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1.
BMJ Open ; 11(9): e051066, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34475183

RESUMO

OBJECTIVES: To describe the design and conduct of core outcome set (COS) studies that have included patients as participants, exploring how study characteristics might impact their response rates. DESIGN: Systematic review of COS studies published between 2015 and 2019 that included more than one patient, carer or representative as participants (hereafter referred to as patients for brevity) in scoring outcomes in a Delphi. RESULTS: There were variations in the design and conduct of COS studies that included patients in the Delphi process, including differing: scoring and feedback systems, approaches to recruiting patients, length of time between rounds, use of reminders, incentives, patient and public involvement, and piloting. Minimal reporting of participant characteristics and a lack of translation of Delphi surveys into local languages were found. Additionally, there were indications that studies that recruited patients through treatment centres had higher round two response rates than studies recruiting through patient organisations. CONCLUSIONS: Variability was striking in how COS Delphi surveys were designed and conducted to include patient participants and other stakeholders. Future research is needed to explore what motivates patients to take part in COS studies and what factors influence COS developer recruitment strategies. Improved reporting would increase knowledge of how methods affect patient participation in COS Delphi studies.


Assuntos
Participação do Paciente , Projetos de Pesquisa , Consenso , Técnica Delfos , Humanos , Avaliação de Resultados em Cuidados de Saúde , Resultado do Tratamento
2.
J Assoc Physicians India ; 69(8): 11-12, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34472819

RESUMO

Worldwide, coronary heart disease (CHD), have assumed epidemic proportions. Increasing use of interventional therapy and a higher adherence to medical therapy have led to a 33% reduction in cardiac deaths at 5 years after hospital discharge. Angina pectoris is a common symptom of ischemic heart disease. The goals of anti-ischemia therapy in patients with stable coronary artery disease (CAD) include relieving angina symptoms, improving duration of exercise and quality of life, improving prognosis and preventing cardiovascular (CV) events. The consensus statement was devised with the help of multiple meetings held across India. Ten regional advisory board e-meetings were held in Mumbai, Delhi, Chennai, Kolkata, Ahmedabad, Cochin, Trivandrum, Lucknow, Bhopal and Varanasi. These meetings were attended by ten eminent experts from the field of cardiology from each region. Extensive literature review, intense discussions, and feedback from the cardiologists led to the development of the following consensus statements on definition, diagnosis, and management of angina, which have been reported in this article.


Assuntos
Doença da Artéria Coronariana , Qualidade de Vida , Angina Pectoris/diagnóstico , Angina Pectoris/terapia , Consenso , Humanos , Índia
3.
Lancet Oncol ; 22(9): e400-e409, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34478676

RESUMO

Cancer has not been an explicit priority of Canada's international health and development agenda, but it is key to realising the country's Sustainable Development Goal commitments. Multiple converging political, health, and social forces could now drive support for a more integrated Canadian approach to global cancer control. Success will depend on the extent to which Canadian leaders and institutions can build consensus as a community and agree to work together. Collaboration should include agreement on the framing and prioritisation of the core issues, building a broad coalition base, aligning with priorities of international partners, and on a governance structure that reflects the principles of equity, diversity, and inclusion. This Series paper will discuss global cancer control within Canada's global health agenda, how Canada can address its history of colonisation and present-day disparities in its global work, and the challenges and opportunities of creating a Canadian global cancer control network.


Assuntos
Saúde Global , Neoplasias/prevenção & controle , Canadá , Consenso , Equidade em Saúde , Humanos , Cooperação Internacional , Oncologia/organização & administração
4.
BMC Ophthalmol ; 21(1): 327, 2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34493256

RESUMO

BACKGROUND: Neurotrophic keratopathy (NK) is a relatively uncommon, underdiagnosed degenerative corneal disease that is caused by damage to the ophthalmic branch of the trigeminal nerve by conditions such as herpes simplex or zoster keratitis, intracranial space-occupying lesions, diabetes, or neurosurgical procedures. Over time, epithelial breakdown, corneal ulceration, corneal melting (thinning), perforation, and loss of vision may occur. The best opportunity to reverse ocular surface damage is in the earliest stage of NK. However, patients typically experience few symptoms and diagnosis is often delayed. Increased awareness of the causes of NK, consensus on when and how to screen for NK, and recommendations for how to treat NK are needed. METHODS: An 11-member expert panel used a validated methodology (a RAND/UCLA modified Delphi panel) to develop consensus on when to screen for and how best to diagnose and treat NK. Clinicians reviewed literature on the diagnosis and management of NK then rated a detailed set of 735 scenarios. In 646 scenarios, panelists rated whether a test of corneal sensitivity was warranted; in 20 scenarios, they considered the adequacy of specific tests and examinations to diagnose and stage NK; and in 69 scenarios, they rated the appropriateness of treatments for NK. Panelist ratings were used to develop clinical recommendations. RESULTS: There was agreement on 94% of scenarios. Based on this consensus, we present distinct circumstances when we strongly recommend or may consider a test for corneal sensitivity. We also present recommendations on the diagnostic tests to be performed in patients in whom NK is suspected and treatment options for NK. CONCLUSIONS: These expert recommendations should be validated with clinical data. The recommendations represent the consensus of experts, are informed by published literature and experience, and may improve outcomes by helping improve diagnosis and treatment of patients with NK.


Assuntos
Distrofias Hereditárias da Córnea , Ceratite , Doenças do Nervo Trigêmeo , Consenso , Córnea , Humanos , Doenças do Nervo Trigêmeo/diagnóstico , Doenças do Nervo Trigêmeo/terapia
7.
Zhonghua Wei Chang Wai Ke Za Zhi ; 24(9): 741-748, 2021 Sep 25.
Artigo em Chinês | MEDLINE | ID: mdl-34530553

RESUMO

In recent years, the treatment strategy of locally advanced gastric cancer (LAGC) has changed from surgery alone to multidisciplinary comprehensive treatment (MDT) based on surgery. Many evidences have shown that perioperative therapy can improve the survival of most patients with late-stage LAGC compared to surgery combined with postoperative adjuvant chemotherapy. However, there is still a lack of standards and guidelines for precise preoperative staging, indications of perioperative neoadjuvant and adjuvant therapy, and regimen selection. Based on relevant literature and clinical practice, Chinese Journal of Gastrointestinal Surgery combined with Gastric Cancer Association, China Anti-Cancer Association took the lead and organized multidisciplinary experts to discuss, and finally formulate this expert consensus. This consensus aims to improve surgeons' and physicians' cognition on the MDT of LAGC, especially for doctors in primary hospitals; to clarify the preoperative staging, the indication and regimen selection of perioperative neoadjuvant and adjuvant therapy; so as to improve the diagnosis and treatment level of gastric cancer and the prognosis of LAGC in China. The level of evidence and recommendation of this consensus is determined by the criteria of Grading of Recommendations, Assessment, Development and Evaluations (GRADE).


Assuntos
Neoplasias Gástricas , Protocolos de Quimioterapia Combinada Antineoplásica , Quimioterapia Adjuvante , China , Consenso , Gastrectomia , Humanos , Terapia Neoadjuvante , Estadiamento de Neoplasias , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/cirurgia
8.
Zhonghua Zhong Liu Za Zhi ; 43(9): 897-900, 2021 Sep 23.
Artigo em Chinês | MEDLINE | ID: mdl-34530569

RESUMO

The standardized diagnosis and treatment of tumor and the rational use of antineoplastic drugs are not only the central issue of the government and society, but also the difficulty of medical quality control. In order to implement "the Administrative Measures for the Clinical Application of Antineoplastic Drugs (Trial)" issued by the National Health Commission of the People's Republic of China, on the basis of extensive investigation and through Delphi method and several rounds of expert discussion, an expert consensus on the guiding road map and management points of drug classification was formed. Suggestions are provided to guide other medical institutions to do the related work in the graded management of antineoplastic drugs.


Assuntos
Antineoplásicos , Antineoplásicos/uso terapêutico , China , Consenso , Humanos
9.
Zhongguo Zhong Yao Za Zhi ; 46(16): 4287-4292, 2021 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-34467743

RESUMO

The formulation of expert consensus on clinical application of Chinese patent medicines, in means of exploring the effective combination of experience and evidence to form a research method in line with the characteristics of Chinese patent medicines, is an important transitional stage for clinical researches on Chinese patent medicines. Pre-searching is a new step in the formulation of expert consensus on clinical application of Chinese patent medicines. Before steps of interview and investigation on clinical application, pre-searching is conducted to collect publications and literature on certain variety and similar Chinese patent medicines; the publications on related medical classics and formulas of this variety; the recommendation condition of this variety in clinical practice guidelines and expert consensus; and the medication regimens recommended in disease-specific guidelines. Pre-searching is designed to know about the advantages of certain variety of Chinese patent medicine as well as its potential problems recorded in the literature, which is helpful to find out the clinical positioning of Chinese patent medicines, develop reasonable clinical questions and provide ideas for formal literature searching. However, it is not the direct basis for developing clinical questions. Moreover, interviews and investigations are still needed to further clarify the clinical positioning of Chinese patent medicines and develop reasonable questions. This paper took expert consensus on clinical application of Yanshen Jianwei Capsules as an example to introduce the pre-searching process and methods used during formulation of expert consensus on clinical application of Chinese patent medicines, and to further discuss the role of pre-searching to facilitate the formulation of clinical questions on selection of participants, interventions, controls and outcomes.


Assuntos
Medicamentos de Ervas Chinesas , Medicamentos sem Prescrição , Cápsulas , China , Consenso , Humanos , Medicina Tradicional Chinesa
10.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(8): 761-772, 2021 Aug 15.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-34511163

RESUMO

Metabolic bone disease of prematurity (MBDP) is a systemic bone disease with a reduction in bone mineral content due to disorder of calcium and phosphorus metabolism. There is still a lack of in-depth research and systematic understanding of MBDP in China, and there are many irregularities in clinical management of this disease. Based on relevant studies in China and overseas, Grading of Recommendations Assessment, Development and Evaluation was used to develop the expert consensus on the clinical management of MBDP, which provides recommendations from the following five aspects: high-risk factors, screening/diagnosis, prevention, treatment, and post-discharge follow-up of MBDP, so as to provide relevant practitioners with recommendations on the clinical management of MBDP to reduce the incidence rate of MBDP and improve its short- and long-term prognosis.


Assuntos
Assistência ao Convalescente , Doenças Ósseas Metabólicas , Doenças Ósseas Metabólicas/diagnóstico , Doenças Ósseas Metabólicas/etiologia , Doenças Ósseas Metabólicas/terapia , Consenso , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Alta do Paciente
12.
Lakartidningen ; 1182021 Aug 23.
Artigo em Sueco | MEDLINE | ID: mdl-34498243

RESUMO

The PAH and CTEPH care in Sweden is since 2007 structured in collaboration with the Swedish Society of Pulmonary Hypertension (SveFPH) and centralized to pulmonary hypertension (PH) centers at the university hospitals. At biannual SveFPH meetings, ideas are exchanged to spread new knowledge on diagnostics and treatment in Sweden. The PAH-CTEPH centers are to be further stimulated to provide individual equal and equivalent care within multidisciplinary PAH-CTEPH teams in Sweden, as summarized in the document "Nationell samsyn kring PAH och CTEPH specialistcenter och mottagningar", prepared in collaboration between SveFPH and the Swedish PAH patient association, for initiation during the spring of 2021.


Assuntos
Hipertensão Pulmonar , Embolia Pulmonar , Doença Crônica , Consenso , Humanos , Hipertensão Pulmonar/terapia , Suécia
13.
Lakartidningen ; 1182021 Aug 11.
Artigo em Sueco | MEDLINE | ID: mdl-34498245

RESUMO

Predatory journals exploit researchers' desire for a fast review process and quick publication; this is achieved at the expense of proper scientific review and high publication costs for the authors. During the last decade, international consensus on what characterises predatory journals and publishers has emerged. The proportion of health sciences articles published in predatory journals is around 2 per cent, considerably lower than in other life sciences and social sciences.  In health sciences, China has the highest proportion of articles published in predatory journals. The phenomenon is widespread both in terms of health disciplines and geography; there are examples of Swedish health science being infiltrated. In The European Code of Conduct for Research Integrity, supporting predatory journals is characterised as an unacceptable practice. There are now tools to be used by researchers who want to avoid publishing in predatory journals.


Assuntos
Medicina , Publicações Periódicas como Assunto , Consenso , Humanos , Editoração , Pesquisadores
14.
BMJ Open ; 11(9): e045724, 2021 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-34493505

RESUMO

OBJECTIVES: To provide a consensus from a panel of international experts about electronic nicotine delivery systems (ENDS) and heated tobacco products (HTP). DESIGN: Cross-sectional survey. METHODS: A Delphi survey was conducted among international experts in tobacco control and smoking cessation. The first part addressed statements or recommendations about ENDS, the second about HTP, both divided into four categories: regulation, sale, use and general issues. SETTING: Experts from 15 countries. PARTICIPANTS: Individuals with clinical, public health or research expertise in tobacco control and/or smoking cessation. RESULTS: 268 experts were contacted, 92 (34%) completed the first, 55/92 (60%) the second round. Consensus for ENDS: components of e-liquids, an upper limit of nicotine concentration should be defined; a warning on the lack of evidence in long-term safety and addiction potential should be stated; ENDS should not be regulated as consumer products but either as a new category of nicotine delivery or tobacco products; ENDS should not be sold in general stores but in specialised shops, shops selling tobacco or in pharmacies with restriction on sale to minors; administration of illegal drugs is likely with ENDS. Consensus for HTP: HTP have the same addictive potential as cigarettes; they should be regulated as a tobacco product with similar warning messages as cigarettes; their advertisement should not be allowed. ENDS and HTP use should not be allowed in indoor public places; a specific tax should be implemented for ENDS, taxes on HTP should not be lower than those for cigarettes; use of cigarettes is more likely with both ENDS and HTP (dual use) than quitting smoking. CONCLUSIONS: Experts in tobacco control and/or smoking cessation recommend differential regulation for ENDS and HTP. The results of this survey may be useful for health authorities, decision makers and researchers of the tobacco use and cessation field.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Produtos do Tabaco , Consenso , Estudos Transversais , Humanos , Nicotina
15.
BMJ Open ; 11(9): e049212, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34475168

RESUMO

INTRODUCTION: Idiopathic congenital talipes equinovarus (CTEV) is the most common congenital limb deformity. Non-operative intervention using the Ponseti method has shown to be superior to soft tissue release and has become the gold standard for first-line treatment. However, numerous deviations from the Ponseti protocol are still reported following incomplete correction or deformity relapse. Significant variation in treatment protocols and management is evident in the literature. Reducing geographical treatment variation has been identified as one of The James Lind Alliance priorities in children's orthopaedics. For this reason, the British Society of Children's Orthopaedic Surgery (BSCOS) commissioned a consensus document to form a benchmark for practitioners and ensure consistent high quality care for children with CTEV. METHODS AND ANALYSIS: The consensus will follow an established Delphi approach aiming at gaining an agreement on the items to be included in the consensus statement for the management of primary idiopathic CTEV up to walking age. The process will include the following steps: (1) establishing a steering group, (2) steering group meetings, (3) a two-round Delphi survey aimed at BSCOS members, (4) final consensus meeting and (5) dissemination of the consensus statement. Degree of agreement for each item will be predetermined. Descriptive statistics will be used for analysis of the Delphi survey results. ETHICS AND DISSEMINATION: No patient involvement is required for this project. Informed consent will be assumed from participants taking part in the Delphi survey. Study findings will be published in an open access journal and presented at relevant national and international conferences. Charities and associations will be engaged to promote awareness of the consensus statement.


Assuntos
Pé Torto Equinovaro , Procedimentos Ortopédicos , Criança , Pé Torto Equinovaro/terapia , Consenso , Técnica Delfos , Humanos , Projetos de Pesquisa , Relatório de Pesquisa
16.
Pneumologie ; 75(9): 641-643, 2021 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-34525486

RESUMO

Therapy of non-small cell lung cancer (NSCLC) should be based on biomarker test results in the palliative setting. To this end, testing of all patients in stage IV and in the future also in the earlier stages will be important. In a conference with the patronage of the German Cancer Society, the question of "reflex testing", i. e. independently of tumor stage, was discussed but not deemed to be acceptable. The current report summarizes the results of the consensus conference and discusses possible paths to efficent biomarker testing in NSCLC.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Biomarcadores , Biomarcadores Tumorais , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Carcinoma Pulmonar de Células não Pequenas/terapia , Consenso , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/terapia , Cuidados Paliativos
17.
BMJ Open ; 11(8): e051381, 2021 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-34373314

RESUMO

OBJECTIVES: This study aimed to achieve an expert consensus on how to define and group footwear interventions for children, with a further focus on the design characteristics and prescription of off-the-shelf stability footwear for children with mobility impairment. SETTING: A group of multinational professionals, from clinicians to those involved in the footwear industry, were recruited to ensure a spectrum of opinions. PARTICIPANTS: Thirty panellists were contacted, of which 24 consented to participate and six withdrew before round 1, a further two withdrew after round 1. Sixteen panellists completed the consensus exercise. PRIMARY AND SECONDARY OUTCOME MEASURES: A Delphi consensus method was employed with round 1 split into three sections: (1) terms and definitions, (2) specifics of off-the-shelf stability footwear design and (3) criteria for clinical prescription of off-the-shelf stability footwear. The panel was asked to rate their level of agreement with statements and to provide further insights through open-ended questions. The opinions of the experts were analysed to assess consensus set at 75% agreement or to modify or form new statements presented through the subsequent two rounds. RESULTS: Therapeutic footwear was the agreed term to represent children's footwear interventions, with grouping and subgrouping of therapeutic footwear being dependent on their intended clinical outcomes (accommodative, corrective or functional). Both the heel counter and topline as well as the stiffness and width of the sole were identified as potentially influencing mediolateral stability in children's gait. A consensus was achieved in the prescription criteria and outcome measures for off-the-shelf stability therapeutic footwear for cerebral palsy, mobile symptomatic pes planus, Duchenne muscular dystrophy, spina bifida and Down's syndrome. CONCLUSIONS: Through a structured synthesis of expert opinion, this study has established a standardisation of terminology and groupings along with prescription criteria for the first time. Reported findings have implications for communication between stakeholders, evidence-based clinical intervention and standardised outcome measures to assess effectiveness.


Assuntos
Exercício Físico , Marcha , Criança , Consenso , Técnica Delfos , Humanos , Prescrições
19.
Intern Med J ; 51(8): 1321-1323, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34423546

RESUMO

Australia and New Zealand have achieved excellent community control of COVID-19 infection. In light of the imminent COVID-19 vaccination roll out in both countries, representatives of all adult and paediatric allogeneic bone marrow transplant and cellular therapy (TCT) centres as well as representatives from autologous transplant only centres in Australia and New Zealand collaborated with infectious diseases specialists with expertise in TCT on this consensus position statement regarding COVID-19 vaccination in TCT patients in Australia and New Zealand. It is our recommendation that TCT patients, should have expedited access to high-efficacy COVID-19 vaccines given that these patients are at high risk of morbidity and mortality from COVID-19 infection. We also recommend prioritising vaccination of TCT healthcare workers and household members of TCT patients. Vaccination should not replace other public health measures in TCT patients given the effectiveness of COVID-19 vaccination in TCT patients is unknown. Furthermore, given the limited available data, prospective collection of safety and efficacy data of COVID-19 vaccination in this patient group is a priority.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Transplantados , Adulto , Austrália/epidemiologia , COVID-19/prevenção & controle , Criança , Consenso , Humanos , Nova Zelândia/epidemiologia , Estudos Prospectivos , Vacinação
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