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PubMed2007

European Society of Gastrointestinal and Abdominal Radiology (ESGAR): consensus statement on CT colonography.

Rapid clinical dissemination of CT colonography (CTC) is occurring in parallel with continued research into technique optimisation and diagnostic performance. A need exists therefore for current guidance as to basic prerequisites for effective clinical implementation. A questionnaire detailing CTC technique, analysis, training and clinical implementation was developed by the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) CTC committee and circulated to all faculty members of previous ESGAR "hands-on" CTC training courses. Responses were collated and a consensus statement produced. Of 27 invited to participate, 24 responded. Reasonable consensus was reached on bowel preparation, colonic distension, patient positioning, use of IV contrast and optimal scan parameters. Both primary 2D and primary 3D analysis were advocated equally, with some evidence that more experienced readers prefer primary 2D. Training was universally recommended, although there was no consensus regarding minimum requirements. CTC was thought superior to barium enema, although recommended for screening only in the presence of validated local experience. There was consensus that polyps 4 mm or less could be ignored assuming agreement from local gastroenterological colleagues. There is increasing consensus amongst European experts as to the current best practice in CTC.

Advisory Committees↗
PubMed1997

Breast Cancer Screening For Women Ages 40-49--NIH Consensus Statement.

For 2 days, January 21 and 22, a panel of experts representing specialties in women's health, oncology, radiology, epidemiology, and public health listened to presentations by researchers and to public discussion and debate designed to reach a consensus on 5 questions: (1) Is there a reduction in breast cancer mortality due to screening women ages 40-49 with mammography, with or without physical examination? (2) What are the risks associated with screening women ages 40-49 with mammography and with physical examination? (3) Are there other benefits? If so, what and how do they change with age? (4) What is known about how the benefits and risks of breast cancer screening differ based on known risk factors for breast cancer? (5) What are the directions for future research? On January 23, the panel issued a consensus statement concluding that, while mammography has been shown to be clearly effective in reducing cancer mortality in women ages 50-69, there is no difference in breast cancer death within 7 years between 40- to 49-year-old women assigned to receive or not receive screening. For women in their 40s, the potential benefits of earlier diagnosis and breast-conserving therapy must be weighed against the potential risks of mammograms, including discomfort, inconvenience, radiation, and false reassurance given to women with false-negative screens. At the present time, the available data do not warrant a single recommendation for mammography for all women in their 40s. Each woman should decide for herself whether to undergo mammography.

Journal Article↗
PubMed2002

Consensus statement for the management of chronic pelvic pain and endometriosis: proceedings of an expert-panel consensus process.

OBJECTIVE: To develop recommendations for the medical and surgical care of women who present with chronic pelvic pain (CPP) and are likely to have endometriosis as the underlying cause. DESIGN: An expert panel comprised of practicing gynecologists from throughout the United States and experts in consensus guideline development was convened. After completion of a structured literature search and creation of draft algorithms by an executive committee, the expert panel of >50 practicing gynecologists met for a 2-day consensus conference during which the clinical recommendations and algorithms were reviewed, refined, and then ratified by unanimous or near-unanimous votes. PATIENT(S): Women presenting with CPP who are likely to have endometriosis as the underlying cause. MAIN OUTCOME MEASURE(S): None. CONCLUSION(S): Chronic pelvic pain frequently occurs secondary to nongynecologic conditions that must be considered in the evaluation of affected women. For women in whom endometriosis is the suspected cause of the pain, laparoscopic confirmation of the diagnosis is unnecessary, and a trial of medical therapy, including second-line therapies such as danazol, GnRH agonists, and progestins, is justified provided that there are no other indications for surgery such as the presence of a suspicious adnexal mass. When surgery is necessary, laparoscopic approaches seem to offer comparable clinical outcomes to those performed via laparotomy, but with reduced morbidity. The balance of evidence supports the use of adjuvant postoperative medical therapy after conservative surgery for CPP. There is some evidence that adjuvant presacral neurectomy adds benefit for midline pain, but currently, there is inadequate evidence to support the use of uterosacral nerve ablation or uterine suspension. Hysterectomy alone has undocumented value in the surgical management of women with endometriosis-associated CPP.

Algorithms↗
PubMed1999

Notified body consensus statements.

The ability of governments, official bodies, industry and others to uniformly interpret the European Directives for medical devices will have a profound effect on the success of the European system regulating these products. This is particularly important for Notified Bodies. This article will discuss Notified Body consensus statements. An article in the near future will discuss Notified Body recommendations.

Certification↗
PubMedDate not supplied

Assessment of dementia in elderly outpatients: a comparative study of European centers and consensus statement.

Large numbers of elderly patients, suspected of having dementia, need medical evaluation, often in early phases of their illness. A complete outpatient assessment clearly could be advantageous. Thirty-five centers from 15 European countries, known to their scientific gerontological and geriatric societies to have experience in outpatient care for elderly patients with dementia, participated in an effort to develop a consensus statement for the assessment needs of these patients. The comparison of the centers showed that a wide variety of approaches was currently in practice. Differences appeared to be mainly based on local facilities and organization. A consensus for diagnostic outpatient assessment was easily reached. Diagnosis should be based on DSM-IV criteria, which requires a standardized assessment (including neuropsychological, functional and technical evaluation) and should be multidisciplinary. An assessment of dementia of elderly outpatients appears to be very feasible - a consensus approach with minimum diagnostic requirements is presented.

Journal Article↗
PubMed2004

Antiemetic therapy for multiple-day chemotherapy and high-dose chemotherapy with stem cell transplant: review and consensus statement.

The objective of this paper is to evaluate the efficacy of modern antiemetic therapy for chemotherapy-induced nausea and vomiting for patients receiving multiple-day or high-dose chemotherapy. Published phase II and phase III studies as well as their personal experiences were evaluated by the authors to develop this consensus statement. The largest published experience with multiple-day chemotherapy is with 5-day cisplatin combination chemotherapy. The introduction of 5-HT3 antagonists greatly improved emetic control. However, day 4-5 nausea as well as delayed nausea and vomiting remains a clinical problem despite the inclusion of dexamethasone. A 5-HT3 antagonist plus dexamethasone is the preferred current option for patients receiving high-dose chemotherapy with stem cell transplant. However, the results do not appear as successful as for highly emetic standard-dose chemotherapy.

Antiemetics↗