CONTEXT: The European Association of Urology Guideline Panel for Renal Cell Carcinoma (RCC) has prepared evidence-based guidelines and recommendations for RCC management. OBJECTIVES: To provide an update of the 2010 RCC guideline based on a standardised methodology that is robust, transparent, reproducible, and reliable. EVIDENCE ACQUISITION: For the 2014 update, the panel prioritised the following topics: percutaneous biopsy of renal masses, treatment of localised RCC (including surgical and nonsurgical management), lymph node dissection, management of venous thrombus, systemic therapy, and local treatment of metastases, for which evidence synthesis was undertaken based on systematic reviews adhering to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Relevant databases (Medline, Cochrane Library, trial registries, conference proceedings) were searched (January 2000 to November 2013) including randomised controlled trials (RCTs) and retrospective or controlled studies with a comparator arm. Risk of bias (RoB) assessment and qualitative and quantitative synthesis of the evidence were performed. The remaining sections of the document were updated following a structured literature assessment. EVIDENCE SYNTHESIS: All chapters of the RCC guideline were updated. For the various systematic reviews, the search identified a total of 10,862 articles. A total of 151 studies reporting on 78,792 patients were eligible for inclusion; where applicable, data from RCTs were included and meta-analyses were performed. For RCTs, there was low RoB across studies; however, clinical and methodological heterogeneity prevented data pooling for most studies. The majority of studies included were retrospective with matched or unmatched cohorts based on single or multi-institutional data or national registries. The exception was for systemic treatment of metastatic RCC, in which several RCTs have been performed, resulting in recommendations based on higher levels of evidence. CONCLUSIONS: The 2014 guideline has been updated by a multidisciplinary panel using the highest methodological standards, and provides the best and most reliable contemporary evidence base for RCC management. PATIENT SUMMARY: The European Association of Urology Guideline Panel for Renal Cell Carcinoma has thoroughly evaluated available research data on kidney cancer to establish international standards for the care of kidney cancer patients.

• Klíčová slova
• Guideline, Meta-analysis, Renal cell carcinoma, Systematic review,
• MeSH
• antinematodní látky terapeutické užití   MeSH
• karcinom z renálních buněk farmakoterapie   chirurgie   terapie   MeSH
• lidé MeSH
• lymfadenektomie metody   MeSH
• metastázy nádorů terapie   MeSH
• nefrektomie metody   MeSH
• protokoly protinádorové kombinované chemoterapie terapeutické užití   MeSH
• směrnice pro lékařskou praxi jako téma * MeSH
• urologie normy   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• systematický přehled MeSH
• Názvy látek
• antinematodní látky MeSH

INTRODUCTION: Perioperative care is a broad field covering an array of elective and emergency procedures. Clinical practice guidelines (CPGs) for perioperative care exist with various degrees of methodological quality. We intend to critically appraise them using AGREE II instrument and investigate the use of Grading of Recommendations, Assessment, Development and Evaluations (GRADE). METHODS AND ANALYSIS: We searched MEDLINE (Ovid), Epistemonikos, Cochrane Database of Systematic Reviews and PROSPERO and did not identify any similar systematic review in this area. We will search databases, repositories and websites of guideline developers and medical societies, including MEDLINE (Ovid), Embase (Ovid), DynaMed, the GIN international guideline library and registry of guidelines in development, BIGG international database of GRADE guidelines, ECRI Guideline Trust or National Institute for Clinical Evidence to identify all CPGs for perioperative care in an adult population in a general clinical setting. We will include CPGs, expert guidance, position papers, guidance documents and consensus statements published in the last 5 years by experts or international organisations that provide guidance or recommendations in the available full text with no geographical or language limitation. Excluded will be those containing only good practice statements. Two independent reviewers will perform critical appraisal using the AGREE II tool. The data presented in a narrative and tabular form will include the results of the critical appraisal for all identified CPGs for all AGREE II domains and an assessment of the use of the GRADE approach. ETHICS AND DISSEMINATION: Ethics approval is not required. We will disseminate the findings through professional networks and conference presentations and will publish the results.

• Klíčová slova
• protocols & guidelines, quality in health care, statistics & research methods, surgery,
• MeSH
• databáze faktografické MeSH
• dospělí MeSH
• konsensus MeSH
• lidé MeSH
• perioperační péče * MeSH
• systém GRADE * MeSH
• systematický přehled jako téma MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

AIMS AND OBJECTIVES: This is a protocol of a scoping review that will aim to synthesise methodological evidence on formulating plain language versions of recommendations from guidelines both for clinical practice and for public health. METHOD: We will conduct a search in MEDLINE (Ovid), Embase (Ovid) databases, and webpages of guidelines developers with no language and date limitations. The title/abstract and full-text screening will be performed by two reviewers independently. The team of reviewers will extract data on methods used for developing plain language versions of recommendations in a standardised manner. The data analysis and synthesis will be presented narratively in tabular form. RESULTS AND CONCLUSION: We will conduct a scoping review based on this protocol.

• Klíčová slova
• attitudes, consumer health information, decision making, guideline as topic, health education, health knowledge, language, practice,
• MeSH
• jazyk (prostředek komunikace) MeSH
• lidé MeSH
• scoping review jako téma MeSH
• směrnice pro lékařskou praxi jako téma * normy   MeSH
• výzkumný projekt normy   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Prevention through evaluation and treatment of cardiovascular risk factors is an efficient approach to reduce the risk of cardiovascular events, however, the problem remains that the available treatment options are underused. Implementation of cardiovascular disease prevention guidelines into clinical practice is therefore important for decreasing the burden of cardiovascular disease in general population. However, there are many barriers to this process, including questionable relevance of scientific results for clinical practice, personal preferences and expertise of the doctors, patient attitudes, lack of time, and economical factors. All these factors need to be taken into account for any change in the clinical practice to be successful. With respect to cardiovascular disease prevention, insufficient screening for risk factors, inappropriate risk estimation and hesitation to keep to the guidelines-based treatment targets contribute most to inadequate control of risk factors, and this has been repeatedly demonstrated to be difficult to improve. In this context, our studies demonstrate that the emphasis on systematic application of principles of cardiovascular prevention results in improved control of cardiovascular risk factors. Adequate support for transforming guidelines-based knowledge into practicable habit appears therefore important for successful prevention of cardiovascular disease in clinical practice and may translate into substantial reduction of cardiovascular risk in general population.

• MeSH
• dodržování směrnic * MeSH
• kardiovaskulární nemoci prevence a kontrola   MeSH
• lidé MeSH
• rizikové faktory MeSH
• směrnice pro lékařskou praxi jako téma * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

OBJECTIVE: The aim of the study was to examine the availability of clinical practice guidelines for malnutrition in hospitals over a period of 6 y and the subsequent use of nutritional interventions in malnourished patients. METHODS: This study was conducted as a secondary data analysis of data that were collected from 2012 to 2017 in a quantitative, cross-sectional, multicenter study called the National Prevalence Measurement Quality of Care (LPZ). Data from 15 hospitals and 5650 participating patients were analyzed. RESULTS: The availability of clinical practice guidelines for malnutrition at the institutions increased from 6.7% in 2012 to 100% in 2017 (P < 0.001). The control of compliance to the guidelines increased from 28.6% to 85.7% (P < 0.001) and the documentation of malnutrition risk improved from 63.1% to 87.5% (P = 0.008). In 2017, the intervention "referral to dietitian" was used 8.3% more often (P < 0.001). The number of patients who did not receive any intervention decreased from 70% in 2012 to 55.6% in 2017 (P < 0.001). CONCLUSIONS: The availability of guidelines on malnutrition increased in participating hospitals over the 6-y study period. Regular controls of adherence to the guidelines positively correlated with their availability. More interventions to treat malnutrition were carried out in 2017. The use of clinical practice guidelines in this study was associated with more interventions treating malnutrition.

• Klíčová slova
• Availability, Clinical practice guidelines, Compliance, Interventions, Malnutrition, Risk assessment,
• MeSH
• dodržování směrnic statistika a číselné údaje   MeSH
• hodnocení rizik normy   MeSH
• hodnocení stavu výživy MeSH
• kvalita zdravotní péče statistika a číselné údaje   MeSH
• lidé MeSH
• nemocnice normy   MeSH
• nutriční terapie normy   MeSH
• podvýživa * MeSH
• prevalence MeSH
• průřezové studie MeSH
• průzkumy zdravotní péče MeSH
• směrnice pro lékařskou praxi jako téma * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

BACKGROUND: This study aims to assess the cost-effectiveness of optimized guideline adherence in patients with a history of coronary heart disease. METHODS: An individual-based decision tree model was developed using the SMART risk score tool which estimates the 10-year risk for recurrent vascular events in patients with manifest cardiovascular disease (CVD). Analyses were based on the EUROASPIRE IV survey. Outcomes were expressed as an incremental cost-effectiveness ratio (ICER). RESULTS: Data from 4663 patients from 13 European countries were included in the analyses. The mean estimated 10-year risk for a recurrent vascular event decreased from 20.13% to 18.61% after optimized guideline adherence. Overall, an ICER of 52,968€/QALY was calculated. The ICER lowered to 29,093€/QALY when only considering high-risk patients (≥20%) with decreasing ICERs in higher risk patients. Also, a dose-response relationship was seen with lower ICERs in older patients and in those patients with higher risk reductions. A less stringent LDL target (<2.5 mmol/L vs. <1.8 mmol/L) lowered the ICER to 32,591€/QALY and intensifying cholesterol treatment in high-risk patients (≥20%) instead of high-cholesterol patients lowered the ICER to 28,064€/QALY. An alternative method, applying risk reductions to the CVD events instead of applying risk reductions to the risk factors lowered the ICER to 31,509€/QALY. CONCLUSION: Depending on the method used better or worse ICERs were found. In addition, optimized guidelines adherence is more cost-effective in higher risk patients, in patients with higher risk reductions and when using a less strict LDL-C target. Current analyses advice to maximize guidelines adherence in particular patient subgroups.

• Klíčová slova
• Coronary heart disease, Cost-effectiveness, EUROASPIRE, Guidelines, Secondary prevention,
• MeSH
• analýza nákladů a výnosů metody   normy   MeSH
• dodržování směrnic ekonomika   normy   MeSH
• koronární nemoc ekonomika   epidemiologie   prevence a kontrola   MeSH
• lidé středního věku MeSH
• lidé MeSH
• rozhodovací stromy * MeSH
• senioři MeSH
• směrnice pro lékařskou praxi jako téma normy   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH

Retinal vein occlusion and its complications are among the most common causes of severe loss of sight in developed countries. In recent years, developments in imaging methods have been introduced, leading to an improvement in diagnostic possibilities. At the same time new treatment options have become available (new intravitreal drugs and treatment protocols, laser and surgical methods). The presented guidelines summarize the current knowledge about retinal vein occlusion in order to standardize and update procedures for the diagnosis, classification and treatment of the disease.

• Klíčová slova
• diagnosis, diagnostics, guidelines, retinal vein occlusion, treatment, type 2 diabetes,
• MeSH
• lidé MeSH
• okluze retinální žíly * diagnóza   terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• směrnice pro lékařskou praxi MeSH

AIM: Poor eating habits among young adults are a public health concern. This survey examined the eating habits of undergraduate university students in Finland. We assessed students' dietary intake of a variety of food groups, their adherence to international dietary guidelines (whole sample and by gender), and the associations between importance of eating healthy and dietary guidelines adherence (whole sample and by gender). METHODS: During the 2013-2014 academic year, 1,189 undergraduate students enrolled at the University of Turku in southwestern Finland completed an online self-administered questionnaire. Students reported their eating habits of 12 food groups, the number of daily servings of fruits/vegetables they consume and how important it is for them to eat healthy. For dietary adherence recommendations, we employed WHO guidelines. Chi-square statistic tested the differences in dietary guidelines adherence between males and females and also the associations between the gradients of importance of healthy eating and the self reported eating habits for each of the food groups, for the whole sample and by gender. RESULTS: We observed high levels of dietary adherence (>70%) for most of the 'unhealthy food' items (cake/cookies, snacks, fast food/canned food, and lemonade/soft drinks), and moderate adherence for most of the 'healthy food' items (>50%) (dairy/dairy products, fruit/vegetables servings/day, fresh fruit, salads/raw vegetables and cereal/cereal products). Fish/seafood, meat/sausage products and cooked vegetables had levels <50% for adherence to the guidelines. Women had better adherence for meat/sausage products, fast food/canned food and for most 'healthy food' items (p≤0.001), whereas men had better adherence for sweets (difference=12.8%, p≤0.001), lemonade/soft drinks (difference=16.7%, p≤0.001) and fish/seafood (difference=6.6%, p=0.040) compared to women. Most students considered important to eat healthy (78.8%). The importance of eating healthy was significantly associated with adherence for all food groups besides sweets and cake/cookies. These associations remained significant for women but some of them not for men (cereal/cereal products, snacks and sweets). CONCLUSIONS: The results suggest high adherence to the guidelines mainly for 'unhealthy food' groups, and moderate adherence for healthier food groups. There was also accordance between regarding eating healthy as important and actually eating healthy. However, there are improvements to be considered for specific food groups, as well as gender differences when implementing public health strategies related to food intake.

• Klíčová slova
• Finland, dietary guidelines adherence, eating healthy, food intake, gender, students' health,
• MeSH
• antropometrie MeSH
• dieta * MeSH
• dodržování směrnic * MeSH
• dospělí MeSH
• energetický příjem MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• průzkumy a dotazníky MeSH
• senioři MeSH
• stravovací zvyklosti * MeSH
• univerzity MeSH
• výživová politika * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Finsko MeSH

Together with diabetic retinopathy, diabetic macular edema (DME) ranks among the most common causes of severe loss of vision in working adults. Due to recent developments in imaging methods, new classification schemes of DME have been created. In addition to this, new treatment options have been introduced (new intravitreal drugs as well as treatment protocols). At the same time laser, surgical as well as combination therapy is still available. In this paper we evaluate the current knowledge about DME diagnostic and treatment options and formulate recommended guidelines for the management of DME.

• Klíčová slova
• diabetic macular edema, guidelines, recommended guidelines, treatment, type 2 diabetes,
• MeSH
• diabetes mellitus * farmakoterapie   chirurgie   MeSH
• diabetická retinopatie * terapie   farmakoterapie   MeSH
• dospělí MeSH
• inhibitory angiogeneze terapeutické užití   MeSH
• injekce intravitreální MeSH
• laserová koagulace škodlivé účinky   metody   MeSH
• lidé MeSH
• makulární edém * diagnóza   etiologie   terapie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• inhibitory angiogeneze MeSH

The increasing prevalence of chronic diseases among the European working age population, as well as the implications for the individual and societal level, underline the need for policy guidelines targeting the effective inclusion of persons with chronic diseases in the workplace. The aim of the present paper was to explore the perspectives of European and National-level stakeholders on existing strategies for work re-integration of persons with chronic diseases, and to provide policy guidelines. A highly-structured interview protocol was distributed to 58 National level stakeholders (policy makers, professionals and employers) from seven European countries. Additionally, 20 European organizations concerned with health-related issues and employment completed an online survey. The findings reveal that employment-related challenges remain largely unaddressed. Both national and European stakeholders considered the existing legislative frameworks inadequate and appraised the co-ordination for the implementation of employment re-integration policies as ineffective. Policies targeting at work re-integration of persons with chronic diseases at European and national level should focus on consistent cooperation among all key stakeholders, awareness raising to staff and management, dissemination of effective strategies, developing research and evaluation standards and establishing monitoring systems on inclusive labour markets.

• Klíčová slova
• European stakeholders, chronic diseases, national stakeholders, perspectives, policy guidelines, work inclusion, work re-integration,
• MeSH
• chronická nemoc epidemiologie   rehabilitace   MeSH
• lidé MeSH
• návrat do práce zákonodárství a právo   MeSH
• organizační politika MeSH
• pracoviště zákonodárství a právo   normy   MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• výběr pracovníků zákonodárství a právo   normy   MeSH
• zaměstnanost zákonodárství a právo   normy   statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH