scholarly journals Draft of the clinical practice guidelines “Adrenal incidentaloma”

2021 ◽  
Vol 15 (1) ◽  
pp. 4-26
Author(s):  
D. G. Beltsevich ◽  
E. A. Troshina ◽  
G. A. Melnichenko ◽  
N. M. Platonova ◽  
D. O. Ladygina ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Guidelines ◽  
Adrenal Incidentaloma ◽  
Clinical Problem ◽  
Maximum Efficiency ◽  
Postoperative Rehabilitation ◽  
Technical Improvement ◽  
Structured Information ◽  
Short Time ◽  
Based Medicine

The wider application and technical improvement of abdominal imaging procedures in recent years has led to an increasingly frequent detection of adrenal gland masses — adrenal incidentaloma, which have become a common clinical problem and need to be investigated for evidence of hormonal hypersecretion and/or malignancy. Clinical guidelines are the main working tool of a practicing physician. Laconic, structured information about a specific nosology, methods of its diagnosis and treatment, based on the principles of evidence-based medicine, make it possible to give answers to questions in a short time, to achieve maximum efficiency and personalization of treatment. These clinical guidelines include data on the prevalence, etiology, radiological features and assessment of hormonal status of adrenal incidentalomas. In addition, this clinical practice guideline provides information on indications for surgery, postoperative rehabilitation and follow-up.

scholarly journals Atrioventricular Block in Children

2018 ◽  
Vol 15 (5) ◽  
pp. 365-375
Author(s):  
Igor A. Kovalev ◽  
Yuri M. Belozerov ◽  
Dinara I. Sadykova ◽  
Dina R. Sabirova ◽  
Lyudmila V. Yakovleva ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Atrioventricular Block ◽  
Evidence Based Medicine ◽  
Clinical Guidelines ◽  
Diagnosis And Treatment ◽  
Evidence Based ◽  
Cardiovascular Pathology ◽  
Slowing Down ◽  
Conduction Disorders ◽  
Based Medicine

Rhythm and conduction disorders of the heart occupy one of the leading places in the structure of cardiovascular pathology in children. Atrioventricular block is the slowing down or loss of impulses from the atria to the ventricles. The team of authors presents clinical guidelines based on the principles of evidence-based medicine, including all stages of diagnosis and treatment of children with atrioventricular block. The use of guidelines in clinical practice will allow to choose the best strategy for the diagnosis and treatment of atrioventricular block for each individual patient.

scholarly journals Clinical guidelines: an evidence-based debate

2019 ◽  
Vol 8 (2) ◽  
pp. 92-96
Author(s):  
Fereshte Farhadi ◽  
Masoumeh Abbasi-Asl ◽  
Negar Taleschian-Tabrizi ◽  
Mohammad Ali Hajebrahimi ◽  
Hadi Mostafaie ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Guidelines ◽  
International Student ◽  
Guideline Implementation ◽  
Research Integrity ◽  
Evidence Based ◽  
Clinical Encounters ◽  
Clinical Scenarios ◽  
Practice Methods ◽  
Based Medicine

Background: This study aimed to evaluate the effectiveness of debate as a learning tool for changing audiences’ views regarding the use of clinical guidelines in routine clinical practice. Methods: A debate scenario including different rationales for and against using guidelines in clinical practice, presented by the student section of Iranian Evidence Based Medicine Center of Excellence, was held at the first International Student Congress of Research Integrity and Evidence-Based Practice (Kish Island, Iran, December, 2015). The audience was first asked to check the papers given to them, and if they agreed to the terms, they were asked to choose,"Yes", "No", or "I don’t know". Results: Of the 400 individuals participating in the congress, 100 were present during the scheduled debate time. Among the 71 people completing pretest questionnaires, 73% (52)answered "yes" to the question, "Should we use guidelines? "About 7% (5) claimed that we shouldn’t use guidelines, and 20% (14) had no opinion about using them. Following the debate,the participants who chose "yes" to the guidelines remained in favor of their use in clinical practice. Of the 14 who did not have an opinion for guideline use, all agreed to use guidelines in clinical practice. Surprisingly, the five participants who were against guideline implementation remained fixed in their view, continuing to disagree regarding their use in clinical encounters. Conclusion: Although we were unable to change the attitudes of physicians who were against the use of guidelines in clinical practice, the debate caused a positive shift among participants who did not have an opinion regarding their use in clinical scenarios.

scholarly journals Implementing clinical guidelines

2019 ◽  
Vol 19 (6) ◽  
pp. 529-535
Author(s):  
Josephine Mayer ◽  
Christopher Kipps ◽  
Hannah R Cock
Keyword(s):  
Clinical Practice ◽  
Evidence Based Medicine ◽  
Clinical Guidelines ◽  
Evidence Based ◽  
Healthcare Environment ◽  
Team Working ◽  
Based Medicine ◽  
Provision Of Care

Clinical guidelines that support practice and improve care are essential in this era of evidence-based medicine. However, implementing this guidance often falls short in practice. Sharing knowledge and auditing practice are important, but not sufficient to implement change. This article brings together evidence from the study of behaviour, education and clinical practice and offers practical tips on how practising neurologists might bring about change in the healthcare environment. Common themes include the importance of team working, multidisciplinary engagement, taking time to identify who and what needs changing, and selecting the most appropriate tool(s) for the job. Engaging with the challenge is generally more rewarding than resisting and is important for the effective provision of care.

scholarly journals The Limitations of Evidence Based Practice for Emergency Medicine

2000 ◽  
Vol 7 (2) ◽  
pp. 116-120 ◽  
Author(s):  
Am Kelly ◽  
C Horsley
Keyword(s):  
Decision Making ◽  
Emergency Medicine ◽  
Clinical Practice ◽  
Evidence Based Medicine ◽  
Evidence Based Practice ◽  
Clinical Problem ◽  
Evidence Based ◽  
Based Medicine

Evidence based practice (EBP), also known as evidence based medicine, has been suggested as a more suitable basis for decision-making in clinical practice than the traditional ‘expert' based approach. Central to EBP is the application of evidence (as found in the published literature) to an individual clinical problem. EBP, however, has limitations that may raise questions regarding its applicability to particular types of clinical situations including many of the problems encountered in Emergency Medicine. This article discusses the background and limitations of EBM and suggests some ways that the principles can be incorporated into Emergency Medicine practice.

scholarly journals The Diagnosis and Therapy of Degenerative Knee Joint Disease: Expert Consensus from the Chinese Pain Medicine Panel

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Dong Huang ◽  
Yan-Qing Liu ◽  
Li-Shuang Liang ◽  
Xue-Wu Lin ◽  
Tao Song ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Diagnosis And Treatment ◽  
Joint Disease ◽  
Knee Joints ◽  
Reproduction Rate ◽  
Pain Specialist ◽  
Chinese Association ◽  
The One ◽  
Almost All ◽  
Based Medicine

At present, there are many constantly updated guidelines and consensuses on the diagnosis and treatment of osteoarthritis both at home and abroad. The recommendations established using methods of evidence-based medicine has experienced strict research on controlling bias and promoting reproduction rate. As a result, the previous evidence was reevaluated, and a lot of changes were provoked in the diagnosis and treatment concept of osteoarthritis. However, several methods not recommended by foreign guidelines are still in use in the current clinical practice in China. On the one hand, Chinese experts have not reached extensive consensus on whether it is necessary to make changes according to foreign guidelines. On the other hand, almost all the current relevant guidelines are on osteoarthritis, but the lesions around knee joints which, as a whole, bear the largest weight in human body, cannot be ignored. For this purpose, Chinese Association for the Study of Pain (CASP) organized some leading experts to formulate this Chinese Pain Specialist Consensus on the diagnosis and treatment of degenerative knee osteoarthritis (DKOA) in combination with the guidelines in foreign countries and the expert experience of clinical practice in China. The consensus, which includes the definition, pathophysiology, epidemiology, clinical manifestation, diagnostic criteria, and treatments of DKOA, is intended to be used by first-line doctors, including pain physicians to manage patients with DKOA.

scholarly journals Systematic review of international clinical guidelines for the promotion of physical activity for the primary prevention of cardiovascular diseases

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
N. Aerts ◽  
D. Le Goff ◽  
M. Odorico ◽  
J. Y. Le Reste ◽  
P. Van Bogaert ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Clinical Practice ◽  
Cardiovascular Diseases ◽  
Primary Prevention ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Clinical Guidelines ◽  
Prevention Programs ◽  
Prevention Of Cardiovascular Disease

Abstract Background Cardiovascular diseases are the world’s leading cause of morbidity and mortality. An active lifestyle is one of the cornerstones in the primary prevention of cardiovascular disease. An initial step in guiding primary prevention programs is to refer to clinical guidelines. We aimed to systematically review clinical practice guidelines on primary prevention of cardiovascular disease and their recommendations regarding physical activity. Methods We systematically searched Trip Medical Database, PubMed and Guidelines International Network from January 2012 up to December 2020 using the following search strings: ‘cardiovascular disease’, ‘prevention’, combined with specific cardiovascular disease risk factors. The identified records were screened for relevance and content. We methodologically assessed the selected guidelines using the AGREE II tool. Recommendations were summarized using a consensus-developed extraction form. Results After screening, 27 clinical practice guidelines were included, all of which were developed in Western countries and showed consistent rigor of development. Guidelines were consistent about the benefit of regular, moderate-intensity, aerobic physical activity. However, recommendations on strategies to achieve and sustain behavior change varied. Multicomponent interventions, comprising education, counseling and self-management support, are recommended to be delivered by various providers in primary health care or community settings. Guidelines advise to embed patient-centered care and behavioral change techniques in prevention programs. Conclusions Current clinical practice guidelines recommend similar PA lifestyle advice and propose various delivery models to be considered in the design of such interventions. Guidelines identify a gap in evidence on the implementation of these recommendations into practice.

Adrenal Incidentaloma in Real Clinical Practice in a Developing Country Are Not Studied for Hormonal Production

2015 ◽  
pp. LBT-074-LBT-074
Author(s):  
Alejandro Roman-Gonzalez ◽  
Maria del Pilar Londono ◽  
James Diaz ◽  
Carlos Alfonso Builes-Barrera ◽  
Johnayro Gutierrez
Keyword(s):  
Clinical Practice ◽  
Developing Country ◽  
Adrenal Incidentaloma ◽  
Real Clinical Practice

scholarly journals Psychiatry in the future

2004 ◽  
Vol 28 (8) ◽  
pp. 277-278
Author(s):  
Frank Holloway
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Evidence Based Medicine ◽  
Cochrane Collaboration ◽  
Routine Clinical Practice ◽  
Evidence Based ◽  
Policy Makers ◽  
The Future ◽  
The Cochrane Collaboration ◽  
Based Medicine

In an era of evidence-based medicine, policy-makers and researchers are preoccupied by the task of ensuring that advances in research are implemented in routine clinical practice. This preoccupation has spawned a small but growing research industry of its own, with the development of resources such as the Cochrane Collaboration database and journals such as Evidence-Based Mental Health. In this paper, I adopt a philosophically quite unfashionable methodology – introspection – to address the question: how has research affected my practice?

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