiologically confirmed gross total resections were 75% (95% CI, 66% to 82%) with ISM and 58% (95% CI, 48% to 69%) without ISM. Eloquent locations were involved in 99.9% (95% CI, 99.9% to 100%) of resections with ISM and in 95.8% (95% CI, 73.1% to 99.8%) of resections without ISM. Relevant sources of heterogeneity among studies were ISM, continent, and academic setting. Conclusion Glioma resections using ISM are associated with fewer late severe neurologic deficits and more extensive resection, and they involve eloquent locations more frequently. This indicates that ISM should be universally implemented as standard of care for glioma surgery.

scholarly journals Physicians’ Perceptions and Adherence to Guidelines for the Management of Hypertension: A National, Multicentre, Prospective Study

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Mamas Theodorou ◽  
Panagiotis Stafylas ◽  
Georgia Kourlaba ◽  
Daphne Kaitelidou ◽  
Nikos Maniadakis ◽  
...  
Keyword(s):  
Prospective Observational Study ◽  
Inappropriate Medication ◽  
Lifestyle Changes ◽  
Adherence To Guidelines ◽  
Hypertensive Patients ◽  
European Guidelines ◽  
Risk Patients ◽  
Esc Guidelines ◽  
To Receive ◽  
Multicentre Prospective Study

Background. The aim of the current study was to investigate physicians’ perceptions and adherence to the European guidelines for the management of hypertension.Methods. This is a national, multicentre, prospective, observational study, conducted between November 2007 and June 2008, in Cyprus. Consecutive hypertensive patients have been recruited by a random sample of physicians. The physicians’ recommendations for every single patient have been recorded and compared with the 2007 ESH/ESC guidelines.Results. Of the total of 654 patients, 477 (72.9%) were correctly advised by their physician to receive antihypertensive treatment to control their blood pressure, while 396 (60.5%) correctly got advices to adopt only lifestyle changes. The overall adherence of physicians to the European guidelines (overall agreement rate) was 70.4% (k=0.258,P<0.001). Of the total of 68 physicians, 65 (95.6%) reported that they were aware of some guidelines. There was no statistically significant effect of specific physicians’ characteristics on the overall adherence to guidelines, but there was in the percentage of patients achieving medication guidelines.Conclusions. The study demonstrated that although Cypriot physicians declared that they were aware of the clinical guidelines for the management of hypertension, more than one-fourth of high risk hypertensive patients remained untreated and 40% of low risk patients received inappropriate medication.

scholarly journals National Strategy on Action for Children in Russia and Council of Europe Strategies for the Rights of the Child

2016 ◽  
Vol 21 (1) ◽  
pp. 108-118 ◽  
Author(s):  
G.V. Semya
Keyword(s):  
Sexual Abuse ◽  
Cultural Differences ◽  
International Standards ◽  
National Strategy ◽  
Council Of Europe ◽  
European Guidelines ◽  
Rights Of The Child ◽  
Main Current ◽  
Two Phases ◽  
Guidelines And Standards

Development of the National Strategy for Action on Children for 2012–2017 implemented in two phases (2012–2014 and 2015–2017) coincided with the Council of Europe Strategies for the Rights of the Child for 2012–2015, and the new Council of Europe Strategies for the Rights of the Child for 2016–2022 takes effect in 2016. Author provides description of a new European instrument: the main current challenges in the field of children safeguarding; top areas and measures to respond to these challenges; methods to implement the strategy including based on the recommendations of the Committee of Ministers of the Council of Europe to the Member States. The article gives examples of Russia’s accession to the international legal community through the ratification of various conventions that allowed to take domestic measures to ensure international standards to secure children from such crimes as trafficking in children, underage prostitution and por- nography, sexual abuse. The present paper examines opportunity to take into ac- count the new European guidelines and standards in Russian childhood policy and describes action taken in Russia to protect children’s rights as a response to the integrated European challenges, taking into account social and cultural differences.

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