Literature

文献
  • 文章类型: Journal Article
    背景:患者参与和综合知识翻译(iKT)过程通过建立共识计划和研究中的有意义的伙伴关系来改善健康结果和护理体验。建立共识对于让不同的经验丰富的知识用户参与共同开发和支持一个解决方案至关重要,该解决方案不容易存在或不太理想。患者和护理人员为围绕医疗保健的决策建立共识提供了宝贵的见解,政策和研究。然而,尽管有新的证据,在建立共识的倡议中,患者的参与仍然很少.具体来说,我们的研究发现,患有慢性健康状况的青年及其照顾者缺乏机会参与就向成人护理过渡的指标/基准达成共识.为了弥合这一差距,并为我们与青年/护理人员建立共识的方法提供信息,本范围审查将综合有关患者和其他知识用户参与建立共识的医疗保健计划的文献范围.
    方法:遵循乔安娜·布里格斯研究所的范围审查方法,发表的文献将在MEDLINE中搜索,EMBASE,CINAHL和PsycINFO数据库从成立到2023年7月。灰色文献将进行手工搜索。两名独立审稿人将分两个阶段确定文章的资格,第三审稿人解决了分歧。纳入的研究必须是在医疗保健背景下建立共识的研究,涉及患者参与策略。来自符合条件的研究的数据将被提取并以标准化形式绘制。将对抽象数据进行定量和描述性分析,根据具体的共识方法,以及患者参与模型和/或策略。
    背景:本范围审查方案不需要伦理批准。审查过程和结果将与相关知识用户共享并由其提供信息。调查结果的传播还将包括同行评审的出版物和会议介绍。结果将为支持患者参与建立共识的医疗保健计划提供新的见解。
    背景:https://osf.io/beqjr.
    BACKGROUND: Patient engagement and integrated knowledge translation (iKT) processes improve health outcomes and care experiences through meaningful partnerships in consensus-building initiatives and research. Consensus-building is essential for engaging a diverse group of experienced knowledge users in co-developing and supporting a solution where none readily exists or is less optimal. Patients and caregivers provide invaluable insights for building consensus in decision-making around healthcare, policy and research. However, despite emerging evidence, patient engagement remains sparse within consensus-building initiatives. Specifically, our research has identified a lack of opportunity for youth living with chronic health conditions and their caregivers to participate in developing consensus on indicators/benchmarks for transition into adult care. To bridge this gap and inform our consensus-building approach with youth/caregivers, this scoping review will synthesise the extent of the literature on patient and other knowledge user engagement in consensus-building healthcare initiatives.
    METHODS: Following the scoping review methodology from Joanna Briggs Institute, published literature will be searched in MEDLINE, EMBASE, CINAHL and PsycINFO databases from inception to July 2023. Grey literature will be hand-searched. Two independent reviewers will determine the eligibility of articles in a two-stage process, with disagreements resolved by a third reviewer. Included studies must be consensus-building studies within the healthcare context that involve patient engagement strategies. Data from eligible studies will be extracted and charted on a standardised form. Abstracted data will be analysed quantitatively and descriptively, according to specific consensus methodologies, and patient engagement models and/or strategies.
    BACKGROUND: Ethics approval is not required for this scoping review protocol. The review process and findings will be shared with and informed by relevant knowledge users. Dissemination of findings will also include peer-reviewed publications and conference presentations. The results will offer new insights for supporting patient engagement in consensus-building healthcare initiatives.
    BACKGROUND: https://osf.io/beqjr.
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  • 文章类型: Systematic Review
    目的:本研究旨在评估与中风后感觉丧失管理相关的临床实践指南(CPGs)的方法学质量,并为卫生专业人员开发算法。
    方法:我们使用系统评价和荟萃分析清单的首选报告项目对2017年至2022年发布的相关CPG进行了系统评价。《研究与评价指南》II工具用于评估方法学质量。总结了管理高质量和平均质量CPG引起的中风后感觉损失的建议,并将其开发为算法。
    结果:首先,从数据库搜索和其他来源中确定了1458条记录。最后,包括四个CPG:三个被评为高质量,一个被评为平均质量。从这些CPG中总结了22条建议,并用于开发算法草案。然后,我们根据专家反馈修改了作者开发的算法草案,形成最终版本。
    结论:本研究纳入的4个CPG质量较好。基于这些CPG,我们开发了一种算法,以促进卫生专业人员坚持CPG,并有助于循证医学。在未来,需要更多高质量的CPG来提供更多科学和令人信服的证据来管理卒中后感觉丧失.
    This study aimed to assess the methodological quality of clinical practice guidelines (CPGs) associated with the management of poststroke sensory loss and develop an algorithm for health professionals.
    We conducted a systematic review for relevant CPGs published between 2017 and 2022 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Checklist. Appraisal of Guidelines for Research and Evaluation II instrument was used to assess methodological quality. Recommendations for managing poststroke sensory loss from high and average-quality CPGs were summarised and developed into an algorithm.
    First, 1458 records were identified from the database searches and other sources. Finally, four CPGs were included: three were rated as high quality and one as average quality. Twenty-two recommendations were summarised from these CPGs and used to develop a draft algorithm. Then, we revised the draft algorithm developed by the authors based on expert feedback to form the final version.
    The four CPGs included in this study had good quality. Based on these CPGs, we developed an algorithm to facilitate health professionals\' adherence to CPGs and contribute to evidence-based medicine. In the future, more high-quality CPGs are required to give further scientific and convincing evidence to manage poststroke sensory loss.
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  • 文章类型: Journal Article
    尽管出版物有所减少,病例报告在医学文献中仍然是必不可少的,因为它们提供了个体患者病例的详细描述和对未来管理的宝贵见解.这些报告遵循标准化结构,包括摘要、介绍,病例报告,讨论,和结论。获得知情同意和遵守准则至关重要。病例报告通过检测新疗法和不良事件有助于循证医学。它们还有助于明确报告,指导方针坚持,和指导计划。这些报告对于记录罕见事件至关重要,协助临床医生及时管理,并向忙碌的医疗专业人员传达新颖的信息。遵循病例报告指南确保全面和标准化的报告,提高病例报告的接受度和质量,推进医学知识。
    Despite a decrease in publication, case reports remain essential in medical literature as they offer detailed descriptions of individual patient cases and valuable insights for future management. These reports adhere to a standardized structure comprising sections such as abstract, introduction, case report, discussion, and conclusion. Obtaining informed consent and adhering to guidelines is essential. Case reports contribute to evidence-based medicine by detecting new therapies and adverse events. They also facilitate clear reporting, guideline adherence, and mentorship programs. These reports are vital for documenting rare occurrences, assisting clinicians in timely management, and communicating novel information to busy medical professionals. Following case report guidelines ensures comprehensive and standardized reporting, enhancing the acceptance and quality of case reports, and advancing medical knowledge.
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  • 文章类型: Journal Article
    由物理治疗师和神经科医生组成的美国物理治疗协会志愿者指南制定小组制定了一项关于肱骨关节骨关节炎的临床实践指南。该指南基于对当前科学和临床信息的系统评价,以及接受的物理治疗师治疗肱骨关节骨关节炎的方法。本临床实践指南以西班牙语提供;见补充附录8。
    A clinical practice guideline on glenohumeral joint osteoarthritis was developed by an American Physical Therapy Association volunteer guideline development group that consisted of physical therapists, an occupational therapist, and a physician. The guideline was based on systematic reviews of current scientific and clinical information and accepted approaches for physical therapist management of glenohumeral joint osteoarthritis. This clinical practice guideline is available in Spanish; see Supplementary Appendix 8.
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  • 文章类型: Journal Article
    目的:目前尚不清楚NCCN指南如何在肿瘤学实践中推荐“支持治疗”和“最佳支持治疗”。我们检查了NCCN指南中“支持治疗”和“最佳支持治疗”的用法,并比较了实体瘤和血液恶性肿瘤指南。
    方法:我们在2019年10月回顾了所有更新的NCCN癌症治疗指南。我们记录了发生的频率,定义,以及每个术语的引入时间。我们比较了实体瘤和血液恶性肿瘤指南。
    结果:我们共确定了37个实体瘤和16个血液学指南。37(70%)指南提到“支持性护理”,36(68%)提到“最佳支持性护理”。“血液学指南比实体瘤指南更有可能使用术语“支持性护理”(中位发生率19vs.2;P=0.001),并将“支持性护理”描述为癌症相关并发症的管理(N=11/15,73%vs.N=2/22,9%;P<0.001)。很少提及专科姑息治疗领域(N=10/37,27%)。相比之下,实体瘤指南比血液学指南更有可能提到“最佳支持治疗”(中位发生率6vs.0;P=0.016)。这个术语很少定义,主要用于晚期疾病。
    结论:“支持性护理”和“最佳支持性护理”在NCCN指南中经常使用,实体瘤和血液肿瘤学家之间的用法存在显着差异。在NCCN指南中,“支持性护理”主要限于癌症相关并发症和治疗不良反应的管理。强调需要超越传统的生物医学模式,更多的以患者为中心的护理模式,更多的整合姑息治疗。
    OBJECTIVE: It is unclear how NCCN guidelines recommend \"supportive care\" and \"best supportive care\" in oncology practice. We examined the usage of \"supportive care\" and \"best supportive care\" in NCCN guidelines and compared between solid tumor and hematologic malignancy guidelines.
    METHODS: We reviewed all updated NCCN Guidelines for Treatment of Cancer in October 2019. We documented the frequency of occurrence, definition, and timing of introduction of each term. We compared between solid tumor and hematologic malignancy guidelines.
    RESULTS: We identified a total of 37 solid tumor and 16 hematologic guidelines. Thirty-seven (70%) guidelines mentioned \"supportive care\" and 36 (68%) mentioned \"best supportive care.\" Hematologic guidelines were significantly more likely than solid tumor guidelines to use the term \"supportive care\" (median occurrence 19 vs. 2; P = 0.001) and to describe \"supportive care\" as management of cancer-related complications (N = 11/15, 73% vs. N = 2/22, 9%; P < 0.001). Domains of specialist palliative care were infrequently mentioned (N = 10/37, 27%). In contrast, solid tumor guidelines were significantly more likely than hematologic guidelines to mention \"best supportive care\" (median occurrence 6 vs. 0; P = 0.016). This term was rarely defined and mostly used in the advanced disease setting.
    CONCLUSIONS: \"Supportive care\" and \"best supportive care\" were frequently used in NCCN guidelines, with significant variations in usage between solid tumor and hematologic oncologists. \"Supportive care\" was mostly limited to management of cancer-related complications and treatment adverse effects in NCCN guidelines, highlighting the need to go beyond the traditional biomedical model to more a patient-centered care model with greater integration of palliative care.
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  • 文章类型: Journal Article
    Integration of specialist palliative care into routine oncologic care improves patients\' quality of life and survival. National Comprehensive Cancer Network (NCCN) cancer treatment guidelines are instrumental in standardizing cancer care, yet it is unclear how palliative and hospice care are integrated in these guidelines. In this study, we examined the frequency of occurrence of \"palliative care\" and \"hospice care\" in NCCN guidelines and compared between solid tumor and hematologic malignancy guidelines.
    We reviewed all 53 updated NCCN Guidelines for Treatment of Cancer. We documented the frequency of occurrence of \"palliative care\" and \"hospice care,\" the definitions for these terms if available, and the recommended timing for these services.
    We identified a total of 37 solid tumor and 16 hematologic malignancy guidelines. Palliative care was mentioned in 30 (57%) guidelines (24 solid tumor, 6 hematologic). Palliative care was mentioned more frequently in solid tumor than hematologic guidelines (median, 2 vs. 0; p = .04). Among the guidelines that included palliative care in the treatment recommendation, 25 (83%) only referred to NCCN palliative care guideline. Specialist palliative care referral was specifically mentioned in 5 of 30 (17%) guidelines. Only 14 of 24 (58%) solid tumor guidelines and 2 of 6 (33%) hematologic guidelines recommended palliative care in the front line setting for advanced malignancy. Few guidelines (n = 3/53, 6%) mentioned hospice care.
    \"Palliative care\" was absent in almost half of NCCN cancer treatment guidelines and was rarely discussed in guidelines for hematologic malignancies. Our findings underscored opportunities to standardize timely palliative care access across NCCN guidelines.
    Integration of specialist palliative care into routine oncologic care is associated with improved patient outcomes. National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology have an important role to standardize palliative care involvement for cancer patients. It is unclear how often palliative care referral is recommended in these guidelines. In this study involving 53 NCCN Guidelines for Treatment of Cancer, the researchers found that palliative care was not mentioned in over 40% of NCCN guidelines and was rarely discussed in guidelines for hematologic malignancies. These findings underscored opportunities to standardize timely palliative care access across NCCN guidelines.
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  • 文章类型: Journal Article
    BACKGROUND: Health research reporting guidelines for case reports (CARE - CAse REport) published in 2013 and 2017 have become a generally accepted standard for publishing case reports. The CARE guidelines represent an architectural framework for writing an evidence-based case report that can be customized as need for a specialty (or disease) if needed. We aim to develop a CARE guideline extension for acupuncture following the EQUATOR Network (Enhancing the QUAlity and Transparency Of health Research) and the 2010″Guidance for Developers of Health Research Reporting\". We have established a group of international experts including; clinicians, researchers and methodologists. We performed a needs assessment based on a review of acupuncture case reports published in the indexed medical literature. The needs assessment will be followed by (1) a series of expert interviews to establish a draft, (2) a modified Delphi process, and (3) a consensus meeting. Following the consensus meeting we will pilot test the CARE draft before publishing the CARE extension for acupuncture.
    METHODS: We will develop the CARE extensions for acupuncture following recommendations of the EQUATOR Network and the 2010 \"Guidance for Developers of Health Research Reporting\". We will establish an international multidisciplinary group including clinical practitioners, acupuncturists, researchers of reporting guidelines on acupuncture, clinical epidemiologists and statisticians. We performed a needs assessment, reviewing published case reports using acupuncture as a therapeutic intervention from indexed medical journals (PubMed-PMC and Medline, Scopus, Embase, the Allied and Complementary Medicine Database (AMED), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Wan Fang database, Chinese BioMedicine database (CBM), China National Knowledge Infrastructure (CNKI), and VIP). In consultations with advisors we will develop a draft of potential items to be included in the CARE extension for acupuncture. Then we will conduct a modified Delphi process of at least three rounds, hold a face-to-face consensus meeting, pilot test and submit the CARE extension for acupuncture for publication.
    CONCLUSIONS: The development of a widely accepted CARE extension for acupuncture for case reports published in indexed medical journals. These guidelines will follow the EQUATOR Network recommendations and the 2010 \"Guidance for Developers of Health Research Reporting\".
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  • 文章类型: Journal Article
    背景:评估研究与评估指南(AGREE)II工具是最常用的指南评估工具。它包括在6个领域内组织的23个评估标准(项目)和2个总体评估(1。总体指南质量;2.建议使用)。本系统综述的目的是双重的。首先,调查AGREEII用户进行两次总体评估的频率。其次,调查6个领域分数对2个总体评估中每一个的影响。
    方法:对报告AGREEII指南评估的出版物进行了系统的书目检索。使用多元线性回归模型检查了6个领域得分对指南质量总体评估的影响。它们对使用建议的影响(可能的答案:\"是\",\"是的,修改为\“,\“no\”)使用多项回归模型进行检查。
    结果:确认了118份相关出版物,包括1453份指南。77.1%的出版物报告了至少一次总体评估的结果,但只有32.2%的人报告了两项总体评估的结果。回归分析的结果显示,所有领域对总体指南质量的影响具有统计学意义,领域3(发展的严谨性)具有最强的影响力。对于使用建议,结果显示域3至5的影响显著(“是”与\"no\")和域3和5(\"是,与修改“与\"no\")。
    结论:指南评估人员低估了AGREEII的2项总体评估。域3和5对两项总体评估的结果影响最大,而其他领域有不同的影响。在规范的方法中,我们的研究结果可作为AGREEII中各个领域权重的指导,以使总体评估更加客观.或者,对各个领域进行更强的内容分析可以阐明它们在指南质量方面的重要性.此外,协议二应要求用户透明地展示他们是如何进行评估的。
    BACKGROUND: The Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument is the most commonly used guideline appraisal tool. It includes 23 appraisal criteria (items) organized within 6 domains and 2 overall assessments (1. overall guideline quality; 2. recommendation for use). The aim of this systematic review was twofold. Firstly, to investigate how often AGREE II users conduct the 2 overall assessments. Secondly, to investigate the influence of the 6 domain scores on each of the 2 overall assessments.
    METHODS: A systematic bibliographic search was conducted for publications reporting guideline appraisals with AGREE II. The impact of the 6 domain scores on the overall assessment of guideline quality was examined using a multiple linear regression model. Their impact on the recommendation for use (possible answers: \"yes\", \"yes, with modifications\", \"no\") was examined using a multinomial regression model.
    RESULTS: 118 relevant publications including 1453 guidelines were identified. 77.1% of the publications reported results for at least one overall assessment, but only 32.2% reported results for both overall assessments. The results of the regression analyses showed a statistically significant influence of all domains on overall guideline quality, with Domain 3 (rigour of development) having the strongest influence. For the recommendation for use, the results showed a significant influence of Domains 3 to 5 (\"yes\" vs. \"no\") and Domains 3 and 5 (\"yes, with modifications\" vs. \"no\").
    CONCLUSIONS: The 2 overall assessments of AGREE II are underreported by guideline assessors. Domains 3 and 5 have the strongest influence on the results of the 2 overall assessments, while the other domains have a varying influence. Within a normative approach, our findings could be used as guidance for weighting individual domains in AGREE II to make the overall assessments more objective. Alternatively, a stronger content analysis of the individual domains could clarify their importance in terms of guideline quality. Moreover, AGREE II should require users to transparently present how they conducted the assessments.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    Both experimental and therapeutic uses of the new reproductive technologies have been governed not by the medical ideology of the best interests of patients and their children, but by the market ideology of profit maximization under the guise of \"reproductive liberty.\" Government in our constitutional, democratic society has the authority and obligation to make and enforce reasonable regulations to manage the new reproductive market in order to protect the interests of the public, prospective parents, and their future children. The \"cloning\" debate provides a useful opportunity to compare and contrast the competing regulatory models of the free market, professional guidelines, and government restrictions.
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