OBJECTIVES: The aim of this study is to propose an approach for developing trustworthy recommendations as part of urgent responses (1-2 week) in the clinical, public health, and health systems fields. STUDY DESIGN AND SETTING: We conducted a review of the literature, outlined a draft approach, refined the concept through iterative discussions, a workshop by the Grading of Recommendations Assessment, Development and Evaluation Rapid Guidelines project group, and obtained feedback from the larger Grading of Recommendations Assessment, Development and Evaluation working group. RESULTS: A request for developing recommendations within 2 week is the usual trigger for an urgent response. Although the approach builds on the general principles of trustworthy guideline development, we highlight the following steps: (1) assess the level of urgency; (2) assess feasibility; (3) set up the organizational logistics; (4) specify the question(s); (5) collect the information needed; (6) assess the adequacy of identified information; (7) develop the recommendations using one of the 4 potential approaches: adopt existing recommendations, adapt existing recommendations, develop new recommendations using existing adequate systematic review, or develop new recommendations using expert panel input; and (8) consider an updating plan. CONCLUSION: An urgent response for developing recommendations requires building a cohesive, skilled, and highly motivated multidisciplinary team with the necessary clinical, scientific, and methodological expertise; adapting to shifting needs; complying with the principles of transparency; and properly managing conflicts of interest.
- MeSH
- hodnocení výsledků zdravotní péče metody organizace a řízení MeSH
- informační management * metody organizace a řízení MeSH
- konsensus MeSH
- lidé MeSH
- medicína založená na důkazech normy trendy MeSH
- směrnice pro lékařskou praxi jako téma normy MeSH
- systematický přehled jako téma MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- MeSH
- gynekologické chirurgické výkony normy MeSH
- gynekologie normy MeSH
- klinické rozhodování MeSH
- konsensus MeSH
- lidé MeSH
- medicína založená na důkazech normy MeSH
- nádorové biomarkery analýza MeSH
- nádory vaječníků diagnóza MeSH
- nemoci děložních adnex diagnóza MeSH
- předoperační období MeSH
- společnosti lékařské MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
A European consensus conference on endometrial carcinoma was held in 2014 to produce multidisciplinary evidence-based guidelines on selected questions. Given the large body of literature on the management of endometrial carcinoma published since 2014, the European Society of Gynaecological Oncology (ESGO), the European SocieTy for Radiotherapy & Oncology (ESTRO) and the European Society of Pathology (ESP) jointly decided to update these evidence-based guidelines and to cover new topics in order to improve the quality of care for women with endometrial carcinoma across Europe and worldwide. ESGO/ESTRO/ESP nominated an international multidisciplinary development group consisting of practicing clinicians and researchers who have demonstrated leadership and expertise in the care and research of endometrial carcinoma (27 experts across Europe). To ensure that the guidelines are evidence-based, the literature published since 2014, identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the development group. The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 191 independent international practitioners in cancer care delivery and patient representatives. The guidelines comprehensively cover endometrial carcinoma staging, definition of prognostic risk groups integrating molecular markers, pre- and intra-operative work-up, fertility preservation, management for early, advanced, metastatic, and recurrent disease and palliative treatment. Principles of radiotherapy and pathological evaluation are also defined.
- MeSH
- biopsie normy MeSH
- diagnostické techniky molekulární normy MeSH
- hodnocení rizik MeSH
- karcinom genetika patologie terapie MeSH
- lékařská onkologie normy MeSH
- lidé MeSH
- medicína založená na důkazech normy MeSH
- nádorové biomarkery genetika MeSH
- nádory endometria genetika patologie terapie MeSH
- prediktivní hodnota testů MeSH
- rizikové faktory MeSH
- staging nádorů normy MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- konsensus - konference MeSH
- směrnice pro lékařskou praxi MeSH
- systematický přehled MeSH
Hypertensive disorders are the most common medical complications in the peripartum period associated with a substantial increase in morbidity and mortality. Hypertension in the peripartum period may be due to the continuation of pre-existing or gestational hypertension, de novo development of pre-eclampsia or it may be also induced by some drugs used for analgesia or suppression of postpartum haemorrhage. Women with severe hypertension and hypertensive emergencies are at high risk of life-threatening complications, therefore, despite the lack of evidence-based data, based on expert opinion, antihypertensive treatment is recommended. Labetalol intravenously and methyldopa orally are then the two most frequently used drugs. Short-acting oral nifedipine is suggested to be used only if other drugs or iv access are not available. Induction of labour is associated with improved maternal outcome and should be advised for women with gestational hypertension or mild pre-eclampsia at 37 weeks' gestation. This position paper provides the first interdisciplinary approach to the management of hypertension in the peripartum period based on the best available evidence and expert consensus.
- MeSH
- antihypertenziva škodlivé účinky terapeutické užití MeSH
- hypertenze indukovaná těhotenstvím diagnóza farmakoterapie patofyziologie MeSH
- konsensus MeSH
- krevní tlak účinky léků MeSH
- lidé MeSH
- medicína založená na důkazech normy MeSH
- měření krevního tlaku normy MeSH
- náhlé příhody MeSH
- peripartální období MeSH
- rizikové faktory MeSH
- služby zdravotní péče o matku normy MeSH
- stupeň závažnosti nemoci MeSH
- těhotenství MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- směrnice pro lékařskou praxi MeSH
- MeSH
- arteriovenózní zkrat normy MeSH
- cévy - implantace protéz normy MeSH
- dialýza ledvin normy MeSH
- katetrizace centrálních vén normy MeSH
- konsensus MeSH
- lidé MeSH
- medicína založená na důkazech normy MeSH
- směrnice pro lékařskou praxi jako téma normy MeSH
- společnosti lékařské normy MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- úvodníky MeSH
Quality assessment in vascular access procedures for hemodialysis is not clearly defined. The aim of this article is to compare various guidelines regarding recommendation on quality control in angioaccess surgery. The overall population of end-stage renal disease patients and patients in need for hemodialysis treatment is growing every year. Chronic intermittent hemodialysis is still the main therapy. The formation of a functional angioaccess is the cornerstone in the management of those patients. Native (autologous) arteriovenous fistula is the best vascular access available. A relatively high percentage of primary failure and fistula abandonment increases the need for quality control in this field of surgery. There are very few recommendations of quality assessment on creation of a vascular access for hemodialysis in the searched guidelines. Some guidelines recommend the proportion of native arteriovenous fistula in incident and prevalent patients as well as the maximum tolerable percentage of central venous catheters and complications. According to some guidelines, surgeon's experience and expertise have a considerable influence on outcomes. There are no specific recommendations regarding surgeon's specialty, grade, level of skills, and experience. In conclusion, there is a weak recommendation in the guidelines on quality control in vascular access surgery. Quality assessment criteria should be defined in this field of surgery. According to these criteria, patients and nephrologists could choose the best vascular access center or surgeon. Centers with best results should be referral centers, and centers with poorer results should implement quality improvement programs.
- MeSH
- arteriovenózní zkrat škodlivé účinky normy MeSH
- chirurgové normy MeSH
- chronické selhání ledvin diagnóza terapie MeSH
- dialýza ledvin škodlivé účinky normy MeSH
- konsensus MeSH
- lidé MeSH
- medicína založená na důkazech normy MeSH
- rizikové faktory MeSH
- směrnice pro lékařskou praxi jako téma normy MeSH
- ukazatele kvality zdravotní péče normy MeSH
- výsledek terapie MeSH
- výsledky a postupy - zhodnocení (zdravotní péče) normy MeSH
- zlepšení kvality normy MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Chronic mesenteric ischaemia is a severe and incapacitating disease, causing complaints of post-prandial pain, fear of eating and weight loss. Even though chronic mesenteric ischaemia may progress to acute mesenteric ischaemia, chronic mesenteric ischaemia remains an underappreciated and undertreated disease entity. Probable explanations are the lack of knowledge and awareness among physicians and the lack of a gold standard diagnostic test. The underappreciation of this disease results in diagnostic delays, underdiagnosis and undertreating of patients with chronic mesenteric ischaemia, potentially resulting in fatal acute mesenteric ischaemia. This guideline provides a comprehensive overview and repository of the current evidence and multidisciplinary expert agreement on pertinent issues regarding diagnosis and treatment, and provides guidance in the multidisciplinary field of chronic mesenteric ischaemia.
- MeSH
- arteriae mesentericae diagnostické zobrazování MeSH
- chronická nemoc epidemiologie terapie MeSH
- CT angiografie MeSH
- gastroenterologie metody normy MeSH
- hodnocení rizik metody MeSH
- kontrastní látky aplikace a dávkování MeSH
- magnetická rezonanční angiografie metody MeSH
- medicína založená na důkazech metody normy MeSH
- mezenteriální ischemie diagnóza epidemiologie terapie MeSH
- mezioborová komunikace MeSH
- radiologie metody normy MeSH
- společnosti lékařské normy MeSH
- stupeň závažnosti nemoci MeSH
- týmová péče o pacienty normy MeSH
- výsledek terapie MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- směrnice pro lékařskou praxi MeSH
- Geografické názvy
- Evropa MeSH
This statement paper provides a brief and clear background to the evidence-based medicine concept, systematic reviews and the development of clinical practice guidelines using the Grading of Recommendations, Assessment, Development and Eva luation (GRADE) system and focuses on their application in the fi eld of special education.Its main objective is to suggest ways of applying clinical practice guidelines in the fi eld of special education. Th e paper presents the fi rst Czech national project for developing clinical practice guidelines mainly in the fi eld of medicine and clinical practice with the main investigator being the Czech Health Research Council (AZV ČR). Some of the guidelines prepared within the project are relevant to special educators and the paper suggests that special teachers use the recommendations in their practice and in higher education. Moreover, it proposes that it is possible and useful to develop guidelines using the rigor of the GRADE methodology as described above, for issues directly pertaining to the fi eld of special education, or education in general. In that process, it may be neces-sary to identify the challenges typical for the fi eld of education and to suggest possible solutions. Finally, recommendations for special educators, for future research and for policy-makers are formulated. Specifi cally, the paper suggests that policy-makers, such as the Ministry of Education, Youth and Sports, develop national strategies for spe -cial-edu cational diagnostics and intervention based on rigorous methodology as des cribed on the example of the Czech national project of guideline development in medi cine and place special focus on the ethical aspects, social impacts and values and preferences of target populations.
- Klíčová slova
- vzdělávací politika,
- MeSH
- integrovaná výuka MeSH
- interdisciplinární výzkum organizace a řízení MeSH
- lidé MeSH
- medicína založená na důkazech normy MeSH
- metody pro podporu rozhodování MeSH
- postižení výchova MeSH
- pravidla klinického rozhodování MeSH
- programy národního zdraví organizace a řízení MeSH
- speciální vzdělávání * etika normy MeSH
- vytváření politiky MeSH
- vzdělávací modely MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- Geografické názvy
- Česká republika MeSH
- MeSH
- časové faktory MeSH
- funkce levé komory srdeční * MeSH
- hodnocení rizik MeSH
- implantace protézy škodlivé účinky přístrojové vybavení mortalita normy MeSH
- kardiologie normy MeSH
- klinické rozhodování MeSH
- konsensus MeSH
- lidé MeSH
- medicína založená na důkazech normy MeSH
- obnova funkce MeSH
- podpůrné srdeční systémy normy MeSH
- protézy - design normy MeSH
- rizikové faktory MeSH
- seznamy čekatelů * mortalita MeSH
- srdeční selhání diagnóza mortalita patofyziologie terapie MeSH
- transplantace plic škodlivé účinky mortalita normy MeSH
- transplantace srdce škodlivé účinky mortalita normy MeSH
- výběr pacientů MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- směrnice pro lékařskou praxi MeSH
