Objective: To develop review criteria to assess the quality of care for three major chronic diseases: adult asthma, stable angina, and non-insulin dependent diabetes mellitus.
Subjects And Methods: Modified panel process based upon the RAND/UCLA (University College of Los Angeles) appropriateness method. Three multiprofessional panels made up of general practitioners, hospital specialists, and practice nurses.
Results: The RAND/UCLA appropriateness method of augmenting evidence with expert opinion was used to develop criteria for the care of the three conditions. Of those aspects of care which were rated as necessary by the panels, only 26% (16% asthma, 10% non-insulin dependent diabetes, 40% angina) were subsequently rated by the panels as being based on strong scientific evidence.
Conclusion: The results show the importance of a systematic approach to combining evidence with expert opinion to develop review criteria for assessing the quality of three chronic diseases in general practice. The evidence base for the criteria was often incomplete, and explicit methods need to be used to combine evidence with expert opinion where evidence is not available.
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http://dx.doi.org/10.1136/qshc.8.1.6 | DOI Listing |
Phys Ther
January 2025
SOMT University of Physiotherapy, Amersfoort, Utrecht, The Netherlands.
Objective: This systematic review aimed to determine the methodological quality of international clinical practice guidelines and the clinical credibility and implementability of recommendations regarding manipulation or mobilization treatment recommendations proposed in clinical practice guidelines for the management of people with neck pain. A secondary aim of this review was to provide an overview of recommendations for manipulation or mobilization in patients with neck pain. Manipulation or mobilization treatment of patients with neck pain is under debate for its potential risk of serious adverse events.
View Article and Find Full Text PDFEmerg Med Australas
February 2025
Addiction Psychiatry and Toxicology, Northern Health, Melbourne, Victoria, Australia.
Serotonin toxicity is a potentially fatal condition caused by increased serotonergic activity in the central nervous system. Cyproheptadine, a serotonergic antagonist, is recommended for treatment; however, there is a lack of evidence to support its use. The present study aimed to evaluate the evidence for the use of cyproheptadine in the management of serotonin toxicity following deliberate self-poisoning.
View Article and Find Full Text PDFJ Alzheimers Dis
January 2025
Department of Medical Sciences, Minas Gerais State University, Minas Gerais, Brazil.
Background: Research on body composition and fat distribution in Alzheimer's disease (AD) has presented conflicting findings.
Objective: Compare body composition and anthropometric measurements in older adults with and without AD.
Methods: A systematic review and meta-analysis were conducted following Cochrane guidelines and PRISMA standards.
Cureus
December 2024
Neonatology, Souss Massa University Hospital Center, Agadir, MAR.
Hydranencephaly (HE) is a severe and isolated malformation affecting the cerebral mantle. In this condition, the cerebral hemispheres are entirely or almost entirely absent, replaced by a membranous sac filled with cerebrospinal fluid, while the midbrain is usually preserved. Although HE is a relatively rare brain disorder, the differential diagnosis must include conditions such as severe hydrocephalus, porencephalic cysts, and alobar holoprosencephaly.
View Article and Find Full Text PDFCureus
December 2024
Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, USA.
Purpose Low-dose total skin electron beam therapy (LD-TSEBT) has recently gained popularity in treating mycosis fungoides (MF) due to its reduced toxicity and favorable response rates. Combining accelerated LD-TSEBT with the modified Stanford technique (mST), a condensed cycling approach, offers a promising and convenient option. However, in vivo dosimetry data confirming the effectiveness of this approach is limited.
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