scholarly journals Management of children and adolescents with bronchiectasis: summary of the ERS clinical practice guideline

Breathe ◽  
2021 ◽  
Vol 17 (3) ◽  
pp. 210105
Author(s):  
Anne B. Chang ◽  
Keith Grimwood ◽  
Jeanette Boyd ◽  
Rebecca Fortescue ◽  
Zena Powell ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Children And Adolescents ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Clinical Information ◽  
List Type ◽  
European Respiratory Society ◽  
Assessment Development ◽  
Evaluation Approach ◽  
Bronchial Dilatation

Bronchiectasis, characterised by chronic wet/productive cough with recurrent respiratory exacerbations and abnormal bronchial dilatation on computed tomography scans, remains an increasingly recognised but often neglected chronic pulmonary disorder in children and adolescents. An early diagnosis combined with optimal management offers the prospect, at least in some patients, of curing a condition previously considered irreversible. However, unlike in adults, until now no international paediatric guidelines existed. The recently published European Respiratory Society clinical practice guidelines for the management of children and adolescents with bronchiectasis attempts to address this clinical information gap. The guidelines were formulated by panel members comprised of experts from several relevant health fields, the European Lung Foundation and parents of children with bronchiectasis. Systematic reviews and the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach guided the nature and strength of recommendations. The recommendations are grouped into clinically relevant topics: diagnosis, evaluating for underlying causes, defining exacerbations, management, systematic care, monitoring, reversibility and prevention. The guidelines seek to achieve: 1) optimal lung growth, 2) preserved lung function, 3) enhanced quality of life, 4) minimal exacerbations, 5) few or no complications, and 6) if possible, reversal of lung injury for each child/adolescent with bronchiectasis. This review presents example cases that highlight the recommendations of the clinical practice guidelines.Educational aimsThis article is intended for those involved in caring for children/adolescents with bronchiectasis. It aims to inform:Clinicians of the European Respiratory Society recommendations for the diagnosis and management of children/adolescents with bronchiectasis.Adolescents and parents of children/adolescents with bronchiectasis of these recommendations, so as to assist discussions with healthcare teams and help facilitate access to appropriate care.

scholarly journals First Latin American clinical practice guidelines for the treatment of systemic lupus erythematosus: Latin American Group for the Study of Lupus (GLADEL, Grupo Latino Americano de Estudio del Lupus)–Pan-American League of Associations of Rheumatology (PANLAR)

2018 ◽  
Vol 77 (11) ◽  
pp. 1549-1557 ◽  
Author(s):  
Bernardo A Pons-Estel ◽  
Eloisa Bonfa ◽  
Enrique R Soriano ◽  
Mario H Cardiel ◽  
Ariel Izcovich ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Clinical Practice ◽  
Latin American ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Lupus Erythematosus ◽  
Special Focus ◽  
Systemic Lupus ◽  
Assessment Development ◽  
Evaluation Approach

Systemic lupus erythematosus (SLE), a complex and heterogeneous autoimmune disease, represents a significant challenge for both diagnosis and treatment. Patients with SLE in Latin America face special problems that should be considered when therapeutic guidelines are developed. The objective of the study is to develop clinical practice guidelines for Latin American patients with lupus. Two independent teams (rheumatologists with experience in lupus management and methodologists) had an initial meeting in Panama City, Panama, in April 2016. They selected a list of questions for the clinical problems most commonly seen in Latin American patients with SLE. These were addressed with the best available evidence and summarised in a standardised format following the Grading of Recommendations Assessment, Development and Evaluation approach. All preliminary findings were discussed in a second face-to-face meeting in Washington, DC, in November 2016. As a result, nine organ/system sections are presented with the main findings; an ‘overarching’ treatment approach was added. Special emphasis was made on regional implementation issues. Best pharmacologic options were examined for musculoskeletal, mucocutaneous, kidney, cardiac, pulmonary, neuropsychiatric, haematological manifestations and the antiphospholipid syndrome. The roles of main therapeutic options (ie, glucocorticoids, antimalarials, immunosuppressant agents, therapeutic plasma exchange, belimumab, rituximab, abatacept, low-dose aspirin and anticoagulants) were summarised in each section. In all cases, benefits and harms, certainty of the evidence, values and preferences, feasibility, acceptability and equity issues were considered to produce a recommendation with special focus on ethnic and socioeconomic aspects. Guidelines for Latin American patients with lupus have been developed and could be used in similar settings.

scholarly journals Critical appraisal and comparison of recommendations of clinical practice guidelines for treatment of schizophrenia in children and adolescents: a methodological survey protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e038646
Author(s):  
Maíra Ramos Alves ◽  
Cristiane de Cássia Bergamaschi ◽  
Flávia Blaseck Sorrilha ◽  
Izabela Fulone ◽  
Silvio Barberato-Filho ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Children And Adolescents ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Future Research ◽  
High Quality ◽  
Agree Ii ◽  
Ethical Approval ◽  
Over Time

IntroductionThe number of clinical practice guidelines (CPGs) have increased substantially mainly in the paediatric area of mental health. However, little is known about the quality or how recommendations for the treatment of disorders such as schizophrenia in children and adolescents have changed over time. The aim of this study will be to assess the quality of the development of CPGs for the treatment and management of schizophrenia in children and adolescents over time using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool and to compare the recommendations and interventions described in these documents.Methods and analysisCPGs will be identified using a prospective protocol through a systematic search of multiple databases (Medline, Embase, Health Systems Evidence, Epistemonikos, Lilacs, etc) and guideline websites from 2004 to December 2020. The quality of the guidelines will be assessed by three reviewers, independently using the AGREE II. CPGs will be considered of high-quality if they scored ≥60% in four or more domains of the AGREE II instrument. Non-parametric tests will be used to test for the change of quality over time. We will summarise the different evidence grading systems and compare the recommendations.Ethics and disseminationEthical approval is not required since it is a literature-based study. Future results of the research can be submitted for publication in scientific journals of high impact, peer reviewed and also published in national and international conferences. The results derived from this study will contribute to the improvement of health institutions and policies, informing about existing recommendation guidelines and about deficiencies and qualities found in those. This study may also identify key areas for future research. This study may guide the search and choice for high quality CPGs by health policy makers and health professionals and subsidise future adaptations.Protocol registration numberCRD42020164899.

Dental caries prevention in children and adolescents: a systematic quality assessment of clinical practice guidelines

2018 ◽  
Vol 22 (9) ◽  
pp. 3129-3141 ◽  
Author(s):  
Andrea Seiffert ◽  
Carlos Zaror ◽  
Claudia Atala-Acevedo ◽  
Andrea Ormeño ◽  
María José Martínez-Zapata ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Dental Caries ◽  
Quality Assessment ◽  
Children And Adolescents ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Caries Prevention

scholarly journals European Respiratory Society clinical practice guidelines for the diagnosis of asthma in children aged 5–16 years

2021 ◽  
pp. 2004173
Author(s):  
Erol A. Gaillard ◽  
Claudia E. Kuehni ◽  
Steve Turner ◽  
Myrofora Goutaki ◽  
Karl A. Holden ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Critical Appraisal ◽  
Task Force ◽  
Diagnostic Algorithm ◽  
Final Decision ◽  
Decision Framework ◽  
European Respiratory Society ◽  
Asthma In Children

Diagnosing asthma in children represents an important clinical challenge. There is no single gold standard test to confirm the diagnosis. Consequently, both over-, and under-diagnosis of asthma are frequent in children.A Task Force (TF) supported by the European Respiratory Society has developed these evidence-based clinical practice guidelines for the diagnosis of asthma in children aged 5–16 years using nine PICO (Population, Intervention, Comparator and Outcome) questions. The TF conducted systematic literature searches for all PICO questions and screened the outputs from these, including relevant full text articles. All TF members approved the final decision for inclusion of research papers. The TF assessed the quality of the evidence using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach.The TF then developed a diagnostic algorithm based on the critical appraisal of the PICO questions, preferences expressed by lay members and test availability. Proposed cut-offs were determined based on the best available evidence. The TF formulated recommendations using the GRADE Evidence to Decision framework.Based on the critical appraisal of the evidence and the Evidence to Decision Framework the TF recommends spirometry, bronchodilator reversibility testing and FeNO as first line diagnostic tests in children under investigation for asthma. The TF recommends against diagnosing asthma in children based on clinical history alone or following a single abnormal objective test. Finally, this guideline also proposes a set of research priorities to improve asthma diagnosis in children in the future.

Pediatric Mental Health: A Compendium of AAP Clinical Practice Guidelines and Policies

2019 ◽  
Author(s):  
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Children And Adolescents ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Quality Care ◽  
Health Issues ◽  
Mental Health Issues ◽  
Pediatric Mental Health

This new compendium is your source for trustworthy recommendations on quality care of children and adolescents with mental health issues. https://shop.aap.org/mental-health-a-compendium-of-aap-clinical-practice-guidelines-and-policies-paperback/

scholarly journals LO072: Fever in the returning traveller: a systematic review and critical appraisal of existing clinical practice guidelines and approaches to returning travellers presenting with fever

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S54-S55
Author(s):  
A. Collier ◽  
J.J. Perry ◽  
A. Nath
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Practice Guideline ◽  
Critical Appraisal ◽  
Clinical Information ◽  
Final Analysis ◽  
Cochrane Library ◽  
The Cochrane Library

Introduction: Fever in the returning traveller is a common ED presentation; however approaches and level of comfort with tropical diseases vary widely. This project aimed to conduct a systematic review and critical appraisal of existing clinical practice guidelines and approaches, to guide an ED approach, in Canada, to fever in the returning traveller. Methods: A literature review was conducted of peer reviewed papers, national and international practice guidelines, and practice statements presenting approaches to fever in the returning traveller. A literature search was conducted using MEDLINE and Embase (1947-Dec 2014), with librarian assistance to optimize strategy. The databases of guideline clearing houses, CMA, PHAC, WHO, CDC, and the Cochrane library were searched, along with a google scholar search. References of included articles were hand searched. Article titles and abstracts were reviewed by the author for inclusion. Key elements of the guidelines and approaches were identified and grouped by theme and where appropriate, the quality of guidelines were assessed by two reviewers using the AGREEII tool. Results: The search returned 1598 titles. 72 full manuscripts were reviewed based on inclusion from title and abstract, with 24 manuscripts included for final analysis. Common elements suggested by the guidelines or approaches were identified and grouped within three themes (key historical features, physical exam findings, investigations). Most manuscripts presented tables of important clinical information, but limited guidance on how to approach diagnosis in a focused manner. When evaluated by AGREEII, only one guideline (D’Acremont et al) scored > 50% overall quality rating. Unlike other approaches, this guideline proposes a stepwise approach to diagnosis and treatment based on the presence of key exposures, signs/symptoms, and eosinophilia. Conclusion: The guideline by D’Acremont et al was identified as the most rigorous existing practice guideline. This guideline, combined with other elements identified by thematic review, forms the basis of a suggested ED approach to fever in the returning traveller, which will be further refined using the AGREEII model to propose a practice guideline for Canadian EDs.

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