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At least 127 records · Page 7Linked to original sources
PubMed2002

Do the National Institutes of Health consensus guidelines for parathyroidectomy predict symptom severity and surgical outcome in patients with primary hyperparathyroidism?

BACKGROUND: The National Institutes of Health (NIH) consensus guidelines for parathyroidectomy in primary hyperparathyroidism were developed addressing only the classic symptoms and physiologic markers of hyperparathyroidism. The purpose of this study was to assess whether NIH guidelines predict the severity of all symptoms and the outcome of operation. METHODS: Symptom severity measurements using a disease-specific outcome tool called the parathyroidectomy assessment of symptoms (PAS) scores were previously obtained in patients with hyperparathyroidism. Patients were retrospectively stratified into 2 groups: group A, in which 1 or more of the NIH guidelines were met; and group B. in which operation was performed without any of the NIH criteria. For comparison, group C consisted of patients with non-toxic thyroid disease. PAS scores were collected preoperatively, and at 7 days, 3 months, and 12 months postoperatively. RESULTS: There were 95 patients in group A, 22 in group B, and 58 in group C. The median preoperative PAS scores for group A (354) and B (301) were not significantly different, however, both were more symptomatic than group C (176, P <.01). After parathyroidectomy, patients in both group A and B had a significant improvement in their PAS scores (A=177 and B=130, P <.05). CONCLUSIONS: Patients with no NIH criteria for operation are equally symptomatic compared with those who meet the NIH guidelines. Parathyroidectomy significantly improved these symptoms whether or not the patient met the NIH consensus guidelines.

Adult↗
PubMed2000

State-of-the-art methodologies in alcohol-related health services research.

Many of the failures to replicate clinical findings of treatment efficacy in more realistic field and community settings can be attributed to inappropriate research designs and other methodological shortcomings. In order to increase research designers' awareness of existing methodologies that may be better suited to answer the critical questions inherent in health services research on alcohol-related issues, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) convened an expert conference with three specific goals; (1) to identify the critical issues involved in alcohol services research; (2) to develop a primer that explicated each key area; and (3) to compile the resulting primers into an accessible resource for researchers, policy makers and consumers. The 9 papers in this special supplement are the product of that conference and are organized broadly around three phases of the research process: study design and implementation, data collection and use, and the analysis and interpretation of data. A final summary paper discusses the issues and offers a synthesis of key themes as well as some direction for the future.

Alcoholism↗
PubMed2001

Carrier screening for cystic fibrosis among Maryland obstetricians before and after the 1997 NIH Consensus Conference.

The 1997 National Institutes of Health (NIH) Consensus Conference on Cystic Fibrosis (CF) testing recommended that carrier screening be offered to all pregnant women and couples planning a pregnancy. We surveyed 492 Maryland Ob-Gyns before and after the consensus conference to: (1) assess whether obstetricians changed their practice regarding CF carrier testing, and (2) identify the factors associated with changing practice patterns, including awareness of the statement, and knowledge about CF. Fifty-six percent (275) responded to the first mail questionnaire and 107 obstetricians responded to both questionnaires. In 1998, only 18% of respondents to the second questionnaire were familiar with the NIH statement, but 43% reported discussing testing with patients with no family history, a significant increase from 1997, when only 20% reported discussing testing. Less than one-third correctly answered six multiple-choice knowledge questions about CF and carrier testing. In multivariate analysis, knowledge and familiarity with the NIH consensus statement were not associated with beginning to discuss CF carrier testing after the CF conference with their patients without a family history.

Adult↗
PubMed2005

Methodological approaches for a systematic review of end-of-life care.

As background for a National Institutes of Health State of the Science Conference on End-of-Life-Care, we performed a systematic review of end-of-life care and outcomes. The systematic review was intended to evaluate the evidence in the field from the perspective of concerns important to patients, caregivers, and the health care system. This article relates the challenges in performing a systematic review of end-of-life care and outcomes, and describes the methods that we used to define the scope, search the literature, develop exclusion and inclusion criteria, incorporate various types of articles, and synthesize the results. Major challenges to conducting a review included the need to define "end of life," clarify a conceptual framework of outcomes including definitions of terms and the relationships among terms, and determine specific goals for the review. The review identified 24,423 total citations, of which 911 comprised the final set used for the evidence report. This very large, diverse body of literature reflects the tremendous growth of the field of end-of-life care over the last decade.

Consensus Development Conferences, NIH as Topic↗