scholarly journals Seeking international consensus on approaches to primary tumour treatment in Ewing sarcoma

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Craig Gerrand ◽  
Jessica Bate ◽  
Beatrice Seddon ◽  
Uta Dirksen ◽  
R. Lor Randall ◽  
...  
Keyword(s):  
Ewing Sarcoma ◽  
Best Practice ◽  
Online Survey ◽  
Collaborative Work ◽  
Primary Tumour ◽  
Local Treatment ◽  
Consensus Meeting ◽  
International Consensus ◽  
Consensus Statements ◽  
The Impact

Abstract Background The local treatment of Ewing sarcoma of bone involves surgery, radiotherapy or both. The selection of treatment depends on the anatomical extent of the tumour, the effectiveness of the proposed treatment, its morbidity, and the expectation of cure. However, not only are there variations in the approach to local treatment between individual patients, but also between treatment centres and countries. Our aim was to explore variation in practice and develop consensus statements about local treatment. Methods A three stage modified Delphi technique was used with international collaborators. This involved an expert panel to identify areas of controversy, an online survey of international collaborators and a consensus meeting in London, UK in June 2017. In the consensus meeting, teams of clinicians discussed the local management of selected cases and their responses were collected with electronic voting. Results Areas of greater or less consensus were identified. The lack of evidence underpinning different approaches was noted and areas for collaborative research became apparent. Conclusion This has demonstrated that there is an international consensus around many aspects of the local treatment of Ewing sarcoma of bone, including the use of specialist MultiDisciplinary Team (MDT) meetings with access to all appropriate treatments. However, considerable variation remains including the use of different staging investigations, decision making, definitions of response, and radiotherapy doses and timing. Further collaborative work should be undertaken to determine the impact of these variations in order to define best practice.

Diagnosis: History, Physical Examination, Imaging, and Arthroscopy: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

2018 ◽  
Vol 39 (1_suppl) ◽  
pp. 3S-8S ◽  
Author(s):  
Christiaan J. A. van Bergen ◽  
Onno L. Baur ◽  
Christopher D. Murawski ◽  
Pietro Spennacchio ◽  
Dominic S. Carreira ◽  
...  
Keyword(s):  
Physical Examination ◽  
Cartilage Repair ◽  
Best Practice ◽  
Consensus Meeting ◽  
International Consensus ◽  
Best Practice Guidelines ◽  
Consensus Statements ◽  
Cartilage Injuries ◽  
Working Groups ◽  
Strong Consensus

Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on “Diagnosis: History, Physical Examination, Imaging, and Arthroscopy” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available evidence for each statement was graded. Discussion and debate occurred in cases where statements were not agreed upon in unanimous fashion within the working groups. A final vote was then held, and the strength of consensus was characterized as follows: consensus: 51 - 74%; strong consensus: 75 - 99%; unanimous: 100%. Results: A total of 12 statements on the diagnosis of cartilage injuries of the ankle reached consensus during the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Two achieved unanimous support and 10 reached strong consensus (greater than 75% agreement). All statements reached at least 86% agreement. Conclusions: This international consensus derived from leaders in the field will assist clinicians in the diagnosis of cartilage injuries of the ankle.

Osteochondral Allograft: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

2018 ◽  
Vol 39 (1_suppl) ◽  
pp. 35S-40S ◽  
Author(s):  
Niall A. Smyth ◽  
Christopher D. Murawski ◽  
Samuel B. Adams ◽  
Gregory C. Berlet ◽  
Roberto Buda ◽  
...  
Keyword(s):  
Cartilage Repair ◽  
Best Practice ◽  
Consensus Meeting ◽  
Osteochondral Allograft ◽  
Osteochondral Lesions ◽  
International Consensus ◽  
Best Practice Guidelines ◽  
Consensus Statements ◽  
Working Groups ◽  
Strong Consensus

Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle is based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on “Osteochondral Allograft” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available evidence for each statement was graded. Discussion and debate occurred in cases where statements were not agreed upon in unanimous fashion within the working groups. A final vote was then held, and the strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; and unanimous, 100%. Results: A total of 15 statements on osteochondral allograft reached consensus during the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. One achieved unanimous support and 14 reached strong consensus (greater than 75% agreement). All statements reached at least 85% agreement. Conclusions: This international consensus derived from leaders in the field will assist clinicians with osteochondral allograft as a treatment strategy for osteochondral lesions of the talus.

Post-treatment Follow-up, Imaging, and Outcome Scores: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

2018 ◽  
Vol 39 (1_suppl) ◽  
pp. 68S-73S ◽  
Author(s):  
Pim A. D. van Dijk ◽  
Christopher D. Murawski ◽  
Kenneth J. Hunt ◽  
Carol L. Andrews ◽  
Umile Giuseppe Longo ◽  
...  
Keyword(s):  
Cartilage Repair ◽  
Best Practice ◽  
Consensus Meeting ◽  
Post Treatment ◽  
International Consensus ◽  
Consensus Statements ◽  
Outcome Scores ◽  
Working Groups ◽  
Strong Consensus

Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on Post-treatment Follow-up, Imaging and Outcome Scores developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available evidence for each statement was graded. Discussion and debate occurred in cases where statements were not agreed on in unanimous fashion within the working groups. A final vote was then held, and the strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; unanimous, 100%. Results: A total of 12 statements on Post-treatment Follow-up, Imaging, and Outcome Scores reached consensus during the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. All 12 statements reached strong consensus (greater than 75% agreement). Conclusions: This international consensus derived from leaders in the field will assist clinicians with post-treatment follow-up, imaging, and outcome scores after management of a cartilage injury of the ankle in the general population. Moreover, healing, rehabilitation, and final outcomes can be optimized for the individual patient.

Fixation Techniques: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

2018 ◽  
Vol 39 (1_suppl) ◽  
pp. 23S-27S ◽  
Author(s):  
Mikel L. Reilingh ◽  
Christopher D. Murawski ◽  
Christopher W. DiGiovanni ◽  
Jari Dahmen ◽  
Paulo N. F. Ferrao ◽  
...  
Keyword(s):  
Cartilage Repair ◽  
Best Practice ◽  
Consensus Meeting ◽  
Osteochondral Lesions ◽  
International Consensus ◽  
Best Practice Guidelines ◽  
Consensus Statements ◽  
Fixation Techniques ◽  
Working Groups ◽  
Strong Consensus

Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle is based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on “Fixation Techniques” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available evidence for each statement was graded. Discussion and debate occurred in cases where statements were not agreed upon in unanimous fashion within the working groups. A final vote was then held, and the strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; and unanimous, 100%. Results: A total of 15 statements on fixation techniques reached consensus during the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. All 15 statements achieved strong consensus, with at least 82% agreement. Conclusions: This international consensus derived from leaders in the field will assist clinicians with using fixation techniques in the treatment of osteochondral lesions of the talus.

Revision and Salvage Management: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

2018 ◽  
Vol 39 (1_suppl) ◽  
pp. 54S-60S ◽  
Author(s):  
Peter N. Mittwede ◽  
Christopher D. Murawski ◽  
Jakob Ackermann ◽  
Simon Görtz ◽  
Beat Hintermann ◽  
...  
Keyword(s):  
Cartilage Repair ◽  
Best Practice ◽  
Consensus Meeting ◽  
International Consensus ◽  
Best Practice Guidelines ◽  
Consensus Statements ◽  
Working Groups ◽  
Strong Consensus ◽  
Low Levels ◽  
International Experts

Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article was to report on the consensus statements on “Revision and Salvage Management” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available evidence for each statement was graded. Discussion and debate occurred in cases where statements were not agreed on in unanimous fashion within the working groups. A final vote was then held, and the strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; unanimous, 100%. Results: A total of 8 statements on revision and salvage management reached consensus during the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. One achieved unanimous support and 7 reached strong consensus (greater than 75% agreement). All statements reached at least 85% agreement. Conclusions: This international consensus derived from leaders in the field will assist clinicians with revision and salvage management in the cartilage repair of the ankle.

Rehabilitation and Return to Sports: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

2018 ◽  
Vol 39 (1_suppl) ◽  
pp. 61S-67S ◽  
Author(s):  
Pieter D’Hooghe ◽  
Christopher D. Murawski ◽  
Lorraine A. T. Boakye ◽  
David O. Osei-Hwedieh ◽  
Mark C. Drakos ◽  
...  
Keyword(s):  
Cartilage Repair ◽  
Best Practice ◽  
Consensus Meeting ◽  
Cartilage Injury ◽  
Return To Sports ◽  
International Consensus ◽  
Best Practice Guidelines ◽  
Consensus Statements ◽  
Working Groups ◽  
Strong Consensus

Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on Rehabilitation and Return to Sports developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available evidence for each statement was graded. Discussion and debate occurred in cases where statements were not agreed upon in unanimous fashion within the working groups. A final vote was then held, and the strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; unanimous, 100%. Results: A total of 9 statements on rehabilitation and return to sports reached consensus during the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. All 9 statements reached strong consensus, with at least 86% agreement. Conclusions: The rehabilitation process for an ankle cartilage injury requires a multidisciplinary and comprehensive approach. This international consensus derived from leaders in the field will assist clinicians with rehabilitation and return to sports after treatment of a cartilage injury of the ankle.

Subchondral Pathology: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

2018 ◽  
Vol 39 (1_suppl) ◽  
pp. 48S-53S ◽  
Author(s):  
Yoshiharu Shimozono ◽  
Alexandra J. Brown ◽  
Jorge P. Batista ◽  
Christopher D. Murawski ◽  
Mohamed Gomaa ◽  
...  
Keyword(s):  
Cartilage Repair ◽  
Best Practice ◽  
Consensus Meeting ◽  
International Consensus ◽  
Best Practice Guidelines ◽  
Consensus Statements ◽  
Working Groups ◽  
Strong Consensus ◽  
Low Levels ◽  
International Experts

Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on “Subchondral Pathology” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available evidence for each statement was graded. Discussion and debate occurred in cases where statements were not agreed upon in unanimous fashion within the working groups. A final vote was then held, and the strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; unanimous, 100%. Results: A total of 9 statements on subchondral pathology reached consensus during the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. No statements achieved unanimous support, but all statements reached strong consensus (greater than 75% agreement). All statements reached at least 81% agreement. Conclusions: This international consensus statements regarding subchondral pathology of the talus derived from leaders in the field will assist clinicians in the assessment and management of this difficult pathology.

Scaffold-Based Therapies: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

2018 ◽  
Vol 39 (1_suppl) ◽  
pp. 41S-47S ◽  
Author(s):  
Benjamin B. Rothrauff ◽  
Christopher D. Murawski ◽  
Chayanin Angthong ◽  
Christoph Becher ◽  
Stefan Nehrer ◽  
...  
Keyword(s):  
Cartilage Repair ◽  
Best Practice ◽  
Consensus Meeting ◽  
Osteochondral Lesions ◽  
Level Of Evidence ◽  
International Consensus ◽  
Best Practice Guidelines ◽  
Consensus Statements ◽  
Working Groups ◽  
Strong Consensus

Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on “Scaffold-Based Therapies” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available evidence for each statement was graded. Discussion and debate occurred in cases where statements were not agreed upon in unanimous fashion within the working groups. A final vote was then held, and the strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; unanimous, 100%. Results: A total of 9 statements on scaffold-based therapies reached consensus during the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. One achieved unanimous support, 8 reached strong consensus (greater than 75% agreement), and 1 was removed because of redundancy in the information provided. All statements reached at least 80% agreement. Conclusions: This international consensus derived from leaders in the field will assist clinicians with applying scaffold-based therapies as a treatment strategy for osteochondral lesions of the talus. Level of Evidence: Level V, expert opinion.

Conservative Management and Biological Treatment Strategies: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

2018 ◽  
Vol 39 (1_suppl) ◽  
pp. 9S-15S ◽  
Author(s):  
Malcolm E. Dombrowski ◽  
Youichi Yasui ◽  
Christopher D. Murawski ◽  
Lisa A. Fortier ◽  
Eric Giza ◽  
...  
Keyword(s):  
Cartilage Repair ◽  
Conservative Management ◽  
Biological Treatment ◽  
Treatment Strategies ◽  
Consensus Meeting ◽  
Osteochondral Lesions ◽  
International Consensus ◽  
Consensus Statements ◽  
Working Groups ◽  
Strong Consensus

Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on “Conservative Management and Biological Treatment Strategies” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available evidence for each statement was graded. Discussion and debate occurred in cases where statements were not agreed upon in unanimous fashion within the working groups. A final vote was then held, and the strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; unanimous, 100%. Results: A total of 12 statements on Conservative Management and Biological Treatment Strategies reached consensus during the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Ten statements reached strong consensus (greater than 75% agreement), and 2 achieved consensus. Conclusions: This international consensus derived from leaders in the field will assist clinicians with conservative management and biological treatment strategies for osteochondral lesions of the talus.

scholarly journals Best Practice Guidance for Adult Infusion Centres during the COVID-19 Pandemic: Report from the COVID-19 International Organization for the Study of IBD [IOIBD] Task Force

2020 ◽  
Vol 14 (Supplement_3) ◽  
pp. S785-S790
Author(s):  
Iris Dotan ◽  
Remo Panaccione ◽  
Gilaad G Kaplan ◽  
Colm O’Morain ◽  
James O Lindsay ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Best Practice ◽  
Online Survey ◽  
Task Force ◽  
International Organization ◽  
Care Givers ◽  
Global Guidance ◽  
Inflammatory Bowel ◽  
The Impact

Abstract Infusion centres are a central part in the management of patients with inflammatory bowel disease [IBD] and could be a source of transmission of SARS-COV-2. Here we aimed to develop global guidance for best practices of infusion centres for IBD patients and to determine the impact of the COVID-19 pandemic on these centres. Under the auspices of the International Organization for the Study of Inflammatory Bowel Disease [IOIBD], a task force [TF] was formed, an online survey was developed to query infusion centre protocols during COVID-19, and recommendations were made, based on TF experience and opinion. Recommendations focus mainly on patients screening, infusion centres re-organization, personnel protection, and protocol modifications such as shortening infusion duration or replacing it with subcutaneous alternatives. Implementing these recommendations will hopefully reduce exposure of both IBD patients and care givers to SARS-COV-2 and improve the function and safety of infusion centres during the COVID-19 pandemic as well as potential future threats.

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