Second edition of the "do not do" recommendations from the Spanish Society of Endocrinology and Nutrition (SEEN).

IntroductionReducing unnecessary, low-value clinical practice (ie, de-adoption) is key to improving value for money in healthcare, especially among patients admitted to intensive care units (ICUs) where resource consumption exceeds other...

Recommendations of the Spanish Society of Endocrinology and Nutrition (SEEN) on "what not to do" in clinical practice.

Multidisciplinary consensus on nutritional and metabolic therapy in enhanced recovery after abdominal surgery programs: NutRICA Project

Tests and treatments that are not supported by evidence and could expose patients to unnecessary harm, referred to here as low-value clinical practices, consume up to 30% of health care resources. Choosing Wisely and other organizations have published lists of clinical practices to be avoided. However, few apply to injury and most are based uniquely on expert consensus. We aimed to identify low-value clinical practices in acute injury care. We conducted a scoping review targeting articles, reviews and guidelines that identified low-value clinical practices specific to injury populations. Thirty-six experts rated clinical practices on a five-point Likert scale from clearly low value to clearly beneficial. Clinical practices reported as low value by at least one level I, II, or III study and considered clearly or potentially low-value by at least 75% of experts were retained as candidates for low-value injury care. Of 50,695 citations, 815 studies were included and led to the identification of 150 clinical practices. Of these, 63 were considered candidates for low-value injury care; 33 in the emergency room, 9 in trauma surgery, 15 in the intensive care unit, and 5 in orthopedics. We also identified 87 "gray zone" practices, which did not meet our criteria for low-value care. We identified 63 low-value clinical practices in acute injury care that are supported by empirical evidence and expert opinion. Conditional on future research, they represent potential targets for guidelines, overuse metrics and de-implementation interventions. We also identified 87 "gray zone" practices, which may be interesting targets for value-based decision-making. Our study represents an important step toward the deimplementation of low-value clinical practices in injury care. Systematic Review, Level IV.

Terms, concepts and definitions in clinical artificial nutrition. The ConT-SEEN Project

Términos, conceptos y definiciones en nutrición clínica artificial. Proyecto ConT-SEEN

Management of benign nodular thyroid disease (BNTD) has changed dramatically over the past two decades, as reflected by international guideline recommendations. We sought to document the preferences regarding the management of euthyroid BNTD among thyroid-dedicated members of the Spanish Society of Endocrinology and Nutrition (SEEN) and assess the extent to which present international guideline recommendations have been incorporated into ordinary practice. An online survey on the management of a standard case of BNTD among SEEN thyroid experts and exploration of variations in management following different clinical scenarios, in which variables such as sex, age, ultrasound characteristics, fine needle aspiration results or patient preferences change. Two hundred and eleven (9% SEEN members) participated in the survey. Most of them, 147 (69.7%), recommended periodic monitoring, 43 (20.3%) surgery and 21 (10.0%) minimally invasive procedures (MIP). No participant opted for levothyroxine or radioiodine. Management of BNTD was modified based on patient preferences, both in favour of more aggressive (surgery) and more conservative (MIP or monitoring) options. The vast majority of Spanish thyroidologists followed the international guideline recommendations for BNTD management. The trend shows the positive impact of the guideline recommendations with a shift towards more conservative management, taking into account patient preference as a binding element in therapeutic decision-making.

Delphi Consensus of the Nutrition Area of ​​the SEEN (NutriSEEN) on the use of enteral tube nutrition in people with advanced dementia.

SEEN guidelines for the management and prevention of acute adrenal insufficiency

Executive summary. Screening, staging and follow-up of type 1 diabetes in preclinical stages: consensus of the scientific societies SED, SEEN and SEEP.

Executive summary. Screening, staging and follow-up of type 1 diabetes in preclinical stages: Consensus of the scientific societies SED, SEEN and SEEP.

Strategic reflections of the Spanish Society of Endocrinology and Nutrition on the future of the speciality in the period 2018–2022

IntroductionTraumatic brain injury (TBI) leads to 50 000 deaths, 85 000 disabilities and costs $60 billion each year in the USA. Despite numerous interventions and treatment options, the outcomes of...

Guía para el manejo y la prevención de la insuficiencia suprarrenal aguda

Guía para el diagnóstico y tratamiento de la insuficiencia suprarrenal en el adulto