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1.
Support Care Cancer ; 32(4): 264, 2024 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-38564034

RESUMEN

OBJECTIVE: This paper aims to provide an evidence-based summary of the most effective strategies for comprehensive healthcare of chemotherapy-induced peripheral neuropathy (CIPN) in cancer patients. METHOD: Following the "6S" model, relevant evidence on CIPN management was collected from reputable evidence-based resource websites and databases nationally and internationally. The included articles were evaluated for methodological quality, and evidence was extracted using the Australian JBI Evidence-based Health Care Center's literature evaluation standard (2016 edition). RESULTS: A total of 60 articles were included in this study, comprising 2 guidelines, 5 expert consensus statements, and 53 systematic reviews. The findings of these articles were summarized across 7 dimensions, including risk factor screening, assessment, diagnosis, prevention, treatment, management, and health education, resulting in the identification of 42 relevant pieces of evidence. CONCLUSIONS: This study provides a comprehensive synthesis of evidence-based recommendations for managing CIPN in cancer patients, offering guidance for healthcare professionals engaged in clinical practice. However, when implementing these recommendations, it is crucial to consider the individual patient's clinical circumstances, preferences, and expert judgment, ensuring feasibility and applicability in real-world clinical settings.


Asunto(s)
Antineoplásicos , Neoplasias , Enfermedades del Sistema Nervioso Periférico , Humanos , Australia , Atención Integral de Salud , Enfermedades del Sistema Nervioso Periférico/inducido químicamente , Enfermedades del Sistema Nervioso Periférico/terapia , Neoplasias/tratamiento farmacológico , Antineoplásicos/efectos adversos
2.
BMC Anesthesiol ; 24(1): 79, 2024 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-38408893

RESUMEN

OBJECTIVE: To evaluate and summarize literature pertaining to evidence of peripheral arterial catheterization in adults, and to provide a reference for clinical practice. METHODS: We undertook a systematic review of literature on the removal of peripheral arterial manometric catheters in adult patients from various sources such as UpToDate, BMJ, National Institute for Health and Care Excellence (NICE), Medlive, Cochrane Library, Joanna Briggs Institute (JBI) Evidence-based Health Care Center Database, CINAHL, PubMed, Wanfang Data, VIP, and other databases. The retrieval time was set as from the establishment of the database till August 30, 2021. We screened the studies that fulfilled the inclusion criteria, evaluated their quality, and retrieved and summarized such articles. RESULTS: The review included 8 articles: 1 clinical decision, 3 guidelines, 2 evidence summaries, 1 systematic review, and 1 expert consensus. In all, 17 pieces of strong evidence were collected and extracted based on the following 5 dimensions: assessment of removal timing, preparation before removal, removal procedure, compression time, and key points after removal. CONCLUSIONS: The removal of a peripheral arterial manometry catheter requires careful consideration by medical professionals. In order to increase the removal standardization rate and decrease the incidence of clinical complications, standardized procedures and training need to be developed.


Asunto(s)
Cateterismo Periférico , Enfermedad Crítica , Remoción de Dispositivos , Cateterismo Periférico/métodos , Enfermedad Crítica/terapia , Remoción de Dispositivos/métodos , Medicina Basada en la Evidencia , Humanos , Adulto
3.
BMC Surg ; 24(1): 281, 2024 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-39354486

RESUMEN

PURPOSE: To retrieve, evaluate, and summarize the best available evidence regarding the safe use of pneumatic tourniquet in patients undergoing Limb surgery, providing guidance for preoperative assessment, operation methods and precautions, complication prevention and treatment in clinical practice. METHODS: Using the PIPOST tool, we formulated an evidence-based question, conducted searches in relevant Chinese and international databases and websites for clinical decisions, guidelines, evidence summaries, systematic reviews, and expert consensus on the use of limb surgical tourniquets. The search was limited to literature published until September 30, 2023. Quality assessment and evidence extraction were performed on eligible documents. RESULTS: This study included a total of 13 articles, including 2 clinical decision-making articles, 3 guidelines, 5 expert consensus articles, 1 standard and 2 systematic reviews. A total of 34 best pieces of evidence recommendations were summarized across 10 aspects, including indications and contraindications for the use of pneumatic tourniquets, preoperative evaluation of operators, selection and placement of tourniquet cuffs, tourniquet inflation, monitoring during inflation, tourniquet deflation, common complications and prevention, equipment safety, documentation, and training and education. CONCLUSION: The best evidence summarized in this study can provide reference for clinical medical staff to safely use pneumatic tourniquets, but in clinical practice, targeted selection and application of evidence should be combined with specific situations to improve the safety and hemostatic effect of pneumatic tourniquet use.


Asunto(s)
Extremidades , Torniquetes , Humanos , Extremidades/irrigación sanguínea , Extremidades/cirugía , Medicina Basada en la Evidencia , Pérdida de Sangre Quirúrgica/prevención & control
4.
J Pediatr Nurs ; 76: e50-e59, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38278746

RESUMEN

PROBLEM: Toddlers are more prone to exposure to widely distributed air pollution and to health damage from it. However, systematic summaries of evidence on protective behaviors against air pollution for toddlers are lacking. OBJECTIVE: To identify currently available evidence on protective behaviors against air pollution for toddlers. METHODS: The literature retrieval was performed in selected databases, limited from 2002 to 2022. Studies meeting the following criteria were included and praised: 1) clinical practice guideline, systematic review, expert consensus, recommended practice, randomized control test (RCT) or cohort study published in Chinese or English; 2) studies reporting effects of protective behaviors against air pollution on toddlers' health outcomes or providing recommendation on these behaviors. The evidence in the included studies was extracted, synthesized and graded for evidence summary. RESULTS: Studies (N = 19) were used for evidence summary development and 35 pieces of best evidence were synthesized, which were divided into three categories, including "avoiding or reducing air pollution generation", "removing existing air pollution", and "avoiding or reducing exposure to existing air pollution". CONCLUSIONS: More evidence is needed to identify protective measures against outdoor air pollution and tobacco smoke. Research in the future should focus on the safety, effectiveness and feasibility of universal measures implemented in toddlers, and try to develop protective measures specific to toddlers which highlight their special nature. IMPLICATIONS: The results of this study can help pediatric nurses provide individualized advice and assistance for toddlers and their families, and conduct research on the effectiveness of toddler-targeting protective behaviors more efficiently.


Asunto(s)
Contaminación del Aire , Humanos , Contaminación del Aire/efectos adversos , Contaminación del Aire/prevención & control , Preescolar , Lactante , Femenino , Exposición a Riesgos Ambientales/efectos adversos , Exposición a Riesgos Ambientales/prevención & control , Masculino
5.
Aesthetic Plast Surg ; 2024 Oct 08.
Artículo en Inglés | MEDLINE | ID: mdl-39377788

RESUMEN

AIM: To integrate and summarize the best evidence on perioperative management practices for hair transplantation patients, providing an evidence-based reference for clinical. METHODS: An exhaustive literature search was conducted to identify the best evidence for managing patients undergoing hair transplantation during the perioperative period. The databases searched included Up To Date, BMJ Best Practice, UK National Institute for Health and Care Excellence, National Guideline Clearing House, Scottish Intercollegiate Guidelines Network, Guidelines International Network, Cochrane Library, JBI Database of Systematic Reviews and Implementation Reports, PubMed, Web of Science, European Dermatology Forum, China National Knowledge Infrastructure, Wanfang Data, Medlive Guideline Network, and Sinomed. The search spanned publications from February 2013 to February 2024, focusing on clinical decisions, evidence summaries, guidelines, and expert consensus. RESULTS: We finally identified 22 articles with high-quality results (consisting of 9 clinical decisions, 6 guidelines, 7 expert consensuses), providing 41 pieces of evidence across seven categories: assessment of transplantation conditions, transplant planning and preoperative preparation, anesthetic preparations, surgical methods and operation skills, postoperative wound management, medication-related guidance, optimization of nursing and treatment strategies. Special emphasis has been placed on the sections covering anesthesia preparation, surgical methods, and operational techniques, with detailed explanations provided. CONCLUSION: The summarized best evidence on perioperative management practices for hair transplantation patients can serve as evidence-based guidelines for clinical. It is recommended that clinical staff adopt evidence-based recommendations to improve and optimize patient outcomes and promote postoperative recovery. As these evidences came from different countries, factors such as the clinical environment should be evaluated before application. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

6.
BMC Nurs ; 23(1): 664, 2024 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-39294683

RESUMEN

PURPOSE: This study aims to summarize the latest and best evidence on central venous access device-related thrombosis (CRT) in hospitalized children, which provides theoretical support for standardizing the preventive care practice of CRT in hospitalized children. METHODS: Relevant guidelines, systematic reviews and expert consensuses were reviewed through ten guideline websites, six professional association websites and seven databases. The literature evaluation was conducted, and the best evidence from qualified studies was extracted and summarized. Furthermore, the best evidence was summarized through expert consultation and localized for the preventive care practice of CRT in hospitalized children in China. RESULTS: A total of 14 topics and 68 best evidence were collected, including personnel qualification and quality management, pediatric patient selection, risk assessment, central venous access device (CVAD) selection and use, tip position, catheter maintenance, basic prevention, drug prevention, imaging examination, health education, nursing records, follow-up, CVAD removal and others. CONCLUSION: In this study, the best evidence based on evidence-based nursing was summarized, and expert consultation was adopted to localize the best evidence collected. It is of great significance to standardize the clinical practice of pediatric nurses and ensure the effectiveness of CRT preventive care for hospitalized children, thus guaranteeing the safety of hospitalized children with CVAD catheterization.

7.
Artículo en Inglés, Zh | MEDLINE | ID: mdl-39319473

RESUMEN

OBJECTIVES: To summarize the best evidence for the management of ovarian hyperstimulation syndrome in patients undergoing assisted reproductive therapy. METHODS: Evidence related to the management of ovarian hyperstimulation syndrome in patients undergoing assisted reproductive therapy, including practice guidelines, systematic evaluation, expert consensuws and evidence summary was systematically searched in UpToDate, BMJ Best Practice, World Health Organization (WHO) website, Guidelines International Network (GIN), National Institute for Health and Clinical Excellence (NICE) website, National Guidelines website, American Society for Reproductive Medicine (ASRM) website, New York Academy of Sciences (NYAS) website, Joanna Briggs Institute (JBI) database, Cochrane Library, CINAHL, PubMed, Wanfang Knowledge Data Service Platform, CNKI, and China Biomedical Literature Database from inception to March 1, 2024. Two researchers independently evaluated the quality of the literature, and a senior researcher made the final decision for literature inclusion. RESULTS: A total of 14 articles met the criteria, including 5 practical guidelines, 3 systematic evaluations, 2 expert consensuses, 1 evidence summary paper and 3 from UptoDate. The final formation includes five aspects: risk assessment, disease monitoring, early prevention, institutional management, and health education, with a total of 27 best pieces of evidence. CONCLUSIONS: The updated evidence indicates that the monitoring and prevention of ovarian hyperstimulation syndrome should start early; medical practitioners should provide personalized treatment plans for patients, promote the rational allocation of treatment resources, and enhance effective management of ovarian hyperstimulation syndrome.

8.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 49(1): 135-144, 2024 Jan 28.
Artículo en Inglés, Zh | MEDLINE | ID: mdl-38615175

RESUMEN

Advance care planning (ACP) is designed to ensure that patients lacking autonomous decision-making capacity receive medical services in accordance with their expectations and preferences. Individuals with advanced cancer are a crucial target for ACP implementation. However, the current practice of ACP in this group in China is suboptimal, demanding high-quality implementation evidence to strengthen ACP in the clinical practice of patients with advanced cancer. The existing literature can be summarized into 27 pieces of evidence across 7 dimensions, including initiation time, intervention content, intervention providers, intervention modalities, communication skills, outcome indicators, and environmental support. The aforementioned evidence could provide crucial support for improving ACP implementation for patients with advanced cancer. Subsequent research efforts should integrate patient preferences and explore the most suitable implementation strategies for ACP in the Chinese population with advanced cancer, considering diverse aspects such as traditional culture, ACP education and training, legislative support, and healthcare system refinement.


Asunto(s)
Planificación Anticipada de Atención , Neoplasias , Humanos , Pueblo Asiatico , China , Cognición , Neoplasias/terapia
9.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 49(4): 497-507, 2024 Apr 28.
Artículo en Inglés, Zh | MEDLINE | ID: mdl-39019778

RESUMEN

OBJECTIVES: The rehabilitation work for patients with motor dysfunction after stroke is crucial. However, there is currently a lack of summarized evidence regarding the rehabilitation management of stroke patients in rehabilitation wards, communities, and at home. This study aims to compile relevant evidence on the rehabilitation management of patients with motor dysfunction after stroke, providing a reference for clinical and community health professionals to carry out rehabilitation interventions. METHODS: A systematic search was conducted in BMJ Best Practice, UpToDate, National Guidebook Clearinghouse, American Heart Association/American Stroke Association, Canadian Medical Association, National Institute for Health and Clinical Excellence, United States Department of Veterans Affairs/ Department of Defense, Registered Nurses Association of Ontario, JBI Evidence-Based Healthcare Center Database, The Cochrane Library, PubMed, Web of Science, Embase, CINAHL, CNKI, Wanfang Database, SinoMed, and other databases for all literature on the rehabilitation management of patients with motor dysfunction after stroke. This included clinical decision-making, guidelines, expert consensuses, recommended practices, systematic reviews, and evidence summaries, with the search period spanning from the establishment of each database to October 2023. Two researchers independently evaluated the quality of the literature. RESULTS: A total of twenty-one documents were included, consisting of 11 guidelines, 2 expert consensus, and 8 systematic reviews. Evidence was extracted and integrated from the included literature, summarizing forty-five pieces of evidence across nine areas: rehabilitation management model, rehabilitation institutions, rehabilitation teams, timing of rehabilitation interventions, rehabilitation assessment, rehabilitation programs, rehabilitation duration and frequency, rehabilitation intensity, and rehabilitation support These covered comprehensive rehabilitation management content for stroke patients in the early, subacute, and chronic phases. CONCLUSIONS: The best evidence summarized in this study for the rehabilitation management of patients with motor dysfunction after stroke is comprehensive and of high quality. It provides important guidance for clinical and community healthcare professionals in carrying out rehabilitation interventions. When applying the evidence, it is recommended to consider the current condition of the stroke patient, the extent of motor dysfunction, environmental factors, and the patient's preferences. Then, select the most appropriate rehabilitation plan, and adjust the type and intensity of training according to each patient's specific needs and preferences.


Asunto(s)
Rehabilitación de Accidente Cerebrovascular , Humanos , Rehabilitación de Accidente Cerebrovascular/métodos , Accidente Cerebrovascular/complicaciones , China
10.
Sleep Breath ; 2023 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-37587356

RESUMEN

PURPOSE: This study aimed to evaluate, and integrate the relevant evidence on the non-pharmacological management of sleep disorders in shift workers to provide a reference for improving sleep of shift workers. METHODS: According to the "6S" pyramid model of evidence, a comprehensive search was conducted in evidence-based databases, including BMJ-Best Practice, UpToDate, DynaMed, Cochrane Library, and Joanna Briggs Institute (JBI); clinical practice guideline websites, such as the Guidelines International Network; professional association websites, such as the World Sleep Society; and literature databases, including PubMed, Embase, CINAHL, China National Knowledge Infrastructure (CNKI), Wanfang Database, and Chinese Biology Medicine disc (CBM) from inception to November 30, 2022. Two researchers independently evaluated the literature in accordance with the evaluation standards; conducted the extraction, classification, and synthesis of the evidence; and evaluated its grade and recommendation grade. RESULTS: A total of 18 studies were included, including 2 clinical decisions, 2 guidelines, 3 expert consensuses, and 11 systematic reviews. In total, 25 pieces of evidence were summarized from 6 aspects: sleep assessment, sleep scheduling, sleep hygiene, light therapy, workplace intervention, and other managements. CONCLUSION: This study summarized the best evidence for the non-pharmacological management of sleep disorders in shift workers. Shift workers should reasonably arrange their sleep time and develop good sleep hygiene. Additionally, work organizations should jointly promote sleep to improve the sleep conditions of shift workers and promote their physical and mental health.

11.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 48(9): 1333-1342, 2023.
Artículo en Inglés, Zh | MEDLINE | ID: mdl-38044644

RESUMEN

OBJECTIVES: Catheter-associated urinary tract infection (CAUTI) is an important cause of prolonged hospital stay, which increases economic and medical burden for patients and hospitals, and it is a key focus of hospital infection prevention and control. However, there are currently few studies that convert evidence-based scientific evidence on CAUTI prevention and control into clinical applications and evaluation on its practical effects in combination with standardized infection ratio (SIR), the critical indicator of infection prevention and control. This study aims to establish a precision management plan for reducing the incidence of CAUTI, driven by the findings of a comprehensive evidence summary, to apply this plan across all the nursing units within the entire hospital, followed by a comparative analysis of CAUTI incidence, SIR, the average duration of indwelling urinary catheter for each patient, and the compliance rate on hand hygiene protocols for medical staff before and after the implementation of the precision management plan. METHODS: Based on a comprehensive review of the best evidence for preventing CAUTI, a precision management plan was meticulously developed through panel discussions and 2 rounds of expert consultations using Delphi technique. Subsequently, a historical control study was conducted to evaluate the plan's effectiveness. A total of 17 658 patients with indwelling urinary catheter in inpatient departments from January to December 2021 comprised the control group. These patients received standard nursing measures for CAUTI. Another 18 753 patients with indwelling urinary catheters in the inpatient departments from January to December 2022 comprised the intervention group, underwent the precision management scheme based on the best available evidence, to enhance CAUTI prevention. The incidence and SIR of CAUTI, the average duration of indwelling urinary catheter for each patient, and the compliance rate on hand hygiene protocols for medical staff were compared between the 2 groups. RESULTS: Compared with the control group, the incidence of CAUTI in the intervention group was significantly decreased (0.48‰ vs 1.12‰, χ2=20.814, P<0.001), SIR was decreased in the intervention group (0.55 vs 1.37); the average duration of indwelling urinary catheter for each patient was significantly decreased [(4.33±1.55) d vs (4.43±1.79) d, t=11.941, P<0.001]. The ratio of compliance rate of medical staff with strict hand hygiene protocols higher than 95% in the intervention group was significantly higher than that in the control group (93.3% vs 83.3%, χ2=5.822, P=0.016). CONCLUSIONS: The implementation of the precision management plan for reducing CAUTI based on a summary of the best available evidence on CAUTI prevention and control in patients with indwelling urinary catheters has found to be effective. This approach significantly reduces the incidence of CAUTI, reduces the average duration of indwelling urinary catheter, and enhances hand hygiene compliance among medical staff. It provides a scientific and efficient strategy for preventing and controlling CAUTI in the hospital, ultimately saving patients from unnecessary medical expense.


Asunto(s)
Infecciones Relacionadas con Catéteres , Infección Hospitalaria , Infecciones Urinarias , Humanos , Infecciones Relacionadas con Catéteres/epidemiología , Infecciones Relacionadas con Catéteres/prevención & control , Infecciones Relacionadas con Catéteres/etiología , Infección Hospitalaria/prevención & control , Infecciones Urinarias/epidemiología , Infecciones Urinarias/etiología , Infecciones Urinarias/prevención & control , Catéteres de Permanencia/efectos adversos , Cuerpo Médico , Cateterismo Urinario/efectos adversos , Cateterismo Urinario/métodos
12.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 51(1): 27-37, 2022 Feb 25.
Artículo en Inglés | MEDLINE | ID: mdl-35576114

RESUMEN

To evaluate and summarize the evidence of diet and physical activity management in patients with metabolic syndrome (MS). BMJ Best Practice, UpToDate, Joanna Briggs Institute (JBI) database, Agency for Healthcare Research and Quality (AHRQ) network, National Institute for Health and Clinical Excellence (NICE) network, Scottish Intercollegiate Guidelines Network (SIGN), Guidelines International Network (GIN), Medlive, Registered Nurses' Association of Ontario (RNAO) network, American Diabetes Association (ADA) network, New Zealand Guideline Group (NZGG) network, Canadian medical association clinical practice guidelines network, PubMed, EmBase, Web of Science, CINAHL, Cochrane Library, CNKI, China Science and Technology Journal Database, Wanfang Knowledge Data Service Platform and Chinese biomedical database were searched systematically to obtain guidelines, evidence summary, expert consensus, best practice information book, clinical decision-making, recommended practice, and systematic review on diet and physical activity management in patients with MS. The retrieval period is from the establishment of database to November 2021. Two researchers with evidence-based medicine background evaluated the quality and evidence level of the included literature. A total of 36 articles met the criteria, including 3 guidelines, 5 expert consensus, 1 clinical decision and 27 systematic reviews. We summarized 49 pieces of evidence related to diet and physical activity in patients with MS, involving 15 aspects, namely diet goals, diet patterns, diet time, carbohydrate intake, fat intake, fiber intake, salt intake, fruits, vegetables and grains intake, coffee intake, effects of diet, principle of physical activity, intensity, form, time of physical activity, effects of physical activity, physical activity prescription of patients with MS and cardiovascular disease, and the joint effects of diet and physical activity. Diet and physical activity management can effectively improve the health outcomes of patients with MS. Health professionals should choose and apply the best evidence with consideration of the clinical situation and patient preference.


Asunto(s)
Síndrome Metabólico , Canadá , Consenso , Dieta , Ejercicio Físico , Humanos , Síndrome Metabólico/terapia
13.
BMC Med Inform Decis Mak ; 20(1): 189, 2020 08 12.
Artículo en Inglés | MEDLINE | ID: mdl-32787829

RESUMEN

BACKGROUND: Shared decision making with older adults living with neurocognitive disorders is challenging for primary healthcare professionals. We studied the implementation of a professional training program featuring an e-learning activity on shared decision making and five Decision Boxes on the care of people with neurocognitive disorders, and measured the program's effects. METHODS: In this mixed-methods study, we recruited healthcare professionals in family medicine clinics and homecare settings in the Quebec City area (Canada). The professionals signed up for training as a continuing professional development activity and answered an online survey before and after training to assess their knowledge, and intention to adopt shared decision making. We recorded healthcare professionals' access to each training component, and conducted telephone interviews with a purposeful sample of extreme cases: half had completed training and the other half had not. We performed bivariate analyses with the survey data and a thematic qualitative analysis of the interviews, as per the theory of planned behaviour. RESULTS: Of the 47 participating healthcare professionals, 31 (66%) completed at least one training component. Several factors restricted participation, including lack of time, training fragmentation into several components, poor adaptation of training to specific professions, and technical/logistical barriers. Ease of access, ease of use, the usefulness of training content and the availability of training credits fostered participation. Training allowed Healthcare professionals to improve their knowledge about risk communication (p = 0.02), and their awareness of the options (P = 0.011). Professionals' intention to adopt shared decision making was high before training (mean ± SD = 5.88 ± 0.99, scale from 1 to 7, with 7 high) and remained high thereafter (5.94 ± 0.9). CONCLUSIONS: The results of this study will allow modifying the training program to improve participation rates and, ultimately, uptake of meaningful shared decision making with patients living with neurocognitive disorders.


Asunto(s)
Envejecimiento , Toma de Decisiones Conjunta , Toma de Decisiones , Demencia , Trastornos Neurocognitivos/psicología , Participación del Paciente , Anciano , Anciano de 80 o más Años , Canadá , Demencia/diagnóstico , Demencia/terapia , Femenino , Personal de Salud , Humanos , Ciencia de la Implementación , Masculino , Trastornos Neurocognitivos/diagnóstico , Atención Primaria de Salud , Quebec
14.
BMC Med Res Methodol ; 17(1): 169, 2017 Dec 12.
Artículo en Inglés | MEDLINE | ID: mdl-29233133

RESUMEN

BACKGROUND: Summary of findings tables in systematic reviews are highly informative but require epidemiological training to be interpreted correctly. The usage of fishbone diagrams as graphical displays could offer researchers an effective approach to simplify content for readers with limited epidemiological training. In this paper we demonstrate how fishbone diagrams can be applied to systematic reviews and present the results of an initial user testing. METHODS: Findings from two systematic reviews were graphically depicted in the form of the fishbone diagram. To test the utility of fishbone diagrams compared with summary of findings tables, we developed and pilot-tested an online survey using Qualtrics. Respondents were randomized to the fishbone diagram or a summary of findings table presenting the same body of evidence. They answered questions in both open-ended and closed-answer formats; all responses were anonymous. Measures of interest focused on first and second impressions, the ability to find and interpret critical information, as well as user experience with both displays. We asked respondents about the perceived utility of fishbone diagrams compared to summary of findings tables. We analyzed quantitative data by conducting t-tests and comparing descriptive statistics. RESULTS: Based on real world systematic reviews, we provide two different fishbone diagrams to show how they might be used to display complex information in a clear and succinct manner. User testing on 77 students with basic epidemiological training revealed that participants preferred summary of findings tables over fishbone diagrams. Significantly more participants liked the summary of findings table than the fishbone diagram (71.8% vs. 44.8%; p < .01); significantly more participants found the fishbone diagram confusing (63.2% vs. 35.9%, p < .05) or indicated that it was difficult to find information (65.8% vs. 45%; p < .01). However, more than half of the participants in both groups were unable to find critical information and answer three respective questions correctly (52.6% in the fishbone group; 51.3% in the summary of findings group). CONCLUSIONS: Fishbone diagrams are compact visualizations that, theoretically, may prove useful for summarizing the findings of systematic reviews. Initial user testing, however, did not support the utility of such graphical displays.


Asunto(s)
Literatura de Revisión como Asunto , Interpretación Estadística de Datos , Medicina Basada en la Evidencia , Humanos
15.
J Indian Prosthodont Soc ; 15(2): 179-82, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26929508

RESUMEN

The failure of dental implant can occurs at the preoperative planning stage, at the surgical stage, and at the postoperative stage. The success of this treatment can be increased if the clinical implant practice guidelines are prepared based on the recommendations from the highest level of research evidence (i.e.,) from systematic review of randomized controlled trials (RCTs) with meta-analysis. The Cochrane reviews of interventions are basically systematic reviews of RCTs with meta-analysis but follow a systematic methodological approach following the guidelines from Cochrane handbook for Systematic Reviews of Intervention. They give the current best evidence as they are updated every 2 years which is being the minimum period for an update. This evidence summary recommends the use of antibiotics, single dose of 2 g of amoxicillin 1 h prior to implant surgery to prevent implant failure, based on the body of evidence from the Cochrane review that was first published in 2003, 2008, and then updated twice in 2010 and 2013. The included studies are not from our population for the research question asked in this updated Cochrane review; hence, the need to do primary research in our population to support the available evidence is mandatory.

16.
J Indian Prosthodont Soc ; 15(1): 65-9, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26929489

RESUMEN

Cochrane reviews are systematic reviews with meta analysis published by the Cochrane collaboration, in the Cochrane Database of Systematic Reviews (CDSR). These reviews provide the clinicians with the highest level of evidence as they use a highly structured and transparent systematic review model to address a specific research question. The management of partially absent dentition is routinely under taken by general dentist and Prosthodontist but clinical practice guidelines based on evidence to this common problem is yet to be summarized. This Cochrane systematic review aims to address the effect of different prosthesis for the treatment of partially absent dentition in the terms of, Long-term success, function, morbidity, and patient satisfaction. All randomized controlled trials were searched till March 18, 2011, based on the inclusion and exclusion criteria, 21 trials were included and 32 trials were excluded and, it was critically appraised using the Cochrane methodology for interventions. The summary of evidence from the study concludes that there is insufficient evidence to state the effectiveness of removable and fixed prosthesis in partially edentulous subjects in the following four outcomes. There were insufficient trials to perform a meta-analysis and sensitivity analysis. This evidence-based summary emphasizes and reinforces the need to reassess the quality of research currently pursued in our profession, to address the need to provide higher level of evidence for common conditions like partial edentulousness. The included studies are basically not from our population too, hence the urgency to address this critical issue.

17.
J Indian Prosthodont Soc ; 15(4): 381-5, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26929543

RESUMEN

The Cochrane reviews have transparent reporting of the methodology to clarify the reader the methods used for writing the review; hence, each review becomes a large volume of scientific literature. This evidence summary of the Cochrane review published in 2015 for the question, what are the clinical effects (preservation of both width and height of bone, esthetic outcomes, complications, and failure of implant) for different alveolar ridge preservation techniques (ARP) and materials used in patients planning implant placement following extraction after 6 months follow-up. This review provides evidence for efficacy of different ARP techniques, materials, and superiority of one over the other. It also tries to settle the controversy of timing of placement of implant after grafting. Of the 8 included studies from 50, two trials provide moderate evidence for xenografts versus extraction favoring xenografts in preserving the width and height of bone by 1.97 mm (2.48-1.46) and 2.60 mm (3.43-1.76), respectively in pooled estimates of meta-analysis. Using different material, five-trial were found; of which, two trials provide moderate evidence for alloplast versus xenografts favoring alloplast in preserving the width by 0.44 mm (0.90-0.02) and low-grade evidence for height of bone by 0.35 mm (0.86-0.16) in pooled estimates of meta-analysis. There is a paucity of randomized controlled trial to address other primary and secondary outcomes addressed in this review.

18.
Neurourol Urodyn ; 33(5): 581-6, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24844430

RESUMEN

AIMS: The ICI-RS Think Tank discussed the diagnostic process for patients who present with symptoms and signs of lower urinary tract (LUT) dysfunction. This manuscript reflects the Think Tank's summary and opinion. METHODS: An overview of the existing evidence and consensus regarding urodynamic testing was presented and discussed in relation to contemporary treatment strategies. RESULTS: Evidence of the validity of the diagnostic process in relation to the contemporary management paradigm is incomplete, scattered, and sometimes conflicting and therefore a process redesign may be necessary. The Think Tanks' suggestion, contained in this manuscript, is that the symptoms and signs that the patients present can be more precisely delineated as syndromes. The overactive bladder syndrome (OAB-S); the stress urinary incontinence syndrome (SUI-S); the urinary incontinence syndrome (UI-S); the voiding dysfunction syndrome (VD-S); and or the neurogenic LUT dysfunction syndrome (NLUTD-S) may become evidence based starting point for initial management. Consistent addition of the word syndrome, if adequately defined, acknowledges the uncertainty, but will improve outcome and will improve selection of patients that need further (invasive) diagnosis before management. CONCLUSIONS: The ICS-RS Think Tank has summarized the level of evidence for UDS and discussed the evidence in association with the currently changing management paradigm. The ICI-RS Think Tank recommends that the diagnostic process for patients with LUTD can be redesigned. Carefully delineated and evidence based LUTD syndromes may better indicate, personalize and improve the outcome of initial management, and may also contribute to improved and rational selection of patients for invasive UDS. Neurourol. Urodynam. 33:581-586, 2014. © 2014 Wiley Periodicals, Inc.


Asunto(s)
Síntomas del Sistema Urinario Inferior/diagnóstico , Obstrucción del Cuello de la Vejiga Urinaria/diagnóstico , Vejiga Urinaria Neurogénica/diagnóstico , Vejiga Urinaria Hiperactiva/diagnóstico , Vejiga Urinaria/fisiopatología , Incontinencia Urinaria/diagnóstico , Urodinámica/fisiología , Femenino , Humanos , Síntomas del Sistema Urinario Inferior/fisiopatología , Masculino , Prostatectomía/efectos adversos , Obstrucción del Cuello de la Vejiga Urinaria/fisiopatología , Vejiga Urinaria Neurogénica/fisiopatología , Vejiga Urinaria Hiperactiva/fisiopatología , Incontinencia Urinaria/etiología , Incontinencia Urinaria/fisiopatología , Incontinencia Urinaria de Esfuerzo/diagnóstico , Incontinencia Urinaria de Esfuerzo/fisiopatología
19.
Patient Prefer Adherence ; 18: 2007-2017, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39345758

RESUMEN

Objective: The objective of this study is to systematically explore and summarize the best evidence on intervention programs for patients with kinesophobia following percutaneous coronary intervention (PCI) to provide a comprehensive reference for clinical practice interventions. Methods: Evidence on interventions for kinesophobia post-PCI was retrieved from Chinese and international integrated databases, treatment guidelines, and websites of professional associations, including systematic reviews and expert consensuses. The evidence considered in this study extends up to May 2022, encompassing information available since the inception of the databases. Two researchers independently evaluated the articles included in the review and extracted and summarized the available evidence. Results: By extracting and integrating data from the 14 articles included in this review, we identified six categories: pre-intervention assessment, psychological intervention, health education, rehabilitation training, social support, and quality control. A total of 21 pieces of evidence were summarized, including mental health assessment, physical fitness evaluation, timing and content of health education, development of personalized exercise prescriptions, and risk control. Conclusion: In clinical settings, using evidence-based practices requires developing feasible intervention programs based on comprehensive consideration of hospital resources, allocation of medical personnel, and consideration of patients' preferences to reduce the kinesophobia of patients post-PCI and improve their compliance with exercise rehabilitation.

20.
Front Oncol ; 14: 1429484, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39314627

RESUMEN

Objective: To retrieve, extract, integrate and evaluate evidence on the rehabilitation of dysphagia in patients undergoing radiotherapy for head and neck cancer (HNC), and to provide a basis for the development of a rehabilitation management protocol for dysphagia in patients undergoing radiotherapy for HNC. Methods: An evidence-based systematic search of the literature related to the rehabilitation of dysphagia in patients with HNC during radiotherapy was conducted from January 2013 to March 2023, and the corresponding evaluation tools were selected according to the different types of literature for quality evaluation. "The Joanna Briggs Institute (JBI) evidence pre-grading system was used to evaluate the quality of the evidence. Results: A total of 17 articles were included, including 3 guidelines, 5 expert articles, 1 clinical decision, 1 practice recommendation, 2 evidence summaries and 5 systematic evaluations. A final total of 28 pieces of evidence were summarised, including 6 areas of swallowing disorder screening and assessment, physiotherapy, preventive swallowing function training, feeding management, pain control, and oral care. Conclusion: This study forms a multidisciplinary collaborative evidence summary for the rehabilitation management of dysphagia in patients undergoing radiotherapy for HNC, but the application of some of the evidence needs to be carried out in the context of the clinical setting and patient-specific circumstances for the rehabilitation evidence selected for patients' dysphagia to improve their swallowing function and their swallowing-related quality of life and reduce the occurrence of related complications.

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