scholarly journals CIRSE standards of practice on gynaecological and obstetric haemorrhage

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Thomas Rand ◽  
Rafiuddin Patel ◽  
Wolfgang Magerle ◽  
Raman Uberoi
Keyword(s):  
Interventional Radiology ◽  
Clinical Practice ◽  
Best Practices ◽  
Practice Guidelines ◽  
Postpartum Haemorrhage ◽  
Standard Of Care ◽  
Writing Group ◽  
Standards Of Practice ◽  
Obstetric Haemorrhage ◽  
Practice Committee

AbstractThis CIRSE Standards of Practice document provides best practices for obstetric haemorrhage embolisation (OHE) in the management of postpartum haemorrhage (PPH). The document is aimed at interventional radiologists involved in treating postpartum haemorrhage, and has been developed by a writing group established by the CIRSE Standards of Practice Committee.CIRSE Standards of Practice documents are not clinical practice guidelines and do not intend to impose a standard of care, rather provide reasonable approaches to and best practices for specific interventional radiology treatments and techniques.

scholarly journals Conflicts of Interest in Clinical Practice Guidelines: Accelerating an Evolution. An Endocrine Society Consensus Statement*

2018 ◽  
Vol 103 (12) ◽  
pp. 4339-4342 ◽  
Author(s):  
Christopher R McCartney ◽  
Clifford J Rosen
Keyword(s):  
Clinical Practice ◽  
Best Practices ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Development Process ◽  
Consensus Statement ◽  
Conflicts Of Interest ◽  
Best Interests ◽  
Endocrine Society ◽  
Open Payments

Abstract An analysis of the Endocrine Society’s clinical practice guidelines (CPGs) published from 2010 to 2017—presented by Irwig et al. in the current issue of The Journal of Endocrinology and Metabolism—suggested that the Endocrine Society met five of seven National Academy of Medicine (NAM) standards concerning financial conflicts of interest in CPGs. As current contributors to the Endocrine Society’s CPG efforts, we offer additional context related to the 2011 NAM standards and the current environment concerning industry support in medicine, and we comment on the nature of industry support received by the Society’s CPG authors according to Irwig and colleagues’ analysis of the Centers for Medicare and Medicaid Services’ Open Payments database. Perhaps most importantly, we outline the Society’s recent and ongoing efforts to enhance the value of its CPGs. Such efforts include a 2016 revision of CPG author conflict of interest rules—a change that was invisible to the investigatory methods used by Irwig et al.—in addition to other processes designed to enhance CPG objectivity. We conclude our commentary by recognizing that good-faith attempts to enhance transparency and to reduce conflicts of interest (real or apparent) in CPGs will ultimately serve the best interests of patients and providers; we confirm the Endocrine Society’s resolute commitment to providing high-quality, evidence-based clinical guidance via a CPG development process that faithfully accords with current CPG best practices.

scholarly journals 4340 Piloting Implementation and Dissemination of Best Practice Guidelines Using BPM+Health

2020 ◽  
Vol 4 (s1) ◽  
pp. 141-142
Author(s):  
James McClay ◽  
Pawan Goyal
Keyword(s):  
Clinical Practice ◽  
Best Practices ◽  
Practice Guidelines ◽  
Point Of Care ◽  
Guideline Implementation ◽  
Software Tool ◽  
First Trimester ◽  
Emergency Physicians ◽  
Implementation And Dissemination ◽  
On Line

OBJECTIVES/GOALS: Clinical translational studies inform clinical practice patterns through dissemination of clinical practice guidelines (CPG). In EM practices change to rapidly for timely local EHR implementation. We test the OMG BPM+Health specification for rapid deployment of best practices relevant to EM. METHODS/STUDY POPULATION: The OMG Business Process Management for Healthcare (BPM+Health) specification combines BPMN™ with Case Management Model and Notation (CMMN™) and Decision Model and Notations (DMN™) to “disseminate and leverage evidence-based best-practices at the point of care.” The American College of Emergency Physicians (ACEP) Board-certified Emergency Physicians modeled practice guidelines in the BPM+ modeling language during on-line meetings. Two common emergency conditions were selected for initial pilot testing: 1) evaluation and treatment of first trimester bleeding in pregnant patients, and 2) the evaluation and treatment of non-traumatic low back pain. RESULTS/ANTICIPATED RESULTS: The protocols were successfully modeled during four on-line meetings in less than 2 months. Process steps from initial evaluation to disposition were implemented using BPMN™. When clinicians need to evaluate the patient to collect data for decision making the inputs and outputs were modeled in CMMN™. Decision logic is represented as DMN™. The software tool linked the components for easy browsing and authoring the logic. The Physicians easily followed the displayed logic. The practice recommendations from each policy were successfully modeled, using the standard BPM+ notation to support rapid implementation in EHRs. Detailed implementation specifications will be shared. DISCUSSION/SIGNIFICANCE OF IMPACT: This pilot project demonstrated the feasibility of the OMG approach to solving Clinical Practice Guideline Implementation and Dissemination Barriers. Ongoing work by involved specialty societies will be necessary to demonstrate the scalability and sustainability of this approach.

scholarly journals Practice Guidelines for Canadian Neurophysiology Laboratories During the COVID-19 Pandemic

2020 ◽  
pp. 1-6
Author(s):  
◽  
Juan Pablo Appendino ◽  
Steven K. Baker ◽  
Kristine M. Chapman ◽  
Tamara Dykstra ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Practice Guidelines ◽  
Health Care Workers ◽  
Good Care ◽  
Canadian Society ◽  
Standards Of Practice ◽  
Canadian Association ◽  
Care Workers ◽  
Review Current

Abstract: The COVID-19 pandemic has had a major impact on clinical practice. Safe standards of practice are essential to protect health care workers while still allowing them to provide good care. The Canadian Society of Clinical Neurophysiologists, the Canadian Association of Electroneurophysiology Technologists, the Association of Electromyography Technologists of Canada, the Board of Registration of Electromyography Technologists of Canada, and the Canadian Board of Registration of Electroencephalograph Technologists have combined to review current published literature about safe practices for neurophysiology laboratories. Herein, we present the results of our review and provide our expert opinion regarding the safe practice of neurophysiology during the COVID-19 pandemic in Canada.

scholarly journals Trends in Female Representation on NCCN Guideline Panels

2020 ◽  
Vol 18 (8) ◽  
pp. 1084-1086 ◽  
Author(s):  
Pranammya Dey ◽  
Angela K. Green ◽  
Michael Haddadin ◽  
Peter B. Bach ◽  
Aaron P. Mitchell
Keyword(s):  
Clinical Practice ◽  
Practice Guidelines ◽  
Time Trends ◽  
Female Physician ◽  
Standard Of Care ◽  
Female Representation ◽  
Nccn Guidelines ◽  
Representation Of Women ◽  
Physician Scientists ◽  
Disease Specific

Background: NCCN produces highly influential disease-specific oncology clinical practice guidelines. Because the number of women in academic oncology has increased, we assessed whether the composition of NCCN Guidelines Panels reflected this trend. Methods: Using historical guidelines requested from NCCN, we investigated time trends for female representation on 21 NCCN Guidelines Panels and analyzed the trends for female-predominant cancers (breast, ovarian, uterine, and cervical) compared with all cancers. Results: From 2013 to 2019, there was an increase from 123 women of 541 total panelists (22.7%) to 175 women of 542 panelists (32.3%). Within the 4 female-predominant cancers, the increase was more rapid: from 30 of 101 total panelists (29.7%) to 66 of 118 panelists (56.4%). Excluding female-predominant cancers, increases were minimal. Conclusions: There could be multiple explanations for these differing trends, including the possibility of more rapid increases in the underlying pool of female physician-scientists in female-predominant specialties or more efforts to increase the representation of women in decisions about the standard of care in cancers predominantly affecting women.

scholarly journals Australasian paramedic clinical practice guidelines for managing cardiac arrest: an appraisal

2019 ◽  
Vol 16 ◽  
Author(s):  
Marc Colbeck ◽  
Andrew Swain ◽  
Jonathan Gibson ◽  
Lachlan Parker ◽  
Paul Bailey ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Clinical Practice ◽  
Best Practices ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Lead Author ◽  
Evidence Based ◽  
Clinical Use ◽  
Agree Ii ◽  
Agree Ii Instrument

IntroductionThere are 10 government-regulated ambulance services (paramedic provider services) in Australasia who are members of the Council of Ambulance Authorities (CAA). These CAA-member services each produce clinical practice guidelines (CPGs), which guide the practice of their paramedics. Common to each set of CAA-member CPG is a guideline that addresses cardiac arrest due to ventricular fibrillation and pulseless ventricular tachycardia (pulseless VT/VF). This study sought to answer the question: ‘Are current CAA-member CPGs developed with sufficient methodological rigour to consistently produce guidelines that, according to validated, evidence-based best practices, can be recommended for clinical use?’MethodsThis question was addressed by performing a comparison of existing CAA-member CPGs for pulseless VT/VF against the Appraisal of Guidelines for Research & Evaluation (AGREE II) instrument. All CPGs were anonymised and sent to each appraiser along with the AGREE II appraisal sheet. Appraisals were conducted independently for each CPG and returned to the lead author for collation. The anonymised results were then shared among all appraisers for consideration and discussion. Appraisers were free to change their appraisal after considering the comments from the other appraisers, and results were then converted into a final percent score for each CPG in accord with the recommended AGREE II instrument methodology. One appraisal question, in addition to the AGREE II criteria was added to each appraisal; the response to this was analysed separately.ResultsNine CPGs were evaluated according to the AGREE II instrument. The appraisers gave passing marks to only two of the six domains in the AGREE II instrument: Domain 1 – Scope and Purpose (73%), and Domain 4 – Clarity of Presentation (74%). Less than passing marks were awarded for Domain 2 – Stakeholder Involvement (27%). Scores of less than 10% were awarded for Domain 5 – Applicability (8%) and Editorial Independence (1%).ConclusionBased on the findings of this paper, the authors conclude that it cannot be assumed that current CAA-member paramedic CPGs are developed with sufficient methodological rigour to consistently produce guidelines that, according to validated, evidence-based best practices can be recommended for clinical use. However, most of the authors agree that the CPGs reviewed could be recommended for clinical use with relatively minor modifications. It would be useful to determine whether end users of the CAA-member CPGs agree on the importance of characteristics of CPGs that the AGREE II instrument appraises.

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