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101.
Franssen MT Korevaar JC van der Veen F Boer K Leschot NJ Goddijn M 《Human reproduction (Oxford, England)》2007,22(5):1298-1303
BACKGROUND: Little is known on the actual diagnostic and therapeutic management of recurrent miscarriage and the impact of introducing guidelines on this topic. The objective of this study was to evaluate any changes in the management of recurrent miscarriage among Dutch gynaecologists after the introduction of the Dutch guideline 'Recurrent Miscarriage' in 1999. METHODS: Questionnaires were sent to all practices for obstetrics and gynaecology in the Netherlands. Data concerned definition, diagnosis and treatment of recurrent miscarriage. Results were compared with a similar study conducted before the introduction of the guideline and with the recommendations in the guideline. RESULTS: The response rate was 83%. Regarding gestational age, only 3% of the respondents used the definition as advised in the guideline. After the introduction of the guideline, thrombophilia factors were tested more frequently, anticoagulants were prescribed more frequently and more respondents reported to correct uterine malformations. Therapies not described in the guideline, e.g. donor insemination and oocyte donation, were still applied. CONCLUSIONS: The adherence to the Dutch guideline 'Recurrent Miscarriage' was rather poor, presumably due to guideline-related as well as physician-related barriers. Too many diagnostic tests and ineffective therapeutic interventions were performed. This study demonstrates the importance of appropriate implementation and revision. 相似文献
102.
Ketsia Yekpe Bernard Bataille Ryan Gosselin Tahmer Sharkawi Jean-Sébastien Simard 《Pharmaceutical development and technology》2018,23(6):646-654
AbstractThis study applied the concept of Quality by Design (QbD) to tablet dissolution. Its goal was to propose a quality control strategy to model dissolution testing of solid oral dose products according to International Conference on Harmonization guidelines. The methodology involved the following three steps: (1) a risk analysis to identify the material- and process-related parameters impacting the critical quality attributes of dissolution testing, (2) an experimental design to evaluate the influence of design factors (attributes and parameters selected by risk analysis) on dissolution testing, and (3) an investigation of the relationship between design factors and dissolution profiles. Results show that (a) in the case studied, the two parameters impacting dissolution kinetics are active pharmaceutical ingredient particle size distributions and tablet hardness and (b) these two parameters could be monitored with PAT tools to predict dissolution profiles. Moreover, based on the results obtained, modeling dissolution is possible. The practicality and effectiveness of the QbD approach were demonstrated through this industrial case study. Implementing such an approach systematically in industrial pharmaceutical production would reduce the need for tablet dissolution testing. 相似文献
103.
2型糖尿病(T2DM)是一种常见的慢性代谢性疾病。近年来,随着国内外相关指南的不断更新,T2DM患者的身体活动建议日趋完善,但在日常活动过程中仍有难点有待解决。2022年2月,美国运动医学会(ACSM)和美国糖尿病协会(ADA)在2010年《运动和2型糖尿病》的基础上进行了更新,针对不同年龄段T2DM患者的身体活动、最佳活动时机、医疗干预与身体活动的有效性、身体活动和饮食注意事项等方面提供了新的临床指导建议。本文对2022年指南的主要内容及重点更新内容进行解读,并提出对我国临床工作者开展T2DM患者运动/身体活动干预的建议。 相似文献
104.
国外制定循证临床实践指南的进展 总被引:4,自引:1,他引:4
邓可刚 《中国循证医学杂志》2005,5(4):335-339
在查阅制定循证临床实践指南相关文献的基础上,介绍了评价循证临床实践指南质量的关键内容,包括制定和报道指南的程序. 相似文献
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The explosion of scientific evidence has outstripped the ability of individual clinicians to acquire, process, and apply it within a clinical context. Clinical practice guidelines bridge the gap between this large body of evidence and clinical practice by translating evidence into recommendations. As such, they are an important extension of the evidence‐based medicine paradigm. Guidelines promise to translate evidence into actionable clinical recommendations. However, this promise can only be realized if they are both useful and trustworthy. As the number of guidelines increases users’ question their role, the quality of the scientific evidence behind them and the strength of the recommendations made. In this article, we provide definitions and outline the features of the common forms of clinical guidance. We then describe the essential characteristics of good quality clinical guidance and outline initiatives aimed at improving quality. Specific issues and limitations related to guideline development in perioperative care of children are discussed. Finally, two clinical guidance documents, published recently in Pediatric Anesthesia, are discussed based upon these criteria. 相似文献
108.
Eric Chung Michael Gillman John Tuckey Shane La Bianca Chris Love 《BJU international》2020,126(Z1):12-17
109.
Vincent Wu Christopher W. Noel David Forner Zhi‐Jian Zhang Kevin M. Higgins Danny J. Enepekides John M. Lee Ian J. Witterick John J. Kim John N. Waldron Jonathan C. Irish Qing‐Quan Hua Antoine Eskander 《Head & neck》2020,42(6):1202-1208
The practices of head and neck surgical oncologists must evolve to meet the unprecedented needs placed on our health care system by the Coronavirus disease 2019 (COVID‐19) pandemic. Guidelines are emerging to help guide the provision of head and neck cancer care, though in practice, it can be challenging to operationalize such recommendations. Head and neck surgeons at Wuhan University faced significant challenges in providing care for their patients. Similar challenges were faced by the University of Toronto during the severe acute respiratory syndrome (SARS) pandemic in 2003. Herein, we outline our combined experience and key practical considerations for maintaining an oncology service in the midst of a pandemic. 相似文献
110.
Yelda Jozaghi Mark E. Zafereo Nancy D. Perrier Jennifer R. Wang Elizabeth Grubbs Neil D. Gross Sarah Fisher Erich M. Sturgis Ryan P. Goepfert Stephen Y. Lai Conor Best Naifa L. Busaidy Maria E. Cabanillas Ramona Dadu Robert F. Gagel Mouhammed A. Habra Mimi I. Hu Camilo Jimenez Steven I. Sherman Sonali Thosani Jeena Varghese Steven G. Waguespack Steven Weitzman Anita K. Ying Paul H. Graham 《Head & neck》2020,42(6):1325-1328