Guidelines for Assessment of Work Disability: An International Survey.

Gesundheitswesen. 2011 Jun;73(6):e103-e110

Authors: Boer WE, Rijkenberg AM, Donceel P

BACKGROUND: Assessments of long-term work disability are carried out by social insurance physicians (SIPs) and are little supported with evidence or instruments. Guidelines are hardly ever used in social insurance medicine. Developments in social insurance medicine might be slow as insurance is different from clinical medicine. AIMS: We explored the comparability of assessments in social insurance medicine in different countries and asked what guidelines were in official use. METHODS: Eighteen European countries were invited. A questionnaire on assessments practices was sent to national experts. A comparative table was presented to all contributors. Countries with guidelines were visited. Guidelines were categorised according to their purpose and their contents were compared. The results were presented to experts of the participating countries for validation. RESULTS: Fourteen countries participated. Functional capacity assessment was common. Guidelines for SIPs were reported to be officially in use in Germany, Ireland, the Netherlands and Switzerland. Twenty-two guidelines were medical and eleven were procedural. Medical guidelines mainly treated the same topics. Procedural guidelines were more variable. CONCLUSION: Assessment of work disability is comparable between countries. Medical and procedural guidelines should be further developed and tested on their value in practice. The procedural guidelines need to be published in a clear and comparable manner. The legal security of claimants would be endorsed by this. Germany and the Netherlands are most experienced and could take the lead in international development.

PMID: 20496319 [PubMed - as supplied by publisher]

Comment on: “Evaluation and comparison of guidelines for the management of people with type 2 diabetes from eight European countries” by Stone et al. on behalf of the GUIDANCE study group (Diabetes Res Clin Pract. 2010; 87(2): 252-60).

Diabetes Res Clin Pract. 2011 Jun;92(3):407-8

Authors: Wens J, Van Royen P

The authors compared eight national type 2 diabetes guidelines for key process and outcome indicators. The comparison was performed after accurate selection, and quality of the different guidelines was assessed by means of the AGREE instrument, developed to address the issue of variability in guideline quality. Unless this precise methodological description some concerns remain after reading the paper.

PMID: 20638147 [PubMed - in process]

Use of psychotropic medication guidelines at child-serving community mental health centers as assessed by clinic directors.

Community Ment Health J. 2011 Jun;47(3):361-3

Authors: Stevens J, Kelleher KJ, Wang W, Schoenwald SK, Hoagwood KE, Landsverk J,

This study assessed the proportion of large, child-serving community mental health centers that used medication guidelines. Two hundred clinic directors from across the country completed an hour-long semi-structured interview, and 152 of these directors answered whether or not medication guidelines were used at their clinics. Half of these clinics’ directors reported that their prescribers followed any form of medication guidelines. Governmental agencies and professional medical societies were among the most common sources of information regarding which specific guidelines to follow. Utilization of standardized child outcome measures, but not the employment of a child psychiatrist, was related to following medication guidelines. Despite the mental health field’s recent emphasis on disseminating evidence-base practice, many directors reported their clinics did not use any pediatric medication guidelines.

PMID: 20878547 [PubMed - in process]

The adherence of GPs to guidelines for the diagnosis and treatment of lower urinary tract infections in women is poor.

Fam Pract. 2011 Jun;28(3):294-9

Authors: Llor C, Rabanaque G, López A, Cots JM

To assess the adherence of GPs to evidence-based guidelines for the diagnosis and management of lower urinary tract infection (UTI) in women.

PMID: 21127022 [PubMed - in process]

American Academy of Dermatology evidence-based guideline development process: Responding to new challenges and establishing transparency.

J Am Acad Dermatol. 2011 Jun;64(6):e105-12

Authors: Smith Begolka W, Elston DM, Beutner KR

Evidence-based clinical guidelines are developed to educate and inform physicians about best practices in patient care, and assist providers in the application of treatments and technologies that can improve outcomes. Clinical guidelines also aid appeal of payment decisions; serve as the basis for quality measure development, appropriateness criteria, and maintenance of certification modules; and help identify areas for further clinical research.

PMID: 21281988 [PubMed - in process]

Clinical practice guidelines to inform evidence-based clinical practice.

World J Urol. 2011 Jun;29(3):303-9

Authors: Wolf JS, Hubbard H, Faraday MM, Forrest JB

With the volume of medical research currently published, any one practitioner cannot independently review the literature to determine best evidence-based medical care. Additionally, non-specialists usually do not have the experience to know best practice for all of the frequent clinical circumstances for which there is no good evidence. Clinical practice guidelines (CPGs) help clinicians to address these problems because they are systematically created documents that summarize knowledge and provide guidance to assist in delivering high-quality medicine. They aim to improve health care by identifying evidence that supports the best clinical care and making clear which practices appear to be ineffective.

PMID: 21331629 [PubMed - in process]

The antibiotic crisis: can we reverse 65 years of failed stewardship?: comment on “decreased antibiotic utilization after implementation of a guideline for inpatient cellulitis and cutaneous abscess”.

Arch Intern Med. 2011 Jun 27;171(12):1080-1

Authors: Spellberg B

PMID: 21357798 [PubMed - in process]

Decreased antibiotic utilization after implementation of a guideline for inpatient cellulitis and cutaneous abscess.

Arch Intern Med. 2011 Jun 27;171(12):1072-9

Authors: Jenkins TC, Knepper BC, Sabel AL, Sarcone EE, Long JA, Haukoos JS, Morgan SJ, Biffl WL, Steele AW, Price CS, Mehler PS, Burman WJ

Cellulitis and cutaneous abscess are among the most common infections leading to hospitalization, yet optimal management strategies have not been adequately studied. We hypothesized that implementation of an institutional guideline to standardize and streamline the evaluation and treatment of inpatient cellulitis and abscess would decrease antibiotic and health care resource utilization.

PMID: 21357799 [PubMed - in process]

Thyroid nodule guidelines: agreement, disagreement and need for future research.

Nat Rev Endocrinol. 2011 Jun;7(6):354-61

Authors: Paschke R, Hegedüs L, Alexander E, Valcavi R, Papini E, Gharib H

This article reviews agreement, disagreement and need for future research of the thyroid nodule guidelines published by the British Thyroid Association, National Cancer Institute, American Thyroid Association and the joint, transatlantic effort of three large societies, the American Society of Clinical Endocrinologists, Associazione Medici Endocrinologi and the European Thyroid Association, published in 2010. Consensus exists for most topics in the various guidelines. A few areas of disagreement, such as the use of scintigraphy, are mostly due to differences in disease prevalence in different countries. Most of the discordance, for example, on the use of calcitonin screening or fine-needle aspiration cytology classification, could probably be resolved by further expert discussions, as the basis is the same published evidence. Importantly, owing to a current lack of evidence in many areas, clinically very relevant areas of uncertainty need to be addressed by further research. This situation applies, for instance, to better definition of ultrasound malignancy criteria and the evaluation of emerging new diagnostic and therapeutic techniques, including molecular markers. For clinicians who advise individual patients, these areas of uncertainty can currently only be resolved by sound management on the basis of clinical judgment, experience and patient preference.

PMID: 21364517 [PubMed - in process]

Performance of current guidelines for coronary heart disease prevention: Optimal use of the Framingham-based risk assessment.

Atherosclerosis. 2011 Jun;216(2):452-7

Authors: Murphy TP, Dhangana R, Pencina MJ, Zafar AM, D’Agostino RB

There is a strong positive association between Framingham Risk Scores (FRS) in a population and incidence of hard coronary heart disease (hCHD) events. Under current Adult Treatment Panel III guidelines, individuals with FRS that indicate ?20% 10-year risk of hCHD are recommended to receive intensive medical risk factor modification. We sought to assess the performance of FRS as a predictive tool when used as in current guidelines.

PMID: 21411089 [PubMed - in process]