scholarly journals Clinical Consensus Statement: Balloon Dilation of the Sinuses

2018 ◽  
Vol 158 (2) ◽  
pp. 203-214 ◽  
Author(s):  
Jay F. Piccirillo ◽  
Spencer C. Payne ◽  
Richard M. Rosenfeld ◽  
Fuad M. Baroody ◽  
Pete S. Batra ◽  
...  
Keyword(s):  
Ct Scan ◽  
Delphi Method ◽  
Consensus Statement ◽  
Expert Panel ◽  
Balloon Dilation ◽  
Target Population ◽  
Sinus Surgery ◽  
Consensus Statements ◽  
Strong Consensus ◽  
Definition Of

Objective To develop a clinical consensus statement on the use of sinus ostial dilation (SOD) of the paranasal sinuses. Methods An expert panel of otolaryngologists was assembled to represent general otolaryngology and relevant subspecialty societies. The target population is adults 18 years or older with chronic or recurrent rhinosinusitis (with or without nasal polyps, with or without prior sinus surgery) for whom SOD is being recommended, defined as endoscopic use of a balloon device to enlarge or open the outflow tracts of the maxillary, frontal, or sphenoid sinuses, as a standalone procedure or with endoscopic surgery. A modified Delphi method was used to distill expert opinion into clinical statements that met a standardized definition of consensus. Results After 3 iterative Delphi method surveys, 13 statements met the standardized definition of consensus while 45 statements did not. The clinical statements were grouped into 3 categories for presentation and discussion: (1) patient criteria, (2) perioperative considerations, and (3) outcomes. Strong consensus was obtained for not performing SOD in patients without sinonasal symptoms or positive findings on computed tomography (CT) in patients with symptoms only of headache or sleep apnea without criteria for sinusitis. In addition, strong consensus was met that CT scan of the sinuses was necessary before performing SOD and that surgeons need to understand and abide by regulations set forth by the US Food and Drug Administration if they choose to reuse/reprocess devices. Conclusion Expert panel consensus may provide helpful information for the otolaryngologist considering the use of SOD for the management of patients with a diagnosis of rhinosinusitis. This panel reached consensus on a number of statements that defined the use of SOD as inappropriate in the management of a variety of symptoms or diseases in the absence of underlying sinusitis. When patients meet the definition of chronic sinusitis as confirmed by CT scan, SOD of the sinuses can be indicated and/or effective in certain scenarios. Additional consensus statements regarding proper setting and safeguards for performing the procedure are described.

Clinical Consensus Statement: Balloon Dilation of the Eustachian Tube

2019 ◽  
Vol 161 (1) ◽  
pp. 6-17 ◽  
Author(s):  
Debara L. Tucci ◽  
Edward D. McCoul ◽  
Richard M. Rosenfeld ◽  
David E. Tunkel ◽  
Pete S. Batra ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Delphi Method ◽  
Consensus Statement ◽  
Expert Panel ◽  
Balloon Dilation ◽  
Target Population ◽  
Functional Health ◽  
Modified Delphi ◽  
Tube Dysfunction ◽  
Definition Of

ObjectiveTo develop a clinical consensus statement on the use of balloon dilation of the eustachian tube (BDET).MethodsAn expert panel of otolaryngologists was assembled with nominated representatives of general otolaryngology and relevant subspecialty societies. The target population was adults 18 years or older who are candidates for BDET because of obstructive eustachian tube dysfunction (OETD) in 1 or both ears for 3 months or longer that significantly affects quality of life or functional health status. A modified Delphi method was used to distill expert opinion into clinical statements that met a standardized definition of consensus.ResultsAfter 3 iterative Delphi method surveys, 28 statements met the predefined criteria for consensus, while 28 statements did not. The clinical statements were grouped into 3 categories for the purposes of presentation and discussion: (1) patient criteria, (2) perioperative considerations, and (3) outcomes.ConclusionThis panel reached consensus on several statements that clarify diagnosis and perioperative management of OETD. Lack of consensus on other statements likely reflects knowledge gaps regarding the role of BDET in managing OETD. Expert panel consensus may provide helpful information for the otolaryngologist considering the use of BDET for the management of patients with OETD.

scholarly journals Clinical Consensus Statement: Ankyloglossia in Children

2020 ◽  
Vol 162 (5) ◽  
pp. 597-611 ◽  
Author(s):  
Anna H. Messner ◽  
Jonathan Walsh ◽  
Richard M. Rosenfeld ◽  
Seth R. Schwartz ◽  
Stacey L. Ishman ◽  
...  
Keyword(s):  
American Academy ◽  
Head And Neck ◽  
Delphi Method ◽  
Expert Panel ◽  
Target Population ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Older Children ◽  
Modified Delphi ◽  
Consensus Statements

Objective To identify and seek consensus on issues and controversies related to ankyloglossia and upper lip tie in children by using established methodology for American Academy of Otolaryngology–Head and Neck Surgery clinical consensus statements. Methods An expert panel of pediatric otolaryngologists was assembled with nominated representatives of otolaryngology organizations. The target population was children aged 0 to 18 years, including breastfeeding infants. A modified Delphi method was used to distill expert opinion into clinical statements that met a standardized definition of consensus, per established methodology published by the American Academy of Otolaryngology–Head and Neck Surgery. Results After 3 iterative Delphi method surveys of 89 total statements, 41 met the predefined criteria for consensus, 17 were near consensus, and 28 did not reach consensus. The clinical statements were grouped into several categories for the purposes of presentation and discussion: ankyloglossia (general), buccal tie, ankyloglossia and sleep apnea, ankyloglossia and breastfeeding, frenotomy indications and informed consent, frenotomy procedure, ankyloglossia in older children, and maxillary labial frenulum. Conclusion This expert panel reached consensus on several statements that clarify the diagnosis, management, and treatment of ankyloglossia in children 0 to 18 years of age. Lack of consensus on other statements likely reflects knowledge gaps and lack of evidence regarding the diagnosis, management, and treatment of ankyloglossia. Expert panel consensus may provide helpful information for otolaryngologists treating patients with ankyloglossia.

scholarly journals Searching for an Operational Definition of Frailty: A Delphi Method Based Consensus Statement. The Frailty Operative Definition-Consensus Conference Project

2012 ◽  
Vol 68 (1) ◽  
pp. 62-67 ◽  
Author(s):  
Leocadio Rodríguez-Mañas ◽  
Catherine Féart ◽  
Giovanni Mann ◽  
Jose Viña ◽  
Somnath Chatterji ◽  
...  
Keyword(s):  
Delphi Method ◽  
Consensus Statement ◽  
Operational Definition ◽  
Consensus Conference ◽  
Definition Of

Procedural pain in patients with cancer: a Delphi expert management consensus

2021 ◽  
pp. bmjspcare-2020-002668
Author(s):  
Francisco J Villegas Estévez ◽  
Maria Dolores López Alarcón ◽  
Carmen Beato ◽  
Almudena Sanz-Yagüe ◽  
Josep Porta-Sales ◽  
...  
Keyword(s):  
Pain Management ◽  
Delphi Method ◽  
Radiation Oncology ◽  
Healthcare Professionals ◽  
Procedural Pain ◽  
Patients With Cancer ◽  
Current Definition ◽  
Palliative Care Units ◽  
Strong Consensus ◽  
Definition Of

ObjectivesDiagnosis, treatment and care of cancer often involve procedures that may be distressing and potentially painful for patients. The PROCEDIO Study aimed to generate expert-based recommendations on the management of moderate to severe procedural pain in inpatients and outpatients with cancer.MethodsUsing a two-round Delphi method, experts from pain and palliative care units, medical and radiation oncology and haematology departments expressed their agreement on 24 statements using a 9-point Likert scale, which were classified as appropriate (median 7–9), uncertain (4–6) or inappropriate (1–3). Consensus was achieved if at least two-thirds of the panel scored within the range containing the median.ResultsWith an overall agreement on the current definition of procedural pain, participants suggested a wider description based on evidence and their clinical experience. A strong consensus was achieved regarding the need for a comprehensive pre-procedural pain assessment and experts emphasised that healthcare professionals involved in procedural pain management should be adequately trained. Most panellists (98.2%) agreed that pharmacological treatment should be chosen considering the duration of the procedure. Transmucosal fentanyl (96.5%) and morphine (71.7%) were recommended as the most appropriate drugs. Oral and nasal transmucosal fentanyl were agreed as the most suitable for both outpatients and inpatients, while consensus was reached for intravenous and subcutaneous morphine for inpatients.ConclusionsThese results provide updated expert-based recommendations on the definition, prevention and treatment of moderate to severe procedural pain, which could inform specialists involved in pain management of patients with cancer.

LOOKING BACK ON 5 YEARS OF HORIZON SCANNING IN ONCOLOGY

2016 ◽  
Vol 32 (1-2) ◽  
pp. 54-60 ◽  
Author(s):  
Anna Nachtnebel ◽  
Johanna Breuer ◽  
Wolfgang Willenbacher ◽  
Anna Bucsics ◽  
Peter Krippl ◽  
...  
Keyword(s):  
Environmental Analysis ◽  
User Satisfaction ◽  
Expert Panel ◽  
Target Population ◽  
Dissemination Strategy ◽  
Horizon Scanning ◽  
Definition Of ◽  
High Level ◽  
The Impact ◽  
Collaborative Efforts

Objectives: The regularly structured adaptation of health technology assessment (HTA) programs is of utmost importance to sustain the relevance of the products for stakeholders and to justify investment of scarce financial resources. This study describes internal adjustments and external measures taken to ensure the Horizon Scanning Programme in Oncology (HSO) is current.Methods: Formal evaluation methods comprising a survey, a download, an environmental analysis, and a Web site questionnaire were used to evaluate user satisfaction.Results: The evaluation showed that users were satisfied with HSO outputs in terms of timeliness, topics selected, and depth of information provided. Discussion of these findings with an expert panel led to changes such as an improved dissemination strategy and the introduction of an additional output, that is, the publication of a league table of emerging oncology drugs. The rather high level of international usage and the environmental analysis highlighted a considerable overlap in topics assessed and, thus, the potential for international collaboration. As a consequence, thirteen reports were jointly published based on eleven “calls for collaboration.” To further facilitate collaboration and the usability of reports for other agencies, HSO reports will be adjusted according to tools developed at a European level.Conclusions: Evaluation of the impact of HTA programs allows the tailoring of outputs to fit the needs of the target population. However, within a fast developing HTA community, estimates of impact will increasingly be determined by international collaborative efforts. Refined methods and a broader definition of impact are needed to ultimately capture the efficiency of national HTA programs.

scholarly journals Establishing an Operational Definition of Sarcopenia in Australia and New Zealand: Delphi Method Based Consensus Statement

2018 ◽  
Vol 23 (1) ◽  
pp. 105-110 ◽  
Author(s):  
J. Zanker ◽  
◽  
D. Scott ◽  
E. M. Reijnierse ◽  
S. L. Brennan-Olsen ◽  
...  
Keyword(s):  
New Zealand ◽  
Delphi Method ◽  
Consensus Statement ◽  
Operational Definition ◽  
Definition Of

scholarly journals Priority concerns for people with intellectual and developmental disabilities during the COVID-19 pandemic

BJPsych Open ◽  
2020 ◽  
Vol 6 (6) ◽  
Author(s):  
Sam Tromans ◽  
Michael Kinney ◽  
Verity Chester ◽  
Regi Alexander ◽  
Ashok Roy ◽  
...  
Keyword(s):  
Intellectual Disabilities ◽  
Consensus Statement ◽  
Point Of View ◽  
Intellectual And Developmental Disabilities ◽  
Family Carers ◽  
Vulnerable Group ◽  
Consensus Statements ◽  
Expert Clinician ◽  
Strong Consensus ◽  
People With Intellectual Disabilities

Background The approach taken to support individuals during the coronavirus disease 2019 (COVID-19) pandemic needs to take into account the requirements of people with intellectual disabilities and/or autism, who represent a major vulnerable group, with higher rates of co-occurring health conditions and a greater risk of dying prematurely. To date, little evidence on COVID-related concerns have been produced and no report has provided structured feedback from the point of view of people with intellectual disabilities and/or autism or of their family/carers. Aims To provide systemised evidence-based information of the priority concerns for people with intellectual disabilities and/or autism regarding the COVID-19 pandemic. Method Senior representatives of major UK-based professional and service-user representative organisations with a stake in the care of people with intellectual disabilities and/or autism were contacted to provide a list of concerns across three domains: ‘mental health and challenging behaviour’, ‘physical health and epilepsy’ and ‘social circumstances and support’. The feedback was developed into statements on frequently reported priorities. These statements were then rated independently by expert clinicians. A video-conference meeting to reconcile outliers and to generate a consensus statement list was held. Results Thirty-two organisations were contacted, of which 26 (81%) replied. From the respondent's data, 30 draft consensus statements were generated. Following expert clinician review, there was initially strong consensus for seven statements (23%), increasing to 27 statements (90%) following video conferencing. Conclusions These recommendations highlight the expectations of people with intellectual disabilities and/or autism in the current pandemic. This could support policymakers and professionals’ deliver and evidence person-centred care.

Consensus on the change of criteria for cure of acromegaly during the last decade

2011 ◽  
Vol 152 (18) ◽  
pp. 703-708 ◽  
Author(s):  
Gábor László Kovács ◽  
Judit Dénes ◽  
Erika Hubina ◽  
László Kovács ◽  
Sándor Czirják ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Factor ◽  
Disease Control ◽  
Short Communication ◽  
Consensus Statement ◽  
Diagnosis And Treatment ◽  
Clinical Aspects ◽  
Insulin Like Growth Factor ◽  
Criteria For Diagnosis ◽  
Definition Of

The Acromegaly Consensus Group redefined the consensus criteria for cure of acromegaly. 74 neurosurgeons and experienced endocrinologists summarized the latest results on diagnosis and treatment of acromegaly. In this consensus statement the reliable growth hormone and insulin-like growth factor-1 assays were established. Definition of disease control was discussed based on the available publications and evidence. This short communication summarizes the clinical aspects of consensus criteria for diagnosis and cure of acromegaly based on the original article. Orv. Hetil., 2011, 152, 703–708.

scholarly journals Administrative coding in electronic health care record‐based research of NAFLD: an expert panel consensus statement

Hepatology ◽  
2021 ◽  
Author(s):  
Hannes Hagström ◽  
Leon A Adams ◽  
Alina M. Allen ◽  
Christopher D. Byrne ◽  
Yoosoo Chang ◽  
...  
Keyword(s):  
Health Care ◽  
Consensus Statement ◽  
Expert Panel ◽  
Electronic Health
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