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At least 1,315 records · Page 73Linked to original sources
PubMed1994

Guideline development process for optometric care of the patient with diabetes mellitus. American Optometric Association.

BACKGROUND: The aim of this project was to develop a standard of optometric care for patients with diabetes mellitus in an effort to help the clinician bridge the gap between research and practice. These guidelines are intended to assist optometric practitioners in the prevention, diagnosis, treatment, management, and rehabilitation of their patients. The guidelines are based on the best available research and professional judgment regarding the effectiveness and appropriateness of optometric care and procedures. METHODS: This paper details the methodology used by the AOA's Clinical Guidelines Coordinating Committee, Consensus Panel and the Center for Vision Care Policy of the State College of Optometry, SUNY, to develop practice guidelines for patients with diabetes mellitus.

Diabetes Mellitus↗
PubMed1994

Development of chiropractic nomenclature through consensus.

OBJECTIVES: The establishment of nomenclature is a sign of maturity in any field. Each discipline formally adopts or sanctions the terminology based by its practitioners. METHODS: Description of the development of chiropractic nomenclature through consensus methodology. A model was designed as an algorithm to outline steps leading to broad geographical and philosophical agreement. RESULTS: Moving through a regional nominal panel to an international Delphi panel, consensus at the 80% level of agreement was obtained for 10 terms and definitions commonly used by the chiropractic profession. CONCLUSIONS: It is recommended that the chiropractic profession adopt the 10 terms and definitions that reached the 80% consensus level as part of chiropractic nomenclature.

Algorithms↗
PubMedDate not supplied

The international consensus report on diagnosis and treatment of asthma: a call to action for US practitioners.

Effective management of asthma requires accurate diagnosis and assessment of the severity of the disease. Subjective measures, such as the degree of cough, wheezing, and chest tightness, and objective assessments of pulmonary function, provide diagnostic evidence of the presence of asthma. The diagnostic criteria included in the International Consensus Report on Diagnosis and Treatment of Asthma provide one method of classifying asthma by the degree of severity. These guidelines, which were developed by the National Institutes of Health in collaboration with the International Asthma Management Project, include the US Guidelines for the Diagnosis and Management of Asthma. Only the mildest, intermittent cases of asthma generally can be managed with an inhaled short-acting beta 2-agonist given alone as needed. As the frequency or severity of the asthma increases, inhaled corticosteroids, inhaled cromolyn, or inhaled nedocromil should be added to the treatment regimen. Sustained-release theophylline, long-acting oral or inhaled beta 2-agonists, and inhaled anticholinergic agents also have a place in the treatment of selected patients.

Administration, Inhalation↗
PubMed1994

Consensus development for producing diagnostic procedure guidelines: SPECT brain perfusion imaging with exametazime.

UNLABELLED: A method for developing diagnostic practice guidelines is presented in which a team of experts used a semiquantitative scoring system to reach consensus on a standard procedure for SPECT cerebral perfusion imaging. METHODS: An expert panel generated a list of elements that they thought were important for the optimal performance of cerebral perfusion imaging as the first phase of a modified Delphi panel technique. Panel members then scored each statement to indicate the importance of that statement for the performance of cerebral perfusion imaging. The scores were recorded for each statement and the average score, s.d. and variance for each statement were determined for each successive panel round. A total of three panel rounds were conducted. The change in average s.d. between scoring rounds was analyzed for significance using both parametric and nonparametric tests. RESULTS: The average s.d. decreased by 35% from 2.1 to 1.32 between the first and final panel round. This change in average s.d., which indicated enhanced consensus, was significant at p < 0.0001. Following consensus, all statements were grouped into four categories based on average score: critical elements, important elements, less important elements and elements of uncertain importance. This grouping formed the basis for a guideline summary narrative. Results were generated in 3 mo, at low cost and with clear documentation of rationale. CONCLUSION: Through simple adaptations of this methodology, expert panels that develop practice guidelines can replace informal discussion with systematic scoring methods to rate the quality of evidence, generalizability to practice conditions, appropriate indications and strength of recommendations.

Brain↗
PubMed1994

Is a clinical consensus possible for the polycythaemic patients?

No conference of consensus was previously held in France, in the field of hematology. We decided to study the polycythemias, since it is a disease of relatively large frequency (about 1-2/100,000/year) relatively well defined, but in which initial evaluation, choice of treatment, quality or survey need really a consensus. Since the definition given in 1975 by the Polycythemia Vera Study Group (PVSG), some examinations became obsolete, and new ones (erythropoietin, stem cell culture) did appear, so that it seems useful to re-define the criteria of the disease. On another hand, the financial problems of our health systems make necessary do define what biological tests are really useful. As the vascular complications are the main risk of these patients, it would be useful to define what type of study is necessary for predicting the risk and also what preventive treatment could be advised. Such a study has presently never been done. Many questions still remain un-solved concerning the treatment. Beyond which age are the advantages of 32 P higher than the risk of leukemia? Is the chemotherapy by hydroxyurea or vercyte as easy to use than it is perhaps too often said? What is the best treatment, able to delay the development of myelofibrosis? The problem of survey is also, often, badly solved. What is the part of the specialist and that of the private physician?

Chronic Disease↗