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2.
BMC Psychiatry ; 22(1): 585, 2022 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-36057589

RESUMO

BACKGROUND: The life expectancy of people with severe mental illness (SMI) is shorter than those without SMI, with multimorbidity and poorer physical health contributing to health inequality. Screening tools could potentially assist the optimisation of medicines to protect the physical health of people with SMI. The aim of our research was to design and validate a medicines optimisation tool (OPTIMISE) to help clinicians to optimise physical health in people with SMI. METHODS: A review of existing published guidelines, PubMed and Medline was carried out. Literature was examined for medicines optimisation recommendations and also for reference to the management of physical illness in people with mental illness. Potential indicators were grouped according to physiological system. A multidisciplinary team with expertise in mental health and the development of screening tools agreed that 83 indicators should be included in the first draft of OPTIMISE. The Delphi consensus technique was used to develop and validate the contents. A 17-member multidisciplinary panel of experts from the UK and Ireland completed 2 rounds of Delphi consensus, rating their level of agreement to 83 prescribing indicators using a 5-point Likert scale. Indicators were accepted for inclusion in the OPTIMISE tool after achieving a median score of 1 or 2, where 1 indicated strongly agree and 2 indicated agree, and 75th centile value of ≤ 2. Interrater reliability was assessed among 4 clinicians across 20 datasets and the chance corrected level of agreement (kappa) was calculated. The kappa statistic was interpreted as poor if 0.2 or less, fair if 0.21-0.4, moderate if 0.41-0.6, substantial if 0.61-0.8, and good if 0.81-1.0. RESULTS: Consensus was achieved after 2 rounds of Delphi for 62 prescribing indicators where 53 indicators were accepted after round 1 and a further 9 indicators were accepted after round 2. Interrater reliability of OPTIMISE between physicians and pharmacists indicated a substantial level of agreement with a kappa statistic of 0.75. CONCLUSIONS: OPTIMISE is a 62 indicator medicines optimisation tool designed to assist decision making in those treating adults with SMI. It was developed using a Delphi consensus methodology and interrater reliability is substantial. OPTIMISE has the potential to improve medicines optimisation by ensuring preventative medicines are considered when clinically indicated. Further research involving the implementation of OPTIMISE is required to demonstrate its true benefit. TRIAL REGISTRATION: This article does not report the results of a health care intervention on human participants.


Assuntos
Disparidades nos Níveis de Saúde , Transtornos Mentais , Adulto , Consenso , Técnica Delfos , Humanos , Transtornos Mentais/complicações , Transtornos Mentais/tratamento farmacológico , Reprodutibilidade dos Testes
3.
Palliat Med ; 36(8): 1285-1295, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36062725

RESUMO

BACKGROUND: The SARS-CoV-2 pandemic is a constant challenge for health care systems, also in Germany. Care of seriously ill and dying people and their relatives is often neglected and suffering increased due to sub-optimal symptom management, visiting restrictions and lonely dying. The project "Palliative Care in Pandemics (PallPan)" intended to develop a national strategy including evidence- and consensus-based recommendations for the care of seriously ill and dying people and their relatives during pandemic times in Germany. AIM: To reach consensus on evidence-based recommendations for the care of seriously ill and dying people and their relatives in pandemics. METHODS: Three-step consensus process comprising two online Delphi rounds and an expert workshop conducted from April to June 2021. One hundred twenty experts from various areas of healthcare, administration, and politics in Germany were included. RESULTS: During the consensus-process, pre-formulated evidence-based recommendations were refined step-by-step. This resulted in consensus on 33 recommendations on the topics of "supporting patients and their relatives," "supporting staff," and "supporting and maintaining structures and provision of palliative care." The recommendations address professional carers and various responsibilities on a governmental, federal state and municipal level, and in healthcare facilities. CONCLUSION: We provide evidence and consensus-based recommendations for the care of seriously ill and dying people and their relatives in pandemics in Germany. This is an important step towards a pandemic preparedness and hopefully improves the future palliative care response to pandemics.


Assuntos
COVID-19 , Pandemias , Consenso , Técnica Delfos , Humanos , Cuidados Paliativos , SARS-CoV-2
4.
Trials ; 23(1): 748, 2022 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-36064628

RESUMO

BACKGROUND: Ankle osteoarthritis (OA) is a debilitating health condition that is increasing in prevalence. Currently, there are no evidence-based guidelines for managing ankle OA. One of the current challenges to establishing guidelines is the lack of a widely agreed-upon set of outcome measures that are consistently used in ankle OA research. Without a set of agreed-upon outcome measures, it is difficult to synthesise clinical trial outcomes through meta-analysis-an essential element of evidence-informed practice. In order to develop an appropriate set of outcome measures for ankle OA, it is important first to develop a core domain set. In this protocol, we describe the methodological approach that we will use to develop such a core domain set for ankle OA. METHODS: We established an international steering committee to guide the development of a core domain set for ankle OA. The core domain set development will follow a multi-staged approach consisting of three phases, involving participation by patients and clinicians/healthcare professionals. In phase 1, a list of candidate domains will be gleaned from (a) a scoping review of outcome measures used in ankle OA research, (b) qualitative interviews with individuals with ankle OA, and (c) qualitative interviews with healthcare professionals with expertise in ankle OA. In phase 2, the steering committee will review and generate a list of candidate domains from those gleaned in phase 1. In phase 3, this list of candidate domains will be considered in a Delphi process to reach a consensus on a core domain set. We anticipated this will involve 3 rounds of surveys. CONCLUSION: This protocol describes the methods that will be used to develop a core domain set of health-related aspects for ankle OA. Importantly, it will include both healthcare professional and patient involvement. This is a prerequisite step to developing a core outcome set for ankle OA that should be reported in all clinical trials for ankle OA. The findings will be widely disseminated across peer-refereed publication(s) and national and international conferences, as well as via relevant professional societies, patient support group organisations, and social media platforms. PROJECT REGISTRATION: This project is registered with the Core Outcome Measures in Effectiveness Trials (COMET) database on 17 March 2021. https://www.comet-initiative.org/Studies/Details/1837 .


Assuntos
Tornozelo , Osteoartrite , Ensaios Clínicos como Assunto , Consenso , Humanos , Metanálise como Assunto , Osteoartrite/terapia
5.
J Antimicrob Chemother ; 77(Supplement_1): i2-i9, 2022 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-36065724

RESUMO

BACKGROUND: In the late 1990s, as a response to rising antimicrobial resistance (AMR), an independent multinational, interdisciplinary group was formed specifically targeting primary care antibiotic prescribing for community-acquired respiratory tract infections (CA-RTIs). The group comprised senior clinicians from Canada, Israel, Spain, Sweden, UK and USA. The group's objectives were to provide recommendations for antibiotic stewardship in the community because, whilst it was widely accepted that inappropriate antibiotic use was contributing to AMR, it remained difficult to change prescribing behaviour. The group aimed to identify principles underlying appropriate antibiotic prescribing and guideline formulation to reduce morbidity from CA-RTIs, limit therapeutic failure and, importantly, curb AMR emergence. The group published a report in 2002, which has become known as the Consensus Principles. OBJECTIVES: (i) To consider the relevance of the Consensus Principles in 2022 by reviewing current global approaches to rising AMR. A wide range of factors, such as antibiotic overuse, most recently seen in COVID-19 patients, are still driving rising AMR even though there has been a high-level international response to the AMR threat; and (ii) as an introduction to this Supplement, which reports the findings of analyses of how AMR is being addressed in nine disparate countries (Brazil, India, Kuwait, Mexico, Pakistan, Russia, Saudi Arabia, Türkiye and Vietnam). Understanding how these initiatives are being pursued in different countries helps identify areas where more information is needed. CONCLUSIONS: Adherence to the Consensus Principles remains as important now as it was in 2002. Achieving appropriate antibiotic prescribing is a vital objective in order that the right patient receives the right antibiotics at the right time to ensure optimal clinical outcomes while at the same time helping to limit further increases in AMR.


Assuntos
Gestão de Antimicrobianos , COVID-19 , Infecções Comunitárias Adquiridas , Infecções Respiratórias , Antibacterianos/uso terapêutico , Infecções Comunitárias Adquiridas/tratamento farmacológico , Consenso , Humanos , Prescrição Inadequada , Infecções Respiratórias/tratamento farmacológico
6.
Sci Rep ; 12(1): 15137, 2022 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-36071175

RESUMO

Impact assessment of large-scale projects involves a plethora of technical, economic, social, and environmental factors that must be assessed along with the expectations of the stakeholders of each project. While impact assessment is required for a development project to receive regulatory approval to proceed, it is also an invaluable tool during the design phase of complex projects, providing for informed decision-making. Molding multiple perspectives of diverse stakeholders into a single collective choice is a key challenge in the process. Multi-Criteria Decision Analysis (MCDA) is the methodology used to rank a finite number of decision options based on a finite set of evaluation criteria. Different MCDA techniques, however, may lead to different decisions when applied to the same problem while different sets of criteria and weights may rank choices differently even when the same method is applied. This is a cause of concern, and even acrimony, amongst the stakeholders, often leading to protracted periods of negotiation and delaying project launching. The objective of this paper is to present an intelligent system to ameliorate the effects of the inherent subjectivity in MCDA techniques and to develop a consensus amongst the stakeholders in a data-driven setting. A case study from the field of offshore construction is used as a running example. This case study, informed by real-world experience in the field, demonstrates succinctly the issues involved and illustrates clearly the proposed intelligent methodology and its merits.


Assuntos
Técnicas de Apoio para a Decisão , Inteligência , Consenso
7.
Med Oncol ; 39(12): 181, 2022 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-36071292

RESUMO

Since the first definition by Hellman and Weichselbaum in 1995, the concept of OligoMetastatic Disease (OMD) is a growing oncology field. It was hypothesized that OMD is a clinical temporal window between localized primary tumor and widespread metastases deserving of potentially curative treatment. In real-world clinical practice, OMD is a "spectrum of disease" that includes a highly heterogeneous population of patients with different prognosis. Metastasis directed therapy with local ablative treatment have proved to be a valid alternative to surgical approach. Stereotactic body radiation therapy demonstrated high local control rate and increased survival outcomes in this setting with a low rate of toxicity. However, there is a lack of consensus regarding many clinical, therapeutic, and prognostic aspects of this disease entity. In this review, we try to summarize the major critical features that could drive radiation oncologists toward a better selection of patients, treatments, and study endpoints. With the help of a set of practical questions, we aim to integrate the literature discussion.


Assuntos
Neoplasias , Radiocirurgia , Consenso , Humanos , Neoplasias/patologia , Neoplasias/radioterapia , Prognóstico , Radio-Oncologistas
8.
Adv Rheumatol ; 62(1): 34, 2022 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-36071498

RESUMO

BACKGROUND: The VI Brazilian Consensus on Autoantibodies against HEp-2 cells for determination of autoantibodies against cellular constituents on HEp-2 cells was held on September, 2019, in Fortaleza (CE, Brazil). The guidelines in this edition were formulated by the group of Brazilian experts discussing the classification of complex patterns, the classification of the nuclear discrete dots (few and multiple), the identification of the discrete fine speckled pattern (AC-4a) and improvements on the ANA report. MAINBODY: Sixteen Brazilian researchers and experts from universities and clinical laboratories representing the various geographical regions of Brazil participated in the meeting. Four main topics were discussed: (1) How to classify patterns with fluorescence in more than one cell compartment considering three relevant categoris: composite patterns, mixed patterns and multiple patterns; (2) The splitting of the discrete nuclear dots pattern into the multiple discrete nuclear dots (AC-6) and few discrete nuclear dots (AC-7) patterns, respectively; (3) Inclusion of a novel nuclear pattern characterized by discrete fine speckled pattern highly associated with antibodies to SS-A/Ro60, classified as AC-4a. In addition, adjustments on the Brazilian Consensus nomenclature were implemented aiming to harmonize the designation of some patterns with the International Consensus on ANA Patterns (ICAP). Furthermore, the designations of the PCNA-like pattern (AC-13), CENP-F-like pattern (AC-14) and Topo I-like pattern (AC-29) were adjusted in accordance to ICAP. Finally, there was a recommendation for adjustment in the test report in order to address the status of nuclear envelope staining. For all topics, the aim was to establish specific guidelines for laboratories and clinicians. All recommendations were based on consensus among participants. All recommendations from the V Consensus were maintained and there was relevant progress in the BCA/HEp-2 guidelines and further harmonization with ICAP. CONCLUSION: The VI BCA/HEp-2 edition was successful in establishing important recommendations regarding the classification of complex patterns, in supporting the identification of a novel pattern within the AC-4 group and in the harmonization process with the ICAP terminology.


Assuntos
Anticorpos Antinucleares , Autoanticorpos , Brasil , Consenso , Humanos
9.
Lancet Haematol ; 9(9): e698-e706, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36055334

RESUMO

The International Consortium for Health Outcomes Measurement assembled an international working group of venous thromboembolism experts and patient representatives to develop a standardised minimum set of outcomes and outcome measurements for integration into clinical practice and potentially research to support clinical decision making and benchmarking of quality of care. 15 core outcomes important to patients and health-care professionals were selected and categorised into four domains: patient-reported outcomes, long term consequences of the disease, disease-specific complications, and treatment-related complications. The outcomes and outcome measures were designed to apply to all patients with venous thromboembolism aged 16 years or older. A measurement tool package was selected for inclusion in the core standard set, with a minimum number of items to be measured at predefined timepoints, which capture all core outcomes. Additional measures can be introduced to the user by a cascade opt-in system that allows for further assessment if required. This set of outcomes and measurement tools will facilitate the implementation of the use of patient-centred outcomes in daily practice.


Assuntos
Tromboembolia Venosa , Consenso , Humanos , Avaliação de Resultados em Cuidados de Saúde , Medidas de Resultados Relatados pelo Paciente , Tromboembolia Venosa/terapia
10.
Comput Intell Neurosci ; 2022: 3035231, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36065372

RESUMO

As a decentralized, distributed system between functional and benefit management functions, blockchain is effective for financial transaction data security, data tracking and antitampering, product tracking, and access control. In this context, we have conducted experimental research on the blockchain product traceability trusted data analysis consensus mechanism and reached the following conclusions. (1) There are decentralization, irreversible tampering, traceability, and openness through the blockchain's own information and other functions so that a series of processes from raw material production, transportation, and logistics sales are well documented. (2) Under the same network environment, if the number of matches in the system increases, the average matching time consumed by the original engine is greater than the average matching time on the optimized engine. For example, taking 10% of Byzantine nodes in the system, the number of consensus increases, the average ITPBFT consensus time is about 5.74 s, and the average consensus time of the PBFT consensus mechanism is about 6.13 s. As a decentralized distributed data management system through nodes, blockchain is widely used in financial transactions, copyright protection, and product areas such as tracking and access control. In this regard, we conducted an experimental study of the consensus mechanism to analyze reliable data on the traceability of blockchain products and came to the conclusion of the experiment.


Assuntos
Blockchain , Redes de Comunicação de Computadores , Segurança Computacional , Consenso , Análise de Dados
11.
Pol Przegl Chir ; 94(4): 53-60, 2022 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-36047361

RESUMO

This document - "Polish Consensus on Gastric Cancer Diagnosis and Treatment - Update 2022" - represents an expert consensus following a year's worth of dedicated effort by a team of specialists throughout 2021, put forward in a conference in December 2021 in Krakow, and finalized below for publication in 2022. The effective date of this document is June 14th 2022. The work that went into updating this consensus was made under auspices of the Polish Society of Surgical Oncology and the Association of Polish Surgeons.


Assuntos
Neoplasias Gástricas , Consenso , Humanos , Polônia , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/terapia
12.
Int J Oral Implantol (Berl) ; 15(3): 265-275, 2022 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-36082660

RESUMO

The aim of the present study was to generate an international and multidisciplinary consensus on the clinical management of implant protrusion into the maxillary sinuses and nasal fossae. A total of 31 experts participated, 23 of whom were experts in implantology (periodontologists, maxillofacial surgeons and implantologists), 6 were otolaryngologists and 2 were radiologists. All the participants were informed of the current scientific knowledge on the topic based on a systematic search of the literature. A list of statements was created and divided into three surveys: one for all participants, one for implant providers and radiologists and one for otolaryngologists and radiologists. A consensus was reached on 15 out of 17 statements. According to the participants, osseointegrated implants protruding radiographically into the maxillary sinus or nasal fossae require as much monitoring and maintenance as implants fully covered by bone. In the event of symptoms of sinusitis, collaboration between implant providers and otolaryngologists is required. Implant removal should be considered only after pharmacological and surgical management of sinusitis have failed.


Assuntos
Implantes Dentários , Sinusite , Consenso , Técnica Delfos , Implantes Dentários/efeitos adversos , Humanos , Seio Maxilar/diagnóstico por imagem
13.
BMJ Paediatr Open ; 6(1)2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-36053613

RESUMO

BACKGROUND: Paediatric track and trigger tools (PTTTs) based on vital parameters have been implemented in hospitals worldwide to help healthcare professionals identify signs of critical illness and incipient deterioration in hospitalised children. It has been documented that nurses do not use PTTT as intended, but deviate from PTTT protocols because, in some situations, PTTT observations make little sense to them. The present study aimed to reach consensus on whether automatically generated PTTT scores that are higher than deemed reasonable by healthcare professionals according to their professional experience and clinical expertise may be downgraded. METHODS: A two-round modified Delphi technique was used to explore consensus on 14 patient cases for hospitalised children with a high PTTT score that did not raise concerns by systematically collating questionnaire responses. Participants rated their level of agreement on a 9-point Likert scale. IQR and median were calculated for each case. FINDINGS: A total of 221 participants completed round 1 and 101 participants completed round 2. Across the two rounds, majority of the participants were from paediatric departments, nurses and women. In round 1, consensus on inclusion was reached on 2 of the 14 cases. In round 2, consensus was reached on one additional patient case. Three of the 11 non-consensus cases remaining after rounds 1 and 2 were included by the research group based on predefined criteria. CONCLUSION: In conclusion, a consensus opinion was achieved on six patient cases where the child had a high PTTT score but where the healthcare professionals were not as concerned as indicated by the PTTT score.


Assuntos
Criança Hospitalizada , Pessoal de Saúde , Criança , Consenso , Técnica Delfos , Feminino , Humanos , Fatores Desencadeantes
14.
BMJ Paediatr Open ; 6(1)2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-36053637

RESUMO

INTRODUCTION: As patient-reported outcome measures (PROMs) have become of significant importance in evaluation of care and clinical research, adequately selecting the appropriate instrument is an integral part of paediatric orthopaedic research and clinical practice. This systematic review aims to provide a comprehensive overview of PROMs targeted at children with impairment of the lower limb, and to critically appraise and summarise the quality of their measurement properties by applying the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. METHOD AND ANALYSIS: A systematic search of the MEDLINE and EMBASE databases will be performed to identify relevant publications reporting on the development and/or validation of PROMs used for evaluating children with impairment of the lower extremity. Data extraction and quality assessment of the included studies will be undertaken by two reviewers independently and in accordance with COSMIN guidelines. ETHICS AND DISSEMINATION: It is not necessary to obtain ethical approval for this systematic review. The results will be published in a peer-reviewed journal and will be presented at relevant conferences to enhance information dissemination. PROSPERO REGISTRATION NUMBER: CRD42021287323.


Assuntos
Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida , Criança , Consenso , Bases de Dados Factuais , Humanos , Extremidade Inferior , Revisões Sistemáticas como Assunto
15.
J Med Internet Res ; 24(9): e37337, 2022 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-36074544

RESUMO

BACKGROUND: Health-related misinformation can be propagated via social media and is a threat to public health. Several quality assessment tools and principles to evaluate health-related information in the public domain exist; however, these were not designed specifically for social media. OBJECTIVE: This study aims to develop Principles for Health-related Information on Social Media (PRHISM), which can be used to evaluate the quality of health-related social media content. METHODS: A modified Delphi approach was used to obtain expert consensus on the principles and functions of PRHISM. Health and social media experts were recruited via Twitter, email, and snowballing. A total of 3 surveys were administered between February 2021 and May 2021. The first survey was informed by a literature review and included open-ended questions and items from existing quality assessment tools. Subsequent surveys were informed by the results of the proceeding survey. Consensus was deemed if ≥80% agreement was reached, and items with consensus were considered relevant to include in PRHISM. After the third survey, principles were finalized, and an instruction manual and scoring tool for PRHISM were developed and circulated to expert participants for final feedback. RESULTS: A total of 34 experts consented to participate, of whom 18 (53%) responded to all 3 Delphi surveys. In total, 13 principles were considered relevant and were included in PRHISM. When the instructions and PRHISM scoring tool were circulated, no objections to the wording of the final principles were received. CONCLUSIONS: A total of 13 quality principles were included in the PRHISM tool, along with a scoring system and implementation tool. The principles promote accessibility, transparency, provision of authoritative and evidence-based information and support for consumers' relationships with health care providers. PRHISM can be used to evaluate the quality of health-related information provided on social media. These principles may also be useful to content creators for developing high-quality health-related social media content and assist consumers in discerning high- and low-quality information.


Assuntos
Mídias Sociais , Consenso , Técnica Delfos , Pessoal de Saúde , Humanos , Inquéritos e Questionários
16.
Trials ; 23(1): 764, 2022 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-36076299

RESUMO

BACKGROUND: Single-sided deafness (SSD) has functional, psychological, and social consequences. Interventions for adults with SSD include hearing aids and auditory implants. Benefits and harms (outcome domains) of these interventions are until now reported inconsistently in clinical trials. Inconsistency in reporting outcome measures prevents meaningful comparisons or syntheses of trial results. The Core Rehabilitation Outcome Set for Single-Sided Deafness (CROSSSD) international initiative used structured communication techniques to achieve consensus among healthcare users and professionals working in the field of SSD. The novel contribution is a set of core outcome domains that experts agree are critically important to assess in all clinical trials of SSD interventions. METHODS: A long list of candidate outcome domains compiled from a systematic review and published qualitative data, informed the content of a two-round online Delphi survey. Overall, 308 participants from 29 countries were enrolled. Of those, 233 participants completed both rounds of the survey and scored each outcome domain on a 9-point scale. The set of core outcome domains was finalised via a web-based consensus meeting with 12 participants. Votes involved all stakeholder groups, with an approximate 2:1 ratio of professionals to healthcare users participating in the Delphi survey, and a 1:1 ratio participating in the consensus meeting. RESULTS: The first round of the survey listed 44 potential outcome domains, organised thematically. A further five outcome domains were included in Round 2 based on participant feedback. The structured voting at round 2 identified 17 candidate outcome domains which were voted on at the consensus meeting. Consensus was reached for a core outcome domain set including three outcome domains: spatial orientation, group conversations in noisy social situations, and impact on social situations. Seventy-seven percent of the remaining Delphi participants agreed with this core outcome domain set. CONCLUSIONS: Adoption of the internationally agreed core outcome domain set would promote consistent assessment and reporting of outcomes that are meaningful and important to all relevant stakeholders. This consistency will in turn enable comparison of outcomes reported across clinical trials comparing SSD interventions in adults and reduce research waste. Further research will determine how those outcome domains should best be measured.


Assuntos
Surdez , Projetos de Pesquisa , Adulto , Consenso , Técnica Delfos , Humanos , Avaliação de Resultados em Cuidados de Saúde , Resultado do Tratamento
17.
Chron Respir Dis ; 19: 14799731221121670, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36068015

RESUMO

BACKGROUND: The roles of physical activity (PA) and exercise within the management of cystic fibrosis (CF) are recognised by their inclusion in numerous standards of care and treatment guidelines. However, information is brief, and both PA and exercise as multi-faceted behaviours require extensive stakeholder input when developing and promoting such guidelines. METHOD: On 30th June and 1st July 2021, 39 stakeholders from 11 countries, including researchers, healthcare professionals and patients participated in a virtual conference to agree an evidence-based and informed expert consensus about PA and exercise for people with CF. This consensus presents the agreement across six themes: (i) patient and system centred outcomes, (ii) health benefits, iii) measurement, (iv) prescription, (v) clinical considerations, and (vi) future directions. The consensus was achieved by a stepwise process, involving: (i) written evidence-based synopses; (ii) peer critique of synopses; (iii) oral presentation to consensus group and peer challenge of revised synopses; and (iv) anonymous voting on final proposed synopses for adoption to the consensus statement. RESULTS: The final consensus document includes 24 statements which surpassed the consensus threshold (>80% agreement) out of 30 proposed statements. CONCLUSION: This consensus can be used to support health promotion by relevant stakeholders for people with CF.


Assuntos
Fibrose Cística , Consenso , Fibrose Cística/terapia , Exercício Físico , Promoção da Saúde , Humanos
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