scholarly journals 2021 Clinical Practice Guidelines for Diabetes Mellitus in Korea

2021 ◽  
Vol 22 (4) ◽  
pp. 244-249
Author(s):  
Seung-Hyun Ko

The Committee of Clinical Practice Guidelines of the Korean Diabetes Association (KDA) updated the previous clinical practice guidelines for Korean adults with diabetes and prediabetes and published the seventh edition in May 2021. We performed a comprehensive systematic review of recent clinical trials and evidence from real-world practice among the Korean population. The guidelines are intended for use at sites across the country by all healthcare providers (including physicians, diabetes experts, and certified diabetes educators) who treat diabetes. The recommendations for screening and antihyperglycemic agents have been revised and updated. Continuous glucose monitoring with insulin pump use and screening and treatment for non-alcoholic fatty liver disease were added in the type 2 diabetes sections. The KDA recommends active vaccination for COVID-19 in patients with diabetes. An abridgement that contains practical information for patient education and systematic clinic management was published separately.

Author(s):  
Mihaela C. Munteanu ◽  
Julie Choi Jordan

Medical professional societies each develop specific clinical practice guidelines (CPGs). Based on the best available evidence, CPGs are intended to control variability and optimize quality of care in clinical practice. Yet, healthcare providers often do not accept or adhere to guidelines, but their reasons are not fully understood. When providers opt to choose not to follow CPGs, unfavorable patient outcomes including unequal access to treatment become negative consequences. In this small qualitative study, we will explore what causes non-adherence to CPGs and what changes have been made to CPGs from when physicians completed their medical residencies to the present. We interviewed physicians from a variety of medical specialties to assess how these changes may influence guideline adherence as well as the consequences of not following them. We found that guidelines may not be followed in cases where patients have comorbidities that are not described in the guidelines or when physicians do not incorporate new evidence and technology advances into their practice. In some specialties, physicians can develop a poor reputation if they do not adhere to the CPGs, and managed care agencies may deny reimbursement for care they provided. To best serve the physician and the patient, we need to find ways to improve CPG adherence. Tactics such as improving the methodology of CPG formation, using information technology, and creating ways to change physician attitudes and behavior are all viable options.


Neurotrauma ◽  
2018 ◽  
pp. 13-20
Author(s):  
Geoffrey S. F. Ling ◽  
James M. Ecklund

Traumatic brain injury (TBI) is a common casualty of war. In Operation Iraqi Freedom and Operation Enduring Freedom in Afghanistan, TBI was described as the “signature injury of these wars.” As in civilian practice, severe TBI is a serious life-threatening medical condition requiring treatment by expert medical providers. Military providers adapt existing civilian clinical practice guidelines (CPG) to manage these patients. Where civilian CPG are nonexistent or inadequate for war theater use, the DoD creates new ones. These CPG are published to enable critique and improvement. Two CPG for TBI to come from the war are the “Guidelines for the Field Management of Combat-Related Head Trauma” and the “VA/DoD Clinical Practice Guidelines for Management of Concussion/Mild TBI.” From these efforts, a new type of TBI, explosive blast TBI, was elucidated. Intracranial vasospasm was identified as a sequelae to this TBI. Treatments used by military healthcare providers include hemicraniectomy and endovascular techniques.


Author(s):  
George Antonogeorgos ◽  
Eirini Bathrellou ◽  
Matina Kouvari ◽  
Dimitrios Poulimeneas ◽  
Mary Yannakoulia ◽  
...  

Obesity and diabetes rates have been rising to epidemic levels during the last decade, especially among young populations. Recommendations for clinicians and primary healthcare providers concerning the improvement of childhood nutrition and the healthcare of childhood nutrition-related diseases are of major interest. Clinical Practice Guidelines (CPGs) of the most updated evidence-based recommendations are useful tools that help clinicians in their practice. However, a gap has been observed between the suggested CPGs and their implementation in the context of everyday clinical practice. This could be merely attributed to the text format that is usually presented. In this review article, all the CPGs about the best dietary advice regarding energy and macronutrient intake in childhood and the most common chronic nutrition-related childhood diseases, i.e., obesity, dyslipidemia, and diabetes mellitus type 1 and 2, are summarized and visualized in an algorithmic format and practical examples are given. This could help healthcare providers to achieve a higher adoption rate of CPGs in clinical practice, thus, resulting in better management of children’s health and improved clinical outcomes. Keywords: nutrition, guidelines, algorithm, children.


2018 ◽  
Author(s):  
Carole A Lunny ◽  
Doug M Salzwedel ◽  
Tracy Liu ◽  
Cynthia Ramasubbu ◽  
Savannah Gerrish ◽  
...  

Background Guidelines are systematically developed recommendations to assist practitioner and patient decisions about treatments for clinical conditions. Researchers, healthcare professionals and policy makers need to be able to retrieve clinical practice guidelines (CPGs) efficiently and quickly from the literature. Despite the widespread use of CPGs in practice and policy formulation, no filter for retrieval of guidelines has been validated to date. The use of a validated search filter for CPGs would make their retrieval from major bibliographic databases more efficient. Objectives We aim to fill this gap by validating search filters for use in the systematic retrieval of CPGs and measure their performance according to sensitivity and precision. Methods We found four search filters for retrieval of CPGs (two CADTH, PubMed and University of Texas filters) which we will validate in three databases (MEDLINE, Embase and PubMed). We will derive a test set of CPGs from a search of the TRIP and Epistemonikos databases. The citations retrieved will be randomly sorted and screened sequentially by two reviewers until at least 100 CPGs are included. We will include CPGs that provide at least two explicit recommendations for the treatment of any clinical condition, and that are produced by a group or organization (i.e., not authored by one person) . We will translate the filters into Ovid MEDLINE, Embase, and PubMed syntax as appropriate. Then, we will run the strategies and assess whether the filters retrieved the citations in our test set. We will calculate and compare the sensitivity and precision of the four filters in each database. The limitations of the CADTH, PubMed and University of Texas search filters for each database will be assessed by examining the keywords in the titles and abstracts of the citations not found by the search filters. Discussion Decision makers, healthcare providers and researcher will be able to choose the most precise and sensitive search strategy among the four available, which will enable them to more efficiently identify relevant clinical practice guidelines.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Thanansayan Dhivagaran ◽  
Umaima Abbas ◽  
Fahad Butt ◽  
Luckshann Arunasalam ◽  
Oswin Chang

Abstract Background In December 2019, a novel coronavirus, severe acute respiratory syndrome coronavirus 2 was identified as the cause of an acute respiratory disease, coronavirus disease 2019 (COVID-19). Given the lack of validated treatments, there is an urgent need for a high-quality management of COVID-19. Clinical practice guidelines (CPGs) are one tool that healthcare providers may use to enhance patient care. As such, it is necessary that they have access to high-quality evidence-based CPGs upon which they may base decisions regarding the management and use of therapeutic interventions (TI) for COVID-19. The purpose of the proposed study is to assess the quality of CPGs that make management or TI recommendations for COVID-19 using the AGREE II instrument. Methods The proposed systematic review will identify CPGs for TI use and/or the management of COVID-19. The MEDLINE, EMBASE, CINAHL, and Web of Science databases, as well as the Guidelines International Network, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, and the World Health Organization websites, will be searched from December 2019 onwards. The primary outcome of this study is the assessed quality of the CPGs. The quality of eligible CPGs will be assessed using the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument. Descriptive statistics will be used to quantify the quality of the CPGs. The secondary outcomes of this study are the types of management and/or TI recommendations made. Inconsistent and duplicate TI and/or management recommendations made between CPGs will be compared across guidelines. To summarize and explain the findings related to the included CPGs, a narrative synthesis will also be provided. Discussion The results of this study will be of utmost importance to enhancing clinical decision-making among healthcare providers caring for patients with COVID-19. Moreover, the results of this study will be relevant to guideline developers in the creation of CPGs or improvement of existing ones, researchers who want to identify gaps in knowledge, and policy-makers looking to encourage and endorse the adoption of CPGs into clinical practice. The results of this review will be published in a peer-reviewed journal and presented at conferences. Systematic review registration International Prospective Register for Systematic Reviews (PROSPERO)—CRD42020219944


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