Biomedical subjects

Karin Verkerk

Publications and source records attributed to Karin Verkerk.

3 recordsLinked to original sources

PubMed2006

Considered judgement in evidence-based guideline development.

BACKGROUND: Clinical practice guidelines should be based on the best available evidence. However, this evidence is often incomplete, controversial, or lacking. Other considerations beyond the evidence are therefore needed to be able to formulate specific and applicable recommendations for clinical practice. OBJECTIVE: The aim of this study is to obtain consensus among experts about a set of domains and items covering the most relevant 'other considerations' to formulate recommendations in evidence-based guideline development. METHODS: An initial list of 10 domains and 49 items for a systematic and considered judgement of scientific evidence was generated from the literature. A panel of Dutch experts in guideline development tested this list using a two-round Delphi consensus technique. Each expert was asked to independently score the relevance of the items on a 4-point Likert scale, ranging from 'very important' to 'not important'. The final list consisted of items that were included by at least 60% consensus. RESULTS: Twenty-eight experts participated in the first Delphi round and 21 of them in the second round. High scoring domains were 'clinical relevance', 'safety', and 'availability of resources'. There was consensus about the relevance of 37 items. The domain 'conflicts of interest by industry' was excluded because of lack of consensus. CONCLUSION: This is the first formal consensus approach towards structuring the considered judgement process in formulating recommendations in clinical guidelines. The final list of items can be used to facilitate the process of guideline development. The next step is to test the practical usefulness and applicability of this list in guideline development.

Consensus↗

PubMed2006

Reproducibility of the measurement of active and passive cervical range of motion.

OBJECTIVE: The primary aim of this study was to assess the reproducibility of tests for the active and passive range of motion used in the physical examination for patients with neck pain. The secondary aim was to determine whether the history of the patients influences the reproducibility and the prevalence of positive findings. METHODS: Sixty-nine participants were recruited in 3 physical therapy practices. Two examiners independently performed a physical examination on all participants. The examiners were blinded for patient characteristics (neck pain/no neck pain) and each other's findings. History findings were available for only half the patients with neck pain. Cohen's kappa was used to express reproducibility. RESULTS: The reproducibility for active and passive range of motion was moderate (kappa = 0.52 and 0.54, respectively), but a wide range in kappa scores was found. Extension of the neck showed good reproducibility for both active and passive movements (kappa = 0.88 and 0.85), whereas lateral flexion showed poor reproducibility (kappa = 0.35 and 0.33). Knowledge of history had no influence on the reproducibility and prevalence of positive findings. CONCLUSION: The reproducibility for active and passive range of motion is moderate. Knowledge of the patient's history did not influence the reproducibility and prevalence of positive findings.

Adult↗

PubMed2005

Effect of bracing and other conservative interventions in the treatment of idiopathic scoliosis in adolescents: a systematic review of clinical trials.

BACKGROUND AND PURPOSE: Many conservative treatments are available for adolescents with idiopathic scoliosis, but the evidence for their accepted use is still unclear. The purpose of this study was to evaluate the effectiveness of braces and other conservative treatments of idiopathic scoliosis in adolescents by systematically reviewing the literature. METHODS: The literature was searched in the PubMed, CINAHL, Cochrane, and PEDro databases. Studies were selected if the design was a randomized clinical trial or a controlled clinical trial, if all patients had an idiopathic scoliosis, if all patients were less than 18 years of age during the intervention, and if the type of intervention was a conservative one. Two reviewers independently assessed the methodological quality using the Delphi list and performed data extraction. Analysis was based on the levels of evidence. RESULTS: Thirteen studies met the final inclusion criteria, showing a wide range of interventions such as bracing, electrical surface stimulation, and exercises. DISCUSSION AND CONCLUSION: The authors conclude that the effectiveness of bracing and exercises is not yet established, but might be promising. They found no evidence of the effectiveness of electrical stimulation.

Adolescent↗