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The Journal of Prosthetic Dentistry Jun 2024Systematic reviews and meta-analyses have emerged as forerunners of evidence-based dentistry, but assessing the quality of the available research is essential so that it...
STATEMENT OF PROBLEM
Systematic reviews and meta-analyses have emerged as forerunners of evidence-based dentistry, but assessing the quality of the available research is essential so that it can be applied to clinical practice. While a wide variety of risk-of-bias tools are available, each specifically developed for different study designs, a comprehensive tool exclusively framed to assess the quality of in vitro dental studies is lacking.
PURPOSE
The purpose of this study was to develop and validate a tool to evaluate the quality and risk of bias of in vitro dental studies.
MATERIAL AND METHODS
A Delphi panel was established to conceptualize and develop the Quality Assessment Tool For In Vitro Studies (QUIN Tool). The tool was evaluated by using content validity and reliability testing methods.
RESULTS
The QUIN Tool includes 12 points along with scoring and grading options to allow clinicians to evaluate the quality of in vitro studies. This tool shows good content validity and reliability.
CONCLUSIONS
The QUIN Tool is user-friendly, efficient, and effective for evaluating the risk of bias of in vitro studies.
Topics: Humans; Delphi Technique; Reproducibility of Results; Bias; Evidence-Based Dentistry; In Vitro Techniques; Research Design; Dental Research
PubMed: 35752496
DOI: 10.1016/j.prosdent.2022.05.019 -
Internal Medicine Journal Jun 2024Older people are at high risk of medicines-related harms. otentially inappropriate medicines (PIMs) list has been developed to assist clinicians and researchers to...
BACKGROUND
Older people are at high risk of medicines-related harms. otentially inappropriate medicines (PIMs) list has been developed to assist clinicians and researchers to identify medicines with risks that may potentially outweigh their benefits in order to improve medication management and safety.
AIM
To develop a list of PIMs for older people specific to Australia.
METHODS
The study obtained expert consensus through the utilisation of the Delphi technique in Australia. A total of 33 experts partook in the initial round, while 32 experts engaged in the subsequent round. The primary outcomes encompass medicines assessed as potentially inappropriate, the specific contexts in which their inappropriateness arises and potentially safer alternatives.
RESULTS
A total of 16 medicines or medicine classes had one or more medicines deemed as potentially inappropriate in older people. Up to 19 medicines or medicine classes had specific conditions that make them more potentially inappropriate, while alternatives were suggested for 16 medicines or classes.
CONCLUSION
An explicit PIMs list for older people living in Australia has been developed containing 19 drugs/drug classes. The PIMs list is intended to be used as a guide for clinicians when assessing medication appropriateness in older people in Australian clinical settings and does not substitute individualised treatment advice from clinicians.
Topics: Humans; Delphi Technique; Australia; Inappropriate Prescribing; Potentially Inappropriate Medication List; Aged; Consensus; Female; Male
PubMed: 38303674
DOI: 10.1111/imj.16322 -
Journal of Science and Medicine in Sport Sep 2023
Topics: Humans; Consensus; Delphi Technique
PubMed: 37793713
DOI: 10.1016/j.jsams.2023.09.007 -
Palliative Medicine Feb 2024The European Association for Palliative Care (EAPC) acknowledges palliative sedation as an important, broadly accepted intervention for patients with life-limiting...
BACKGROUND
The European Association for Palliative Care (EAPC) acknowledges palliative sedation as an important, broadly accepted intervention for patients with life-limiting disease experiencing refractory symptoms. The EAPC therefore developed 2009 a framework on palliative sedation. A revision was needed due to new evidence from literature, ongoing debate and criticism of methodology, terminology and applicability.
AIM
To provide evidence- and consensus-based guidance on palliative sedation for healthcare professionals involved in end-of-life care, for medical associations and health policy decision-makers.
DESIGN
Revision between June 2020 and September 2022 of the 2009 framework using a literature update and a Delphi procedure.
SETTING
European.
PARTICIPANTS
International experts on palliative sedation (identified through literature search and nomination by national palliative care associations) and a European patient organisation.
RESULTS
A framework with 42 statements for which high or very high level of consensus was reached. Terminology is defined more precisely with the terms used to encompass distressing physical and psychological symptoms as well as existential suffering and to describe the untreatable (healthcare professionals) and intolerable (patient) nature of the suffering. The principle of proportionality is introduced in the definition of palliative sedation. No specific period of remaining life expectancy is defined, based on the principles of refractoriness of suffering, proportionality and independent decision-making for hydration. Patient autonomy is emphasised. A stepwise pharmacological approach and a guidance on hydration decision-making are provided.
CONCLUSIONS
This is the first framework on palliative sedation using a strict consensus methodology. It should serve as comprehensive and soundly developed information for healthcare professionals.
Topics: Humans; Palliative Care; Delphi Technique; Terminal Care; Consensus; Anesthesia; Deep Sedation
PubMed: 38297460
DOI: 10.1177/02692163231220225 -
Pediatric Tracheostomy Emergency Readiness Assessment Tool: International Consensus Recommendations.The Laryngoscope Dec 2023To achieve consensus on critical steps and create an assessment tool for actual and simulated pediatric tracheostomy emergencies that incorporates human and systems...
OBJECTIVE
To achieve consensus on critical steps and create an assessment tool for actual and simulated pediatric tracheostomy emergencies that incorporates human and systems factors along with tracheostomy-specific steps.
METHODS
A modified Delphi method was used. Using REDCap software, an instrument comprising 29 potential items was circulated to 171 tracheostomy and simulation experts. Consensus criteria were determined a priori with a goal of consolidating and ordering 15 to 25 final items. In the first round, items were rated as "keep" or "remove". In the second and third rounds, experts were asked to rate the importance of each item on a 9-point Likert scale. Items were refined in subsequent iterations based on analysis of results and respondents' comments.
RESULTS
The response rates were 125/171 (73.1%) for the first round, 111/125 (88.8%) for the second round, and 109/125 (87.2%) for the third round. 133 comments were incorporated. Consensus (>60% participants scoring ≥8, or mean score >7.5) was reached on 22 items distributed across three domains. There were 12, 4, and 6 items in the domains of tracheostomy-specific steps, team and personnel factors, and equipment respectively.
CONCLUSIONS
The resultant assessment tool can be used to assess both tracheostomy-specific steps as well as systems factors affecting hospital team response to simulated and clinical pediatric tracheostomy emergencies. The tool can also be used to guide debriefing discussions of both simulated and clinical emergencies, and to spur quality improvement initiatives.
LEVEL OF EVIDENCE
5 Laryngoscope, 133:3588-3601, 2023.
Topics: Humans; Child; Tracheostomy; Consensus; Emergencies; Delphi Technique; Computer Simulation
PubMed: 37114735
DOI: 10.1002/lary.30674 -
Bulletin of the World Health... Nov 2023
Topics: Humans; Public Health; Delphi Technique; Global Health
PubMed: 37961056
DOI: 10.2471/BLT.23.011123 -
Bulletin of the World Health... Dec 2023
Topics: Humans; Public Health; Delphi Technique; Global Health
PubMed: 38046368
DOI: 10.2471/BLT.23.011223 -
Bulletin of the World Health... Oct 2023
Topics: Humans; Public Health; Delphi Technique; Global Health
PubMed: 37780645
DOI: 10.2471/BLT.23.011023 -
Bulletin of the World Health... Jul 2023
Topics: Humans; Public Health; Delphi Technique; Global Health
PubMed: 37397172
DOI: 10.2471/BLT.23.010723 -
British Journal of Anaesthesia Oct 2023Consensus guidelines on the anaesthetic management of endoscopic retrograde cholangiopancreatography (ERCP) have recently been published. The rigorous synthesis of... (Review)
Review
Consensus guidelines on the anaesthetic management of endoscopic retrograde cholangiopancreatography (ERCP) have recently been published. The rigorous synthesis of expert opinion is invaluable when there are limited data, and these guidelines are a significant step forward. This review both guides practice and identifies important research questions. We challenge those working in this field to collaborate and produce the evidence for whether monitored anaesthesia care (MAC) is associated with a lower incidence of adverse events and better outcomes than general anaesthesia for ERCP.
Topics: Humans; Cholangiopancreatography, Endoscopic Retrograde; Delphi Technique; Anesthetics; Anesthesiology; Anesthesia, General
PubMed: 37718092
DOI: 10.1016/j.bja.2023.07.001