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The 2000 Canadian recommendations for the management of hypertension: part two--diagnosis and assessment of people with high blood pressure.

https://arctichealth.org/en/permalink/ahliterature192030
Source
Can J Cardiol. 2001 Dec;17(12):1249-63
Publication Type
Conference/Meeting Material
Article
Date
Dec-2001
Author
K B Zarnke
M. Levine
F A McAlister
N R Campbell
M G Myers
D W McKay
P. Bolli
G. Honos
M. Lebel
K. Mann
T W Wilson
C. Abbott
S. Tobe
E. Burgess
S. Rabkin
Author Affiliation
Department of Medicine, London Health Sciences Centre, University of Western Ontario, 339 Windermere Road, London, Ontario N6A 5A5, Canada. Kelly.Zarnke@lhsc.on.ca
Source
Can J Cardiol. 2001 Dec;17(12):1249-63
Date
Dec-2001
Language
English
French
Publication Type
Conference/Meeting Material
Article
Keywords
Adrenal Gland Neoplasms - complications
Adult
Blood Pressure Determination - methods - psychology - standards
Blood Pressure Monitoring, Ambulatory - methods - standards
Canada
Cardiovascular Diseases - etiology - prevention & control
Clinical Laboratory Techniques - standards
Diabetes Complications
Diabetic Nephropathies - complications - diagnosis
Echocardiography - standards
Electrocardiography
Evidence-Based Medicine - methods
Humans
Hypertension - complications - diagnosis - etiology - psychology
Hypertension, Renovascular - diagnosis
Hypertrophy, Left Ventricular - complications - ultrasonography
Office Visits
Patient compliance
Pheochromocytoma - complications - diagnosis
Risk factors
Self Care - methods - standards
Abstract
To provide updated, evidence-based recommendations for the diagnosis and assessment of high blood pressure in adults.
For people with high blood pressure, the assignment of a diagnosis of hypertension depends on the appropriate measurement of blood pressure, the level of the blood pressure elevation, the duration of follow-up and the presence of concomitant vascular risk factors, target organ damage and established atherosclerotic diseases. For people diagnosed with hypertension, defining the overall risk of adverse cardiovascular outcomes requires laboratory testing, a search for target organ damage and an assessment of the modifiable causes of hypertension. Out-of-clinic blood pressure assessment and echocardiography are options for selected patients.
People at increased risk of adverse cardiovascular outcomes and were identified and quantified.
Medline searches were conducted from the period of the last revision of the Canadian recommendations for the management of hypertension (May 1998 to October 2000). Reference lists were scanned, experts were polled, and the personal files of the subgroup members and authors were used to identify other studies. All relevant articles were reviewed and appraised, using prespecified levels of evidence, by content experts and methodological experts.
A high value was placed on the identification of people at increased risk of cardiovascular morbidity and mortality.
The identification of people at higher risk of cardiovascular disease will permit counselling for lifestyle manoeuvres and the introduction of antihypertensive drugs to reduce blood pressure for patients with sustained hypertension. In certain settings, and for specific classes of drugs, blood pressure lowering has been associated with reduced cardiovascular morbidity and/or mortality.
The present document contains detailed recommendations pertaining to aspects of the diagnosis and assessment of patients with hypertension, including the accurate measurement of blood pressure, criteria for the diagnosis of hypertension and recommendations for follow-up, routine and optional laboratory testing, assessment for renovascular hypertension, home and ambulatory blood pressure monitoring, and the role of echocardiography in hypertension.
All recommendations were graded according to strength of the evidence and voted on by the Canadian Hypertension Recommendations Working Group. Only the recommendations achieving high levels of consensus are reported here. These guidelines will be updated annually.
These recommendations are endorsed by the Canadian Hypertension Society, The Canadian Coalition for High Blood Pressure Prevention and Control, The College of Family Physicians of Canada, The Heart and Stroke Foundation of Canada, The Adult Disease Division and Bureau of Cardio-Respiratory Diseases and Diabetes at the Centre for Chronic Disease Prevention and Control of Health Canada.
PubMed ID
11773936 View in PubMed
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AACVPR/ACC/AHA 2007 performance measures on cardiac rehabilitation for referral to and delivery of cardiac rehabilitation/secondary prevention services endorsed by the American College of Chest Physicians, American College of Sports Medicine, American Physical Therapy Association, Canadian Association of Cardiac Rehabilitation, European Association for Cardiovascular Prevention and Rehabilitation, Inter-American Heart Foundation, National Association of Clinical Nurse Specialists, Preventive Cardiovascular Nurses Association, and the Society of Thoracic Surgeons.

https://arctichealth.org/en/permalink/ahliterature161050
Source
J Am Coll Cardiol. 2007 Oct 2;50(14):1400-33
Publication Type
Article
Date
Oct-2-2007

Adaptation of trustworthy guidelines developed using the GRADE methodology: a novel five-step process.

https://arctichealth.org/en/permalink/ahliterature259603
Source
Chest. 2014 Sep;146(3):727-34
Publication Type
Article
Date
Sep-2014
Author
Annette Kristiansen
Linn Brandt
Thomas Agoritsas
Elie A Akl
Eivind Berge
Johan Bondi
Anders E Dahm
Lars-Petter Granan
Sigrun Halvorsen
Pål-Andre Holme
Anne Flem Jacobsen
Eva-Marie Jacobsen
Ignacio Neumann
Per Morten Sandset
Torunn Sætre
Arnljot Tveit
Trond Vartdal
Gordon Guyatt
Per Olav Vandvik
Source
Chest. 2014 Sep;146(3):727-34
Date
Sep-2014
Language
English
Publication Type
Article
Keywords
Evidence-Based Medicine - methods
Feasibility Studies
Fibrinolytic Agents - therapeutic use
Humans
Norway
Practice Guidelines as Topic - standards
Publications
Risk factors
Societies, Medical
Thrombosis - drug therapy - epidemiology - prevention & control
Time Factors
Abstract
Adaptation of guidelines for use at the national or local level can facilitate their implementation. We developed and evaluated an adaptation process in adherence with standards for trustworthy guidelines and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, aiming for efficiency and transparency. This article is the first in a series describing our adaptation of Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines for a Norwegian setting.
Informed by the ADAPTE framework, we developed a five-step adaptation process customized to guidelines developed using GRADE: (1) planning, (2) initial assessment of the recommendations, (3) modification, (4) publication, and (5) evaluation. We developed a taxonomy for describing how and why recommendations from the parent guideline were modified and applied a mixed-methods case study design for evaluation of the process.
We published the adapted guideline in November 2013 in a novel multilayered format. The taxonomy for adaptation facilitated transparency of the modification process for both the guideline developers and the end users. We excluded 30 and modified 131 of the 333 original recommendations according to the taxonomy and developed eight new recommendations. Unforeseen obstacles related to acquiring a licensing agreement and procuring a publisher resulted in a 9-month delay. We propose modifications of the adaptation process to overcome these obstacles in the future.
This case study demonstrates the feasibility of a novel guideline adaptation process. Replication is needed to further validate the usefulness of the process in increasing the organizational and methodologic efficiency of guideline adaptation.
PubMed ID
25180723 View in PubMed
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Agreement between Cochrane Neonatal Group reviews and clinical guidelines for newborns at a Copenhagen University Hospital - a cross-sectional study.

https://arctichealth.org/en/permalink/ahliterature79323
Source
Acta Paediatr. 2007 Jan;96(1):39-43
Publication Type
Article
Date
Jan-2007
Author
Brok Jesper
Greisen Gorm
Jacobsen Thorkild
Gluud Lise L
Gluud Christian
Author Affiliation
The Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital, H:S Rigshospitalet, Denmark. jbrok@ctu.rh.dk
Source
Acta Paediatr. 2007 Jan;96(1):39-43
Date
Jan-2007
Language
English
Publication Type
Article
Keywords
Consensus
Denmark
Evidence-Based Medicine - methods
Hospitals, University
Humans
Infant, Newborn
Medical Audit
Neonatology - standards
Practice Guidelines - standards
Abstract
AIM: To assess the agreement between Cochrane Neonatal Group reviews and clinical guidelines of a University Neonatology Department, to evaluate the reasons for potential disagreements and to ascertain whether Cochrane reviews were considered for the guidelines development. METHODS: The recommendations in the reviews and guidelines were compared and classified as being in 'agreement', 'partial agreement' or 'disagreement'. The guideline authors were interviewed for reasons about disagreement and whether Cochrane reviews were considered during the guideline development. RESULTS: Agreement between reviews and guidelines was found for 133 interventions (77%), partial agreement for 31 interventions (18%) and disagreement for nine interventions (5%). Six interventions were recommended in the guidelines, but not in the reviews. Three interventions were recommended in the reviews, but not in the guidelines. Use of consensus statements, evidence on surrogate markers, observational studies, basic immunology and pathophysiological knowledge, expert opinion, economical constraints, reservations about the external validity and unawareness of reviews were reasons for disagreement. Cochrane reviews were rarely (22%) used during the guideline development. CONCLUSION: We found agreement between more than three quarters of Cochrane reviews and neonatal guidelines. However, few important disagreements occurred. Reviews were only used for guideline development in about a fifth of cases.
PubMed ID
17187601 View in PubMed
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The appropriate use of neuroimaging in the diagnostic work-up of dementia: an evidence-based analysis.

https://arctichealth.org/en/permalink/ahliterature256799
Source
Ont Health Technol Assess Ser. 2014;14(1):1-64
Publication Type
Article
Date
2014
Source
Ont Health Technol Assess Ser. 2014;14(1):1-64
Date
2014
Language
English
Publication Type
Article
Keywords
Dementia - diagnosis - pathology - physiopathology
Diagnosis, Differential
Evidence-Based Medicine - methods
Humans
Likelihood Functions
Magnetic Resonance Imaging
Neuroimaging - methods
Ontario
Patient Selection
Positron-Emission Tomography
Practice Guidelines as Topic
Sensitivity and specificity
Tomography, X-Ray Computed
Treatment Outcome
Abstract
Diagnosis of dementia is challenging and requires both ruling out potentially treatable underlying causes and ruling in a diagnosis of dementia subtype to manage patients and suitably plan for the future.
This analysis sought to determine the appropriate use of neuroimaging during the diagnostic work-up of dementia, including indications for neuroimaging and comparative accuracy of alternative technologies.
A literature search was performed using Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid Embase, the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database, for studies published between 2000 and 2013.
Data on diagnostic accuracy and impact on clinical decision making were abstracted from included studies. Quality of evidence was assessed using GRADE.
The search yielded 5,374 citations and 15 studies were included. Approximately 10% of dementia cases are potentially treatable, though less than 1% reverse partially or fully. Neither prediction rules nor clinical indications reliably select the subset of patients who will likely benefit from neuroimaging. Clinical utility is highest in ambiguous cases or where dementia may be mixed, and lowest for clinically diagnosed Alzheimer disease or clinically excluded vascular dementia. There is a lack of evidence that MRI is superior to CT in detecting a vascular component to dementia. Accuracy of structural imaging is moderate to high for discriminating different types of dementia.
There was significant heterogeneity in estimates of diagnostic accuracy, which often prohibited a statistical summary of findings. The quality of data reported by studies prohibited calculation of likelihood ratios in the present analysis. No studies from primary care were found; thus, generalizability beyond tertiary care settings may be limited.
A diagnosis of reversible dementia is rare. Imaging has the most clinical utility in cases where there is potentially mixed dementia or ambiguity as to the type of dementia despite prolonged follow-up (e.g., 2 years or more). Both CT and MRI are useful for detecting a vascular component of dementia.
Notes
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PubMed ID
24592296 View in PubMed
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Association between risperidone treatment and cerebrovascular adverse events: examining the evidence and postulating hypotheses for an underlying mechanism.

https://arctichealth.org/en/permalink/ahliterature181218
Source
J Am Med Dir Assoc. 2004 Mar-Apr;5(2):129-32
Publication Type
Article
Source
J Orthop Trauma. 2015 Dec;29 Suppl 12:S43-6
Publication Type
Article
Date
Dec-2015
Author
Gerard P Slobogean
Peter V Giannoudis
Frede Frihagen
Mary L Forte
Saam Morshed
Mohit Bhandari
Source
J Orthop Trauma. 2015 Dec;29 Suppl 12:S43-6
Date
Dec-2015
Language
English
Publication Type
Article
Keywords
Databases, Factual
Datasets as Topic
Evidence-Based Medicine - methods
Great Britain - epidemiology
Hip Fractures - mortality - surgery
Humans
Outcome Assessment (Health Care) - methods - statistics & numerical data
Prevalence
Prognosis
Registries
Risk factors
Survival Rate
Sweden - epidemiology
Treatment Outcome
Abstract
Clinical studies frequently lack the ability to reliably answer their research questions because of inadequate sample sizes. Underpowered studies are subject to multiple sources of bias, may not represent the larger population, and are regularly unable to detect differences between treatment groups. Most importantly, an underpowered study can lead to incorrect conclusions. Big data can be used to address many of these concerns, enabling researchers to answer questions with increased certainty and less likelihood of bias. Big datasets, such as The National Hip Fracture Database in the United Kingdom and the Swedish Hip Arthroplasty Registry, collect valuable clinical information that can be used by researchers to guide patient care and inform policy makers, chief executives, commissioners, and clinical staff. The range of research questions that can be examined is directly related to the quality and complexity of the data, which is positively associated with the cost of the data. However, technological advancements have unlocked new possibilities for efficient data capture and widespread opportunities to merge massive datasets, particularly in the setting of national registries and administrative data.
PubMed ID
26584266 View in PubMed
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Case-based training of evidence-based clinical practice in primary care and decreased mortality in patients with coronary heart disease.

https://arctichealth.org/en/permalink/ahliterature134657
Source
Ann Fam Med. 2011 May-Jun;9(3):211-8
Publication Type
Article
Author
Anna Kiessling
Moira Lewitt
Peter Henriksson
Author Affiliation
Department of Clinical Sciences, Karolinska Institutet, Division of Cardiovascular Medicine, Danderyd Hospital, Stockholm, Sweden. anna.kiessling@ki.se
Source
Ann Fam Med. 2011 May-Jun;9(3):211-8
Language
English
Publication Type
Article
Keywords
Anticholesteremic Agents - therapeutic use
Clinical Competence
Confidence Intervals
Coronary Artery Disease - drug therapy - mortality
Educational Status
Evidence-Based Medicine - methods
Female
General practitioners
Humans
Male
Middle Aged
Primary Health Care - methods
Problem-Based Learning - methods
Quality of Health Care - standards
Statistics as Topic
Sweden
Abstract
We investigated the 10-year mortality rates in a trial that tested a case-based intervention in primary care aimed at reducing the gap between evidence-based goals and clinical practice in patients with coronary heart disease (CHD).
A prospective randomized controlled pragmatic trial was undertaken in a primary care setting. New evidence-based guidelines, with intensified lipid-lowering recommendations in CHD, were mailed to all general practitioners in the region and presented at a lecture in 1995. General practitioners (n = 54) and patients with CHD (n = 88) were assigned according to their primary health care center to 2 balanced groups and randomly allocated to usual care as a control or to an active intervention. General practitioners in the intervention group participated in repeated case-based training during a 2-year period. Patients whose CHD was treated by specialists (n = 167) served as an internal specialist comparison group. Altogether, 255 consecutive patients were included. Cox regression analysis was used to detect any survival benefit of the intervention.
At 10 years, 22% of the patients in the intervention group had died as compared with 44% in the control group (P = .02), with a hazard ratio of 0.45 (95% confidence interval, 0.20-0.95). This difference was mainly due to reduced cardiovascular mortality in the intervention group (P = .01). In addition, the mortality rate of 22% in the intervention group was comparable to the rate of 23% seen in patients treated by a specialist.
Use of case-based training to implement evidence-based practice in primary care was associated with decreased mortality at 10 years in patients with CHD.
Notes
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Comment In: Ann Fam Med. 2011 May-Jun;9(3):198-20021555746
PubMed ID
21555748 View in PubMed
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Challenges in health promotion policies.

https://arctichealth.org/en/permalink/ahliterature185520
Source
Promot Educ. 2002;9(4):143-6
Publication Type
Article
Date
2002
Author
Vappu Taipale
Author Affiliation
National Research and Development Centre for Welfare and Health (STAKES), P.O. Box 220, Lintulahdenkuja 4, 00530 Helsinki, Finland. vappu.taipale@stakes.fi
Source
Promot Educ. 2002;9(4):143-6
Date
2002
Language
English
Publication Type
Article
Keywords
Alcohol Drinking - prevention & control
Commerce - legislation & jurisprudence
Europe
Evidence-Based Medicine - methods
Female
Finland
Health Promotion - organization & administration
Humans
Internationality
Policy Making
Politics
Social Control, Formal - methods
Women, Working
PubMed ID
12731118 View in PubMed
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69 records – page 1 of 7.