Publications by authors named "Balk E"
The Kidney Disease: Improving Global Outcomes (KDIGO) 2025 Clinical Practice Guideline for the Evaluation, Management, and Treatment of Autosomal Dominant Polycystic Kidney Disease (ADPKD) represents the first KDIGO guideline on this subject. Its scope includes nomenclature, diagnosis, prognosis, and prevalence; kidney manifestations; chronic kidney disease (CKD) management and progression, kidney failure, and kidney replacement therapy; therapies to delay progression of kidney disease; polycystic liver disease; intracranial aneurysms and other extrarenal manifestations; lifestyle and psychosocial aspects; pregnancy and reproductive issues; pediatric issues; and approaches to the management of people with ADPKD. The guideline has been developed with patient partners, clinicians, and researchers around the world, with the goal to generate a useful resource for healthcare providers and patients by providing actionable recommendations.
View Article and Find Full Text PDFObjective: To compare the rates of surgical site infection (SSI) after hysterectomy using vaginal antisepsis with chlorhexidine gluconate (CHG) versus povidone-iodine (PI).
Data Sources: PubMed, Embase, and Clinicaltrials.gov databases were queried from January 1, 1985 through Dec 7, 2023.
In recognition of accelerating health care spending and alignment with the American College of Physicians (ACP) principles of promoting high-value care, the ACP Clinical Guidelines Committee (CGC) developed a framework to standardize its approach to identifying, appraising, and considering economic evidence in the development of ACP clinical guidelines. This article presents the CGC's process for incorporating economic evidence, which encompasses cost-effectiveness analyses, economic outcomes in randomized controlled trials, and resource utilization (intervention cost) data. Economic evidence is one component of ACP recommendations.
View Article and Find Full Text PDFContext: Treatments for obsessive-compulsive disorder (OCD) in children and adolescents.
Objective: Evaluate the comparative efficacy of behavioral and pharmacologic treatments.
Data Sources: Six databases and ClinicalTrials.
Context: Children and adolescents with suspected obsessive-compulsive disorder (OCD).
Objective: To estimate the comparative performance of brief diagnostic assessment tools.
Data Sources: PubMed, the Cochrane Register of Clinical Trials, the Cochrane Database of Systematic Reviews, Embase, CINAHL, PsycINFO, and ERIC, and for unpublished studies with reported results in ClinicalTrials.
Objectives: Development of search queries for systematic reviews (SRs) is time-consuming. In this work, we capitalize on recent advances in large language models (LLMs) and a relatively large dataset of natural language descriptions of reviews and corresponding Boolean searches to generate Boolean search queries from SR titles and key questions.
Materials And Methods: We curated a training dataset of 10 346 SR search queries registered in PROSPERO.
Objective: To systematically review clinical and patient-reported outcomes after radiofrequency ablation (RFA) for the treatment of uterine fibroids.
Data Sources: We searched Medline, EMBASE, Cochrane Registry of Controlled Trials (CENTRAL) on September 8, 2023, and requested additional data from industry sources. We included published, peer-reviewed studies of patient-centered outcomes of RFA when used for symptomatic fibroids.
Article Synopsis
- The study aimed to find the best hysterectomy method for large uteri, focusing on the risks and complications associated with different surgical approaches for benign conditions.
- Researchers analyzed 25 studies, including various types of trials, and found that total vaginal hysterectomy generally had shorter operating times and lower risks of ureteral injury compared to laparoscopic methods.
- Results indicated that total vaginal hysterectomy is preferable for reducing hospital stay and risk of complications, while robotic-assisted methods showed a lower likelihood of blood transfusion compared to traditional abdominal approaches.
Article Synopsis
- OB-GYN has seen a significant female workforce over the last decade, but the relationship between this demographic and issues like gender bias and sexual harassment remains unclear.
- The study systematically reviews the prevalence of harassment and discrimination faced by OB-GYN clinicians and trainees, along with interventions designed to address these issues in OB-GYN and other surgical fields.
- Findings reveal high rates of sexual harassment (up to 70.9% among female gynecologic oncologists), workplace discrimination (up to 67.2% among female gynecologic oncologists), and bullying (52.8% among female gynecologic oncologists), indicating a troubling issue within the specialty.
Description: The American College of Physicians (ACP) developed this clinical guideline to update recommendations on newer pharmacologic treatments of type 2 diabetes. This clinical guideline is based on the best available evidence for effectiveness, comparative benefits and harms, consideration of patients' values and preferences, and costs.
Methods: This clinical guideline is based on a systematic review of the effectiveness and harms of newer pharmacologic treatments of type 2 diabetes, including glucagon-like peptide-1 (GLP-1) agonists, a GLP-1 agonist and glucose-dependent insulinotropic polypeptide agonist, sodium-glucose cotransporter-2 (SGLT-2) inhibitors, dipeptidyl peptidase-4 (DPP-4) inhibitors, and long-acting insulins, used either as monotherapy or in combination with other medications.
Article Synopsis
- In 2021, the KDIGO published updated guidelines for managing glomerular diseases, focusing on the latest findings in nephrology.
- The approval of avacopan in late 2021 for treating ANCA-associated vasculitis prompted significant updates to the guidelines.
- The new evidence supports using lower-dose glucocorticoids, or even eliminating them, during treatment for better patient outcomes.
Article Synopsis
- This study systematically reviewed research on how body mass index (BMI) affects the outcomes of pelvic organ prolapse (POP) surgery, seeking to understand the impact of obesity on surgical success.
- The authors screened over 9,000 abstracts and included 31 articles in their analysis, focusing on different surgical approaches and outcomes related to obesity categories.
- Findings indicated that patients with a BMI of 30 or higher faced higher odds of prolapse recurrence and complications, particularly with mesh exposure, after various types of POP repair surgery.
Objective: To systematically review the literature to evaluate clinical and surgical outcomes for technologies that facilitate vaginal surgical procedures.
Data Sources: We systematically searched MEDLINE, EMBASE, and ClinicalTrials.gov from January 1990 to May 2022.
Study Objectives: We performed a systematic review of long-term health outcomes of continuous positive airway pressure (CPAP) use in adults with obstructive sleep apnea.
Methods: We updated prior systematic reviews with searches in multiple databases through January 3, 2023. We included randomized controlled trials (RCTs) and adjusted nonrandomized comparative studies that reported prespecified long-term (mostly > 1 year) health outcomes.
Background: Physical activity (PA) is important for the long-term health and weight management of patients who undergo metabolic and bariatric surgery (MBS). However, the roles of exercise professionals in MBS settings have not been systematically determined.
Objectives: To investigate: (1) who are the professionals implementing PA programming in MBS clinical settings; and (2) what patient-centric tasks do they perform?
Setting: Clinical and academic exercise settings worldwide.
The use of seclusion to manage conflict behaviours in psychiatric inpatient settings is increasingly viewed as an intervention of last resort. Many protocols have, thus, been developed to reduce the practice. We conducted a systematic review to determine the effectiveness of protocols to reduce seclusion on process outcomes (e.
View Article and Find Full Text PDFArticle Synopsis
- * Advances in drug development have surged due to new genetic and molecular insights into these diseases, prompting KDIGO to commit to regular updates of their guidelines.
- * The first update post-2021 guideline includes new recommendations based on two newly approved drugs for lupus nephritis, summarized for quick reference.
Description: The Kidney Disease: Improving Global Outcomes (KDIGO) 2022 clinical practice guideline on prevention, diagnosis, evaluation, and treatment of hepatitis C in chronic kidney disease (CKD) is an update of the 2018 guideline from KDIGO.
Methods: The KDIGO Work Group (WG) updated the guideline, which included reviewing and grading new evidence that was identified and summarized. As in the previous guideline, the WG used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to appraise evidence and rate the strength of recommendations and used expert judgment to develop recommendations.