Version Of Clinical Practice Guidelines Research Articles

Use, applicability, and dissemination of patient versions of clinical practice guidelines in oncology in Germany: a qualitative interview study with healthcare providers

BackgroundPeople with cancer have high information needs; however, they are often inadequately met. Patient versions of clinical practice guidelines (PVGs), a special form of evidence-based information, translate patient-relevant recommendations from clinical practice guidelines into lay language. To date, little is known about the experience of PVGs from healthcare providers’ perspective in healthcare. This study aims to investigate the use, applicability, and dissemination of PVGs in oncology from the healthcare providers’ perspective in Germany.MethodsTwenty semi-structured telephone interviews were conducted with oncological healthcare providers in Germany between October and December 2021. Interviews were recorded and transcribed verbatim. Mayring’s qualitative content analysis with MAXQDA software was utilised to analyse the data.ResultsA total of 20 healthcare providers (14 female, 6 male), mainly working as psychotherapists/psycho-oncologists and physicians, participated. Most participants (75%) were aware of the existence of PVGs. The content was predominantly perceived as comprehensible and relevant, whereas opinions on the design and format were mixed. The perceived lack of up-to-date information limited participants’ trust in the content. Most felt that PVGs positively impact healthcare owing to the fact that they improve patients’ knowledge about their disease. Additionally, PVGs served as a guide and helped healthcare providers structure physician–patient talks. Healthcare provider’s unawareness of the existence of PVGs was cited as an obstructive factor to its dissemination to patients.ConclusionLimited knowledge of the existence of PVGs among healthcare providers, coupled with alternative patient information, hinders the use and dissemination of PVGs in healthcare. However, the applicability of PVGs seemed to be acceptable owing to their content and good comprehensibility, especially with respect to physician–patient communication.

Barriers and facilitators in developing patient versions of clinical practice guidelines - qualitative interviews on experiences of international guideline producers

BackgroundSeveral guideline organizations produce patient versions of clinical practice guidelines (PVGs) which translate recommendations into simple language. A former study of our working group revealed that few guideline organizations publish their methods used to develop PVGs. Clear definitions of PVGs do not prevail and their purposes often remain unclear. We aimed to explore experts’ perspectives on developing, disseminating and implementing PVGs to discuss and incorporate these experiences when consenting on methodological guidance and further improving PVGs.MethodsWe conducted 17 semi-structured telephone interviews with international experts working with PVGs from September 2021 through January 2022. We conducted the interviews in English or German, they were recorded and transcribed verbatim. We utilized Mayring’s qualitative content analysis with MAXQDA software to analyze the data.ResultsIn two interviews two participants were interviewed at the same time. This resulted in a total of 19 participants from 16 different organizations and eight different countries participated. Most were female (16/19) and their experience in working with PVGs ranged from 1 to 20 years. All follow methodological standards when developing PVGs, but the extent of these standards and their public accessibility differs. Aims and target groups of PVGs vary between organizations. Facilitators for developing PVGs are working with a multidisciplinary team, financial resources, consultation processes and a high-quality underlying CPG. Facilitators for disseminating and implementing PVGs are using various strategies. Barriers, on the other hand, are the lack of these factors. All participants mentioned patient involvement as a key aspect in PVG development.ConclusionThe steps in the PVG development process are largely similar across the countries. Focus is placed on the involvement of patients in the development process, although the extent of participation varies. The experts collectively attribute great importance to PVGs overall, but in order to constantly adapt to medical progress and changing conditions, the focus in the future may be more on formats like living guidelines. Although there are different views on the mandatory development of PVGs, there is a consistent call for more transparency regarding the methodology used for PVGs.

English Version of Clinical Practice Guidelines for the Management of Atopic Dermatitis 2021.

This is the English version of the Clinical Practice Guidelines for the Management of Atopic Dermatitis 2021. Atopic dermatitis (AD) is a disease characterized by relapsing eczema with pruritus as a primary lesion. In Japan, from the perspective of evidence-based medicine, the current strategies for the treatment of AD consist of three primary measures: (i) use of topical corticosteroids, tacrolimus ointment, and delgocitinib ointment as the main treatment of the inflammation; (ii) topical application of emollients to treat the cutaneous barrier dysfunction; and (iii) avoidance of apparent exacerbating factors, psychological counseling, and advice about daily life. In the present revised guidelines, descriptions of three new drugs, namely, dupilumab, delgocitinib, and baricitinib, have been added. The guidelines present recommendations to review clinical research articles, evaluate the balance between the advantages and disadvantages of medical activities, and optimize medical activity-related patient outcomes with respect to several important points requiring decision-making in clinical practice.

Clinical practice guidelines and expert consensus statements on rehabilitation for patients with COVID-19: protocol for a systematic review

IntroductionCOVID-19 is a highly infectious disease, characterised by respiratory, physical and psychological dysfunctions. Rehabilitation could effectively alleviate the symptoms and promote recovery of the physical and mental health of patients...

Investigating the role and applicability of patient versions of guidelines in oncology and deriving recommendations for the development, dissemination and implementation of patient versions in Germany: protocol for multiphase study

IntroductionThe German Guideline Program in Oncology (GGPO) has published patient versions of clinical practice guidelines for more than 10 years. However, a systematic evaluation of these is lacking. The project...

2021 Korean Diabetes Association Clinical Practice Guidelines for Diabetes: Diabetic Kidney Disease

Diabetic kidney disease is one of the most serious complications of type 2 diabetes and a leading cause of end-stage kidney disease. Recently, the Korean Diabetes Association released a new version of clinical practice guidelines including substantial changes in the management of diabetic kidney disease. Of note, sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists are now the preferred glucose-lowering agents for reduced glomerular filtration rate or albuminuria. Convincing evidence from cardiovascular or renal outcome trials supports the recommendation of those drugs. This review summarizes the results of recent clinical studies on diabetic kidney disease and explains new clinical recommendations based on them.

2020 ESC Guidelines for the diagnosis and management of atrial fibrillation: what is new for neurologists?

Clinical practice guidelines for the diagnosis and management of atrial fibrillation (AF) are one of the most regularly updated documents by the European Society of Cardiology. The new version of clinical practice guidelines (2020) contains a number of changes regarding anticoagulant therapy in patients with AF who have developed acute cerebrovascular accidents. In this review, we discuss the statements of the updated document on the timing of the start/restart of anticoagulant therapy after ischemic stroke and intracranial hemorrhage in patients with AF, the choice of antithrombotic therapy in patients with cryptogenic stroke, as well as the need for the additional testing to clarify the origin of the embolism. We provide our original position on the possibility of applying these recommendations to the real clinical practice.

Updates and interpretations of the NCCN Clinical Practice Guidelines (2019 6th version) on gastrointestinal stromal tumor

The diagnosis and treatment of gastrointestinal stromal tumor (GIST) is getting more and more standardized. In the last two decades, due to the elucidation of molecular mechanism of tumorigenesis, as well as the effectiveness of tyrosine kinase inhibitors, GIST has become well-known as one of the most classical models of targeted therapy on solid tumors in the precision medicine era. The National Comprehensive Cancer Network (NCCN) issued the latest version of clinical practice guideline on soft tissue sarcoma in February 2020. Compared with previous versions, the new version of the guideline highlighted the treatment recommendations of avapritinib, which further promoted the precise targeted treatment of GIST.

An Innovative Approach to Clinical Practice Guideline Adaptation in the Nursing Profession in a Developing Country.

IntroductionHealthcare professionals should seek the necessary resources to improve the quality of care. Given the cultural, social, and economic differences, in every health care system, there are increasing needs for the adapted versions of clinical practice guidelines (CPGs). This study aimed to introduce an innovative CPG adaptation approach for nurses working in a developing country.MethodsThis study is comprised of three sections: a. An extensive systematic search of the literature, b. The adaptation process, c. Interviews, which were held with stakeholders, users and/or the target population. We applied all of the stages of guideline adaptation process according to Adaptation Resource Toolkit, with the integration of the findings of a systematic literature search and a qualitative content analysis in an “adolopted” new CPG.ResultsIn this study, we applied a mix of three methods namely adoption, adaptation and development (adolopment) of recommendations to save time, cost, and manpower efficiently. Moreover, we integrated the utilized qualitative research method and literature review with the adolopment approach to develop the recommendations.ConclusionGiven there is a paucity of nursing clinical practice guidelines (NCPGs) in the nursing management of cancer therapy-induced mucositis and to save time and costs, the findings emerging from the adoption, adaptation, and de novo guideline development by a panel of experts and qualitative content analysis (QCA) method were integrated to achieve a more comprehensive nursing practice guideline.

Clinical practice guidelines for hepatocellular carcinoma: The Japan Society of Hepatology 2017 (4th JSH-HCC guidelines) 2019 update.

The fourth version of Clinical Practice Guidelines for Hepatocellular Carcinoma was revised by the Japan Society of Hepatology, according to the methodology of evidence-based medicine and partly to the Grading of Recommendations Assessment, Development, and Evaluation system, which was published in October 2017 in Japanese. New or revised recommendations were described, herein, with a special reference to the surveillance, diagnostic, and treatment algorithms.

Evidence-based Clinical Practice Guidelines for Hepatocellular Carcinoma: The Japan Society of Hepatology 2013 update (3rd JSH-HCC Guidelines).

The 3rd version of Clinical Practice Guidelines for Hepatocellular Carcinoma was revised by the Japan Society of Hepatology, according to the methodology of evidence-based medicine, which was published in October 2013 in Japanese. Here, we briefly describe new or changed recommendations with a special reference to the two algorithms for surveillance, diagnosis, and treatment.

Clinical Practice Guidelines on Perioperative Cardiovascular Evaluation: collaborative efforts among the American College of Cardiology, the American Heart Association, and the European Society of Cardiology

This editorial refers to ‘2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management’[†][1], by The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA), on page 2383. The American College of Cardiology (ACC), the American Heart Association (AHA), and the European Society of Cardiology (ESC) are pleased to announce the publication of two new versions of Clinical Practice Guidelines (CPGs) on Perioperative Cardiovascular Evaluation from our respective organizations.1–3 These revisions were begun independently, dictated both by emerging, new information regarding the topic and the controversy … [1]: #fn-2

Impact of the implementation of electronic guidelines for cardiovascular prevention in primary care: study protocol

The electronic medical records software of the Catalan Institute of Health has recently incorporated an electronic version of clinical practice guidelines (e-CPGs). This study aims to assess the impact of the implementation of e-CPGs on the diagnosis, treatment, control and management of hypercholesterolaemia, diabetes mellitus type 2 and hypertension. Eligible study participants are those aged 35-74 years assigned to family practitioners (FPs) of the Catalan Institute of Health. Routinely collected data from electronic primary care registries covering 80% of the Catalan population will be analysed using two approaches: (1) a cross-sectional study to describe the characteristics of the sample before e-CPG implementation; (2) a controlled before-and-after study with 1-year follow-up to ascertain the effect of e-CPG implementation. Patients of FPs who regularly use the e-CPGs will constitute the intervention group; the control group will comprise patients assigned to FPs not regularly using the e-CPG. The outcomes are: (1) suspected and confirmed diagnoses, (2) control of clinical variables, (3) requests for tests and (4) proportions of patients with adequate drug prescriptions. This protocol should represent a reproducible process to assess the impact of the implementation of e-CPGs. We anticipate reporting results in late 2013. This project will assess the effectiveness of e-CPGs to improve clinical decisions and healthcare procedures in the three disorders analysed. The results will shed light on the use of evidence-based medicine to improve clinical practice of FPs.

Cardiología pediátrica y cardiopatías congénitas: del feto al adulto

This article contains a review of some of the most important publications on congenital heart disease and pediatric cardiology that appeared in 2010 and up until September 2011. Of particular interest were studies on demographic changes reported in this patient population and on the need to manage the patients’ transition from the pediatric to the adult cardiology department. This transition has given rise to the appearance of new areas of interest: for example, pregnancy in women with congenital heart disease, and the effect of genetic factors on the etiology and transmission of particular anomalies. In addition, this review considers some publications on fetal cardiology from the perspective of early diagnosis and, if possible, treatment. There follows a discussion on new contributions to Eisenmenger's syndrome and arrhythmias, as well as on imaging techniques, interventional catheterization and heart transplantation. Finally, there is an overview of the new version of clinical practice guidelines on the management of adult patients with congenital heart disease and of recently published guidelines on pregnancy in women with heart disease, both produced by the European Society of Cardiology.

Dissemination and Implementation of the Royal Australian and New Zealand College of Psychiatrists’ Clinical Practice Guidelines

The aim of this paper is to summarize information about the dissemination and implementation of the Royal Australian and New Zealand College of Psychiatrists' clinical practice guidelines (CPGs) since their completion in 2003, and assess the effectiveness of these activities. The dissemination and implementation activities undertaken from 2003 to the present are described. Data regarding the dissemination of the clinician and consumer-carer versions of the CPGs are presented. The results of a series of implementation pilots are summarized. Available data suggest the CPGs have been widely disseminated through both the clinician and consumer-carer communities in Australia and New Zealand, and that the consumer-carer versions in particular continue to be in high demand. Evaluation of CPG implementation pilots, using tools that assist in bringing summary evidence into clinical practice, have suggested that such tools are acceptable, are a useful aid to implementing evidence-based practice, and have a positive impact on practice. Common barriers to implementing the evidence are highlighted. Summary consumer-carer versions of CPGs seem to be acceptable and useful to both consumer-carers and non-government mental health providers. Locally led implementation of CPGs using tools that summarize evidence and support its use in everyday practice has a positive impact, but also highlights system-level barriers to implementing evidence-based practice.