Reliability Of Guidelines Research Articles

Evidence based laboratory medicine for beginners: getting evidence into practice

Laboratory testing is one of the most widely used diagnostic approaches supporting medical decisions, yet evidence demonstrating the impact of laboratory testing on clinical outcomes is limited. This contributes to inappropriate test utilisation that impacts clinical- and costs-effectiveness of care and patient safety. Trainees will discuss at the workshop diagnostic outcome study designs and their limitations. Evidence-based guidelines are expected to close the gap between research and practice and to promote meaningful utilisation of laboratory medicine. The appearance of so many guidelines, however, created a new gap between their development and use and the quality and reliability of guidelines have been challenged. Therefore critical appraisal of guidelines (e.g., with the AGREE instrument, which will be demonstrated at the workshop; www.agreetrust.org/) is essential before recommendations are implemented. Passive dissemination of guidelines is not sufficient; a multifacet-ed and individualised implementation strategy should be employed including educational outreach visits, individually tailored academic detailing, electronic reminder systems, feedback on performance, and participation of doctors and laboratory professionals in pre- and post-analytical quality assessment or test selection and interpretation programmes, and clinical audits. Examples of these initiatives at the laboratory and clinical interface will be demonstrated and case scenarios will be discussed with trainees.

S40-03 Guidelines in consultation-liaison-psychiatry: A critical comment (TRAC-NR. 1824 5-17-2008)

Background and aims:Psychiatric comorbidity of general hospitals inpatients leads to complicated courses of illness and to increased health car costs as compared to patients that suffer from somatic illnesses alone. Such patients are cared for by psychiatric Consultation-Liaison (CL) services. When analyze guidelines that deal with the organization of psychiatric CL-services in USA and the UK, as well with a guideline developed for psychosomatic CL-services in Germany, and an Dutch guideline released in 2008Methods:Literature search and review of guidelines.Results:Existing guidelines in CL-psychiatry are in part controversial with regard to recommendation for treatments, preferences as to concentrate on clinical, or on organizational issues, and differ even in the grade of evidence given to single topics, such as effectiveness of CL-interventions.Conclusions:To improve the efficiency of CL-psychiatry, guidelines might be important, as well for the treatment of psychiatric diseases in general, but even more so for diseases that are frequent in general hospitals such as delirium. However, reliability of guidelines in CL-psychiatry differing among countries should be improved.

Principles for Assessing the Reliability of Sediment Quality Guidelines

Over the last few years, many different types of sediment quality guidelines have been derived, and a debate has begun on how best to evaluate the predictive reliability of these guidelines. The reliability of sediment quality guidelines has important consequences for selection of specific guidelines for use, sampling designs, regulatory decision frameworks, and the extent to which biological testing is required to make decisions about dredging and cleanup actions. However, the authors of these studies are not all using the same terminology, the same definitions of errors and error rates, or the same methods of calculation. Definitions and general principles for determining the reliability of SQGs are proposed, to promote a common basis for discussion and comparison of the various SQGs available for use. Significant issues with current approaches to estimating reliability are also discussed.

Riglyn 4.003 vir inkomstebepaling: 'n Teoretiese beoordeling

Guideline 4.003 for income determination: A theoretical evaluation During the last few years the distribution and realization principles began to play an increasingly important role in literature. The income of an organization is increasingly viewed as the cash amount that can be withdrawn without hampering the continuity of ongoing action. The purpose of an income system, like the South African guideline 4.003, is to render an index of the income which can be utilized for expansion and/or distribution. There is always a reasonably large optimism and trust in the reliability of guideline 4.003 to accomplish this. The present article highlights some weaknesses of guideline 4.003 which cannot be ignored. These weaknesses are related to the assumption regarding the realization of purchasing income on loans, the calculation of net monetary assets and liabilities, the calculation of loss of purchasing power on distributable income and depreciation and the revaluation of equity capital of the balance sheet. A complete distribution of income according to guideline 4.003 is therefore not always without problems for continuity and is also not necessarily a reliable point of departure for a divided policy during inflation.