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    [Summary of the practice guideline for shoulder complaints from the Dutch College of General Practitioners].
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    Abstract:
    The second revision of the practice guideline for shoulder complaints was presented in 2008 by the Dutch College of General Practitioners. This guideline provides a standard for the diagnosis and treatment of shoulder complaints by general practitioners. The most important items in this new guideline are reviewed.
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    Guideline
    Case reports have been a long held tradition within the surgical literature. Reporting guidelines can improve transparency and reporting quality. However, recent consensus-based guidelines for case reports (CARE) are not surgically focused. Our objective was to develop surgical case report guidelines.The CARE statement was used as the basis for a Delphi consensus. The Delphi questionnaire was administered via Google Forms and conducted using standard Delphi methodology. A multidisciplinary group of surgeons and others with expertise in the reporting of case reports were invited to participate. In round one, participants stated how each item of the CARE statement should be changed and what additional items were needed. Revised and additional items from round one were put forward into a further round, where participants voted on the extent of their agreement with each item, using a nine-point Likert scale, as proposed by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) working group.In round one, there was a 64% (38/59) response rate. Following adjustment of the guideline with the incorporation of recommended changes, round two commenced and there was an 83% (49/59) response rate. All but one of the items were approved by the participants, with Likert scores 7-9 awarded by >70% of respondents. The final guideline consists of a 14-item checklist.We present the SCARE Guideline, consisting of a 14-item checklist that will improve the reporting quality of surgical case reports.
    Guideline
    Grading (engineering)
    Delphi Method
    Delphi
    Statement (logic)
    Concordance
    Citations (1,693)
    Objectives A case report is a detailed report of the symptoms, signs, diagnosis, treatment, and follow-up of an individual patient. The purpose of this study is to evaluate the quality of case reports from the Journal of Korean Medicine by the CARE (CAse REport) Guideline. Methods Case reports published in the Journal of Korean Medicine from January 2016 to March 2020 were searched from Oriental Medicine Advanced Searching Integrated System (OASIS). We assessed the quality of reporting based on CARE (CAse REport) guideline as ‘Sufficient’, ‘Not-Sufficient’ and ‘Not-Report’. Results A total of 22 case reports were finally included for the assessment. The reporting items were reported as of reporting quality. After checking the result, there was a deviation in the sub-item reporting rate by a maximum 89.29%, a minimum 66.67% and a median 82.14% in case reports. Also after checking the quality in case reports by 28 detailed items in CARE guidelines, there were not reported 77% or more in the 5 sub-items ‘Intervention adherence and tolerability’, ‘Informed consent’, ‘Adverse and unanticipated events’, ‘Diagnostic challenges’, ‘Patient perspective’. Conclusion There is a need to improve the quality of case reports in the journal of Korean Medicine based on various studies using CARE guideline. Keywords: Case reports, CARE guideline, The Journal of Korean Medicine, Reporting guidelines, Quality
    Guideline
    Citations (3)
    To design a clinical guideline for the emergency management of retained button batteries (RBBs) through analysis of UK National Health Service hospital guidelines and published literature.49 acute hospitals were contacted, and their guidelines were analysed. A consensus guideline was then created with multidisciplinary input. The final guideline was independently peer reviewed by the British Association of Otorhinolaryngology and Head and Neck Surgery (ENT UK) clinical guidelines committee.40 (82%) trusts responded. 28 had a guideline for the management of a RBB in the aerodigestive tract. Significant variation between guidelines assessment, investigation and management of a RBB was identified.A single-page guideline was designed to improve frontline healthcare professional's immediate investigation and management of a RBB on presentation to emergency care. This has been published by ENT UK as a clinical guideline.
    Guideline
    Presentation (obstetrics)
    This clinical guideline presents recommendations for the management of patients with anterior cruciate ligament (ACL) injury, endorsed by the Japanese Orthopaedic Association (JOA) and Japanese Orthopaedic Society of Knee, Arthroscopy and Sports Medicine (JOSKAS).The JOA ACL guideline committee revised the previous guideline based on "Medical Information Network Distribution Service Handbook for Clinical Practice Guideline Development 2014", which proposed a desirable method for preparing clinical guidelines in Japan. Furthermore, the importance of "the balance of benefit and harm" was also emphasized. This guideline consists of 21 clinical questions (CQ) and 23 background questions (BQ). For each CQ, outcomes from the literature were collected and evaluated systematically according to the adopted study design.We evaluated the objectives and results of each study in order to make a decision on the level of evidence so as to integrate the results with our recommendations for each CQ. For BQ, the guideline committee proposed recommendations based on the literature.This guideline is intended to be used by physicians, orthopedic surgeons, physical therapists, and athletic trainers managing ACL injuries. We hope that this guideline is useful for appropriate decision-making and improved management of ACL injuries.
    Guideline
    Sports medicine
    ACL injury
    Evidence-Based Medicine
    Clinical Practice
    Citations (40)
    Developed within the German Pension Insurance scheme's Guidelines programme, the Guideline for Rehabilitation in Coronary Artery Disease has been publicly available since January 2005. Pension Insurance routine data on the therapeutic benefits and services provided (based on the Classification of Therapeutic Procedures, KTL) were analyzed to assess the extent to which rehabilitation facilities had complied with Guideline requirements already in 2004. In January 2005, the results were disseminated together with the Guideline to the rehabilitation facilities which had participated in Pension Insurance rehabilitation of patients with coronary artery disease in 2004. In an accompanying survey information was requested concerning acceptability and applicability of the Guideline, of the presentation of KTL data, as well as reasons for non-adherence to Guideline requirements.In February 2005 a written, anonymous survey was conducted among 72 clinical directors of rehabilitation facilities. The survey instrument contained three standardized questionnaires covering the aspects cited above. The response rate was 73.6 % (n = 53). Descriptive analyses were performed.Views of the Guideline: The Guideline fulfils most of the seven quality attributes surveyed (completely fulfilled: 11.3-32.7 %, basically fulfilled: 49.1-64.2 %). Volume, structure and clarity of the guideline are judged to be "very good" by 62.3 %, 50.9 % and 36.5 % of the respondents. The KTL-procedure codes forming part of the Guideline to be used to assess guideline adherence, were considered appropriate by 88.5 % to 98 %. Consent to Guideline requirements varies between 80.8 and 34.6 %. Views of the audit feedback based on KTL-data: Depending on the various data table types, 37.7 % to 20.0 % of the respondents stated that the tables should remain unchanged in future evaluations. 28.0 % to 39.0 % consider the tables to be very useful for quality management. Reasons for non-adherence to Guideline recommendations: according to the clinicians, the most important reason for deviation from Guideline requirements is incomplete or incorrect coding of therapeutic procedures.The Guideline for Rehabilitation in Coronary Artery Disease basically fulfils the formal, methodological and content-related quality criteria considered to be most relevant by the clinical directors. As expected, the greatest need for discussion is focussed on the actual Guideline requirements. Form and content of the KTL-feedback are well accepted, and the feedback itself is considered relevant for everyday practice. The main reason given for non-adherence to guideline requirements (i. e., inaccurate coding) should not be overstated as the KTL-analyses was based on data from 2004, when the guideline had not yet been published.The Guideline for Rehabilitation in Coronary Artery Disease is acceptable and practicable, and it is moreover tied in with external quality assurance activities in place (i. e., the quality assurance programme of the statutory Pension Insurance scheme). The audit feedback given in this framework provides rehabilitation facilities participating in the programme not only with comparative analyses but also with input for their internal quality management actions. Future activities within the external quality assurance programme should inter alia focus on more targeted implementation activities and repeated KTL-based appraisals.
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    The European Pressure Ulcer Advisory Panel, the Pan Pacific Pressure Injury Alliance, and the National Pressure Ulcer Advisory Panel are updating the 'Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline' (CPG) in 2019. The aim of this contribution is to summarize and to discuss the guideline development protocol for the 2019 update.A guideline governance group determines and monitors all steps of the CPG development. An international survey of consumers will be undertaken to establish consumer needs and interests. Systematic evidence searches in relevant electronic databases cover the period from July 2013 through August 2018. Risk of bias of included studies will be assessed by two reviewers using established checklists and an overall strength of evidence assigned to the cumulative body of evidence. Small working groups review the evidence available for each topic, review and/or draft the guideline chapters and recommendations and/or good practice statements. Finally, strength of recommendation grades are assigned. The recommendations are rated based on their importance and their potential to improve individual patient outcomes using an international formal consensus process.Major methodological advantages of the current revision are a clear distinction between evidence-based recommendations and good practice statements and strong consumer involvement.The 2019 guideline update builds on the previous 2014 version to ensure consistency and comparability. Methodology changes will improve the guideline quality to increase clarity and to enhance implementation and compliance. The full guideline development protocol can be accessed from the guideline website (http://www.internationalguideline.com/).
    Guideline
    CLARITY
    Comparability
    Citations (259)
    Financial relationships between physicians and industry have influence on patient care. Therefore, organizations producing clinical practice guidelines (CPGs) must have policies limiting financial conflicts during guideline development.To evaluate payments received by physician authors of otolaryngology CPGs, compare disclosure statements for accuracy, and investigate the extent to which the American Academy of Otolaryngology-Head and Neck Surgery complied with standards for guideline development from the Institute of Medicine (IOM).This cross-sectional analysis retrieved CPGs from the American Academy of Otolaryngology-Head and Neck Surgery Foundation that were published or revised from January 1, 2013, through December 31, 2015, by 49 authors. Data were retrieved from December 1 through 31, 2016. Industry payments received by authors were extracted using the Centers for Medicare & Medicaid Services Open Payments database. The values and types of these payments were then evaluated and used to determine whether self-reported disclosure statements were accurate and whether guidelines adhered to applicable IOM standards.The monetary amounts and types of payments received by physicians who author otolaryngology guidelines and the accuracy of disclosure statements.Of the 49 physicians in this sample, 39 (80%) received an industry payment. Twenty-one authors (43%) accepted more than $1000; 12 (24%), more than $10 000; 7 (14%), more than $50 000; and 2 (4%), more than $100 000. Mean (SD) financial payments amounted to $18 431 ($53 459) per physician. Total reimbursement for all authors was $995 282. Disclosure statements disagreed with the Open Payments database for 3 authors, amounting to approximately $20 000 among them. Of the 3 IOM standards assessed, only 1 was consistently enforced.Some CPG authors failed to fully disclose all financial conflicts of interest, and most guideline development panels and chairpersons had conflicts. In addition, adherence to IOM standards for guideline development was lacking. This study is relevant to CPG panels authoring recommendations, physicians implementing CPGs to guide patient care, and the organizations establishing policies for guideline development.
    Reimbursement
    Guideline
    Clinical Practice
    Limiting
    Citations (60)
    Clinical practice guidelines (CPGs) can positively affect the quality of patient care offered by physicians because they decrease variability in clinical practice and may help reduce unnecessary testing, promoting a more responsible use of resources. Building on existing framework for reporting guideline development, including the work of the Enhancing the Quality and Transparency of Health Research Network, the Reporting Items for Practice Guidelines in Healthcare (RIGHT) Working Group created a 2016 checklist of 35 items considered essential for high-quality reporting of CPGs.To evaluate how many previously published CPGs in orthopedic surgery met the RIGHT criteria and assess how improvements can be made in future orthopedic CPGs based on any found deficiencies.All 18 CPGs published before January 1, 2018, by the American Academy of Orthopedic Surgeons (AAOS) are publicly available on orthoguidelines.org. Two authors downloaded each file and both of those authors independently scored each CPG using piloted abstraction RIGHT checklist forms.Of the 35 RIGHT criteria outlined in 22 checklist items, 23 (65.7%) were met across all AAOS guidelines, 6 (17.1%) were not met by any of the AAOS guidelines, and 6 (17.2%) were met by some of the AAOS guidelines.Overall, the AAOS guidelines addressed many important recommendations within the RIGHT checklist. Assessing adherence to the RIGHT checklist can help ensure that future guidelines are more effectively communicated, hopefully assisting end users in efficient implementation and increasing the level of evidence-based patient care.
    Guideline
    CLARITY
    Citations (2)
    BackgroundIn 2009, the National Institute for Health and Clinical Excellence (NICE) produced the guidance: Low back pain: early management of persistent non-specific low back pain aimed at general practitioners (GPs), consultants, and manual therapists in order to ensure all involved in the care of this complex and often debilitating condition are aware of the options most likely to yield a positive outcome.Two years since the publication of the clinical guidance, services have had ample time to adapt and overcome early teething issues in order to deliver these guidelines.MethodsA retrospective audit was carried out at an out-patient physiotherapy department. One-hundred notes were randomly selected from those who meet the NICE criteria, i.e. non-specific low back pain for six weeks to 12 months in duration. A questionnaire was developed to target National Health Service (NHS) musculoskeletal physiotherapists using electronic media, mail shot and professional networking (clinical interest) groups within t...
    Nice
    Excellence
    Clinical audit
    Back Pain
    Citations (0)