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The 1996 and 1997 National survey of physician asthma management practices: background and study methodology.

https://arctichealth.org/en/permalink/ahliterature201629
Source
Can Respir J. 1999 May-Jun;6(3):269-72
Publication Type
Article
Author
R L Jin
B C Choi
Author Affiliation
Laboratory Centre for Disease Control, Ottawa, Canada. robert_jin@hc-sc.gc.ca
Source
Can Respir J. 1999 May-Jun;6(3):269-72
Language
English
Publication Type
Article
Keywords
Adolescent
Analysis of Variance
Asthma - therapy
Attitude of Health Personnel
Canada
Child, Preschool
Confidence Intervals
Female
Health Care Surveys
Humans
Male
Physician's Practice Patterns - statistics & numerical data
Practice Guidelines as Topic - standards
Questionnaires
Abstract
To collect national baseline information on asthma management practices by physicians, and to compare these practices with the recommendations of the Canadian Asthma Consensus Conference ('the guidelines').
Cross-sectional survey of representative samples of physicians in Canada in late 1996 and early 1997.
Five specialty types of physicians who manage asthma patients: respirology, pediatrics, internal medicine, allergy and clinical immunology, and general practice and family medicine. Stratified sampling by province and specialty was used to select physicians for the study. Weighting was used in the analysis to generalize the results to the national level for the five specialty groups of physicians.
Mailed questionnaire, self-administered by the respondent; three mailings of the questionnaires were used to increase the response rate.
The frequency with which each of the five specialty types chose specific asthma management choices was determined, using weighted percentages representative of the specialty groups on a national basis. ANOVA determined the statistically significant differences among the five specialties in choosing particular asthma management actions. Then, logistic regression was used to calculate the odds ratios showing an association between the characteristics of the physician respondents and specific asthma management choices that they made in the survey.
The data analysis demonstrated significant variations among physicians in asthma management practices, according to specialty type and other characteristics. The initial report was released in April 1998, and manuscripts for journal submissions are being prepared.
PubMed ID
10393288 View in PubMed
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1998 revision of the Canadian Asthma Consensus Guidelines. Asthma Consensus Conference Editorial Committee.

https://arctichealth.org/en/permalink/ahliterature201632
Source
Can Respir J. 1999 May-Jun;6(3):231-2
Publication Type
Conference/Meeting Material
Article
Author
L P Boulet
A. Becker
D. Bérubé
P. Ernst
R. Beveridge
Author Affiliation
Institut de cardiologie et de pneumologie de l'Université Laval, Hôpital Laval, Sainte-Foy, Canada.
Source
Can Respir J. 1999 May-Jun;6(3):231-2
Language
English
Publication Type
Conference/Meeting Material
Article
Keywords
Asthma - therapy
Canada
Humans
Patient Care - standards
Practice Guidelines as Topic - standards
Societies, Medical
PubMed ID
10393284 View in PubMed
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The 2006 Canadian dyslipidemia guidelines will prevent more deaths while treating fewer people--but should they be further modified?

https://arctichealth.org/en/permalink/ahliterature155805
Source
Can J Cardiol. 2008 Aug;24(8):617-20
Publication Type
Article
Date
Aug-2008
Author
Douglas G Manuel
Sarah Wilson
Sarah Maaten
Author Affiliation
Institute for Clinical Evaluative Sciences, Faculty of Medicine, University of Toronto, Ontario, Canada. doug.manuel@ices.on.ca
Source
Can J Cardiol. 2008 Aug;24(8):617-20
Date
Aug-2008
Language
English
Publication Type
Article
Keywords
Aged
Canada
Coronary Artery Disease - genetics - mortality - prevention & control
Cross-Cultural Comparison
Dyslipidemias - drug therapy - genetics - mortality
Health Services Accessibility - statistics & numerical data
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Middle Aged
Practice Guidelines as Topic - standards
Risk factors
Survival Analysis
Treatment Outcome
Abstract
When clinical guidelines affect large numbers of individuals or substantial resources, it is important to understand their benefits, harms and costs from a population perspective. Many countries' dyslipidemia guidelines include these perspectives.
To compare the effectiveness and efficiency of the 2003 and 2006 Canadian dyslipidemia guidelines for statin treatment in reducing deaths from coronary artery disease (CAD) in the Canadian population.
The 2003 and 2006 Canadian dyslipidemia guidelines were applied to data from the Canadian Heart Health Survey (weighted sample of 12,300,000 people), which includes information on family history and physical measurements, including fasting lipid profiles. The number of people recommended for statin treatment, the potential number of CAD deaths avoided and the number needed to treat to avoid one CAD death with five years of statin therapy were determined for each guideline.
Compared with the 2003 guidelines, 1.4% fewer people (20 to 74 years of age) are recommended statin treatment, potentially preventing 7% more CAD deaths. The number needed to treat to prevent one CAD death over five years decreased from 172 (2003 guideline) to 147 (2006 guideline).
From a population perspective, the 2006 Canadian dyslipidemia recommendations are an improvement of earlier versions, preventing more CAD events and deaths with fewer statin prescriptions. Despite these improvements, the Canadian dyslipidemia recommendations should explicitly address issues of absolute benefit and cost-effectiveness in future revisions.
Notes
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Comment In: Can J Cardiol. 2008 Aug;24(8):62118697284
PubMed ID
18685741 View in PubMed
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The 2006 K/DOQI guidelines for peritoneal dialysis adequacy are not adequate.

https://arctichealth.org/en/permalink/ahliterature166065
Source
Blood Purif. 2007;25(1):103-5
Publication Type
Article
Date
2007
Author
James F Winchester
Nikolas Harbord
Patrick Audia
Alan Dubrow
Stephen Gruber
Donald Feinfeld
Richard Amerling
Author Affiliation
Division of Nephrology and Hypertension, Beth Israel Medical Center, 350 East 17th Street, New York, NY 10003, USA. jwinches@bethisraelny.org
Source
Blood Purif. 2007;25(1):103-5
Date
2007
Language
English
Publication Type
Article
Keywords
Body mass index
Canada
Humans
Metabolic Clearance Rate
Peritoneal Dialysis - methods - standards
Practice Guidelines as Topic - standards
Randomized Controlled Trials as Topic
Reproducibility of Results
United States
Urea - metabolism
Abstract
The 2006 National Kidney Foundation K/DOQI guidelines have lowered the peritoneal dialysis adequacy standard of Kt/V(urea) from 2.1 to 1.7 in anuric patients, largely based on the patient survival results of 2 clinical trials in Mexico and Hong Kong. It is our contention that the guidelines may be misleading since they have chosen to ignore the bias in these trials and have ignored the adverse outcomes in control groups in the trials on which the guidelines are based, as well as the body size of the subjects in these trials. Body size has changed in the US and Canada over the last few decades and there are similar changes worldwide. We suggest that the minimum targets for peritoneal dialysis be reinstituted at the previous standard Kt/V(urea) of 2.0.
PubMed ID
17170545 View in PubMed
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2009 Canadian Cardiovascular Society/Canadian guidelines for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease in the adult - 2009 recommendations.

https://arctichealth.org/en/permalink/ahliterature148105
Source
Can J Cardiol. 2009 Oct;25(10):567-79
Publication Type
Article
Date
Oct-2009
Author
Jacques Genest
Ruth McPherson
Jiri Frohlich
Todd Anderson
Norm Campbell
André Carpentier
Patrick Couture
Robert Dufour
George Fodor
Gordon A Francis
Steven Grover
Milan Gupta
Robert A Hegele
David C Lau
Lawrence Leiter
Gary F Lewis
Eva Lonn
G B John Mancini
Dominic Ng
Glen J Pearson
Allan Sniderman
James A Stone
Ehud Ur
Author Affiliation
McGill University Health Centre, Montreal, Canada. jacques.genest@muhc.mcgill.ca
Source
Can J Cardiol. 2009 Oct;25(10):567-79
Date
Oct-2009
Language
English
Publication Type
Article
Keywords
Adult
Canada
Cardiovascular Diseases - etiology - prevention & control
Congresses as topic
Diagnostic Techniques, Cardiovascular
Dyslipidemias - complications - diagnosis - drug therapy
Humans
Hypolipidemic Agents - therapeutic use
Practice Guidelines as Topic - standards
Risk Assessment - methods
Societies, Medical
Abstract
The present article represents the 2009 update of the Canadian Cardiovascular Society guidelines for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease in the adult.
Notes
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PubMed ID
19812802 View in PubMed
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The 2012 Canadian hypertension education program recommendations for the management of hypertension: blood pressure measurement, diagnosis, assessment of risk, and therapy.

https://arctichealth.org/en/permalink/ahliterature124290
Source
Can J Cardiol. 2012 May;28(3):270-87
Publication Type
Article
Date
May-2012
Author
Stella S Daskalopoulou
Nadia A Khan
Robert R Quinn
Marcel Ruzicka
Donald W McKay
Daniel G Hackam
Simon W Rabkin
Doreen M Rabi
Richard E Gilbert
Raj S Padwal
Martin Dawes
Rhian M Touyz
Tavis S Campbell
Lyne Cloutier
Steven Grover
George Honos
Robert J Herman
Ernesto L Schiffrin
Peter Bolli
Thomas Wilson
Ross D Feldman
M Patrice Lindsay
Brenda R Hemmelgarn
Michael D Hill
Mark Gelfer
Kevin D Burns
Michel Vallée
G V Ramesh Prasad
Marcel Lebel
Donna McLean
J Malcolm O Arnold
Gordon W Moe
Jonathan G Howlett
Jean-Martin Boulanger
Pierre Larochelle
Lawrence A Leiter
Charlotte Jones
Richard I Ogilvie
Vincent Woo
Janusz Kaczorowski
Luc Trudeau
Simon L Bacon
Robert J Petrella
Alain Milot
James A Stone
Denis Drouin
Maxime Lamarre-Cliché
Marshall Godwin
Guy Tremblay
Pavel Hamet
George Fodor
S George Carruthers
George Pylypchuk
Ellen Burgess
Richard Lewanczuk
George K Dresser
Brian Penner
Robert A Hegele
Philip A McFarlane
Mukul Sharma
Norman R C Campbell
Debra Reid
Luc Poirier
Sheldon W Tobe
Author Affiliation
Division of General Internal Medicine, McGill University, Montreal, Québec, Canada. stella.daskalopoulou@mcgill.ca
Source
Can J Cardiol. 2012 May;28(3):270-87
Date
May-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antihypertensive Agents - therapeutic use
Blood Pressure Determination - methods
Canada
Cardiovascular Diseases - etiology - prevention & control
Education, Medical, Continuing - standards
Evidence-Based Medicine - standards
Female
Health Education - standards
Humans
Hypertension - complications - diagnosis - therapy
Male
Middle Aged
Monitoring, Physiologic - methods
Practice Guidelines as Topic - standards
Prognosis
Risk assessment
Treatment Outcome
Abstract
We updated the evidence-based recommendations for the diagnosis, assessment, prevention, and treatment of hypertension in adults for 2012. The new recommendations are: (1) use of home blood pressure monitoring to confirm a diagnosis of white coat syndrome; (2) mineralocorticoid receptor antagonists may be used in selected patients with hypertension and systolic heart failure; (3) a history of atrial fibrillation in patients with hypertension should not be a factor in deciding to prescribe an angiotensin-receptor blocker for the treatment of hypertension; and (4) the blood pressure target for patients with nondiabetic chronic kidney disease has now been changed to
PubMed ID
22595447 View in PubMed
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Acute pain management in burn patients: appraisal and thematic analysis of four clinical guidelines.

https://arctichealth.org/en/permalink/ahliterature265210
Source
Burns. 2014 Dec;40(8):1463-9
Publication Type
Article
Date
Dec-2014
Author
Hejdi Gamst-Jensen
Pernille Nygaard Vedel
Viktoria Oline Lindberg-Larsen
Ingrid Egerod
Source
Burns. 2014 Dec;40(8):1463-9
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Acute Pain - etiology - psychology - therapy
Adaptation, Psychological
Adult
Analgesics - therapeutic use
Anti-Anxiety Agents - therapeutic use
Anxiety - drug therapy - psychology
Burn Units
Burns - complications - psychology - therapy
Child
Denmark
Evidence-Based Medicine
Humans
Hypnosis, Anesthetic
New Zealand
Pain Management - psychology - standards
Pain Measurement
Pain, Postoperative - psychology - therapy
Practice Guidelines as Topic - standards
Retrospective Studies
Sweden
United States
Abstract
Burn patients suffer excruciating pain due to their injuries and procedures related to surgery, wound care, and mobilization. Acute Stress Disorder, Post-Traumatic Stress Disorder, chronic pain and depression are highly prevalent among survivors of severe burns. Evidence-based pain management addresses and alleviates these complications. The aim of our study was to compare clinical guidelines for pain management in burn patients in selected European and non-European countries. We included pediatric guidelines due to the high rate of children in burn units.
The study had a comparative retrospective design using combined methodology of instrument appraisal and thematic analysis. Three investigators appraised guidelines from burn units in Denmark (DK), Sweden (SE), New Zealand (NZ), and USA using the AGREE Instrument (Appraisal of Guidelines for Research & Evaluation), version II, and identified core themes in the guidelines.
The overall scores expressing quality in six domains of the AGREE instrument were variable at 22% (DK), 44% (SE), 100% (NZ), and 78% (USA). The guidelines from NZ and USA were highly recommended, the Swedish was recommended, whereas the Danish was not recommended. The identified core themes were: continuous pain, procedural pain, postoperative pain, pain assessment, anxiety, and non-pharmacological interventions.
The study demonstrated variability in quality, transparency, and core content in clinical guidelines on pain management in burn patients. The most highly recommended guidelines provided clear and accurate recommendations for the nursing and medical staff on pain management in burn patients. We recommend the use of a validated appraisal tool such as the AGREE instrument to provide more consistent and evidence-based care to burn patients in the clinic, to unify guideline construction, and to enable interdepartmental comparison of treatment and outcomes.
PubMed ID
25277698 View in PubMed
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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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Adherence to cancer screening guidelines across Canadian provinces: an observational study.

https://arctichealth.org/en/permalink/ahliterature142706
Source
BMC Cancer. 2010;10:304
Publication Type
Article
Date
2010
Author
Erin C Strumpf
Zhijin Chai
Srikanth Kadiyala
Author Affiliation
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC H3A 2T7, Canada. erin.strumpf@mcgill.ca
Source
BMC Cancer. 2010;10:304
Date
2010
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Breast Neoplasms - diagnosis - epidemiology - prevention & control
Canada - epidemiology
Colorectal Neoplasms - diagnosis - epidemiology - prevention & control
Cross-Sectional Studies
Early Detection of Cancer
Female
Guideline Adherence - standards
Humans
Male
Mass Screening
Middle Aged
Patient compliance
Practice Guidelines as Topic - standards
Prostatic Neoplasms - diagnosis - epidemiology - prevention & control
Abstract
Cancer screening guidelines reflect the costs and benefits of population-based screening based on evidence from clinical trials. While most of the existing literature on compliance with cancer screening guidelines only measures raw screening rates in the target age groups, we used a novel approach to estimate degree of guideline compliance across Canadian provinces for breast, colorectal and prostate cancer screening. Measuring compliance as the change in age-specific screening rates at the guideline-recommended initiation age (50), we generally found screening patterns across Canadian provinces that were not consistent with guideline compliance.
We calculated age-cancer-specific screening rates for ages 40-60 using the Canadian Community Health Survey (2003 and 2005), a cross-sectional, nationally representative survey of health status, health care utilization and health determinants in the Canadian population. We estimated the degree of compliance using logistic regression to measure the change in adjusted screening rates at the guideline-recommended initiation age for each province in the sample.
For breast cancer, after adjusting for age trends and other covariates, being above age 50 in Quebec increased the probability of being screened by 19 percentage points, from an average screening rate of 24% among 40-49 year olds. None of the other regions exhibited a statistically significant change in screening rates at age 50. Additional analyses indicated that these patterns reflect asymptomatic screening and that Quebec's breast cancer screening program enhanced the degree of guideline compliance in that province. Colorectal cancer screening practice was consistent with guidelines only in Saskatchewan, as screening rates increased at age 50 by 12 percentage points, from an average rate of 6% among 40-49 year olds. For prostate cancer, the regions examined here are not compliant with Canadian guidelines since screening rates were quite high, and there was not a discrete increase at any particular age.
Screening practice for breast, colorectal and prostate cancer was generally not consistent with Canadian clinical guidelines. Quebec (breast) and Saskatchewan (colorectal) were exceptions to this, and the impact of Quebec's breast cancer screening program suggests a role for policy in improving screening guideline compliance.
Notes
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PubMed ID
20565862 View in PubMed
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222 records – page 1 of 23.