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Insight and Judgement

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42. Diagnosis and management of epilepsy in adults

to guideline recommendations will not ensure a successful outcome in every case, nor should they be construed as including all proper methods of care or excluding other acceptable methods of care aimed at the same results. The ultimate judgement must be made by the appropriate healthcare professional(s) responsible for clinical decisions regarding a particular clinical procedure or treatment plan. This judgement should only be arrived at following discussion of the options with the patient, covering

2018 SIGN

43. Bariatric surgery: an HTA report on the efficacy, safety and cost-effectiveness

/fluid content etc.) nor does it provide insight in the type of obesity (adiposity) and the underlying fat distribution (e.g. visceral or abdominal adiposity which encompasses a higher health risk than general or gynoid adiposity which implies a lesser risk).The BMI is a suitable measure to screen for obesity at the population level (for Western countries) since it is easy to measure and does not show clinical meaningful differences in the prediction of adverse outcomes compared to other measures. 7

2019 Belgian Health Care Knowledge Centre

45. Stepping Stones for Families’ Family Wellbeing Service: evaluation

of the Service hang together as a whole – they each have their impact and importance, and the Service would be weaker without any one of them. Furthermore, as much as the practical elements within it, the qualities of the Service generate its added value. The ability of the Service to make a long-term commitment to parents to act with their interests at heart, to treat them as being of value, and to provide skilled, calm and committed staff to work with them in a friendly, welcoming, and non-judgemental way (...) on the issues faced by parents with which the Service engages and or/ which set the context in which it works, in particular: ? Social isolation and lack of confidence. ? Parental wellbeing. ? Child wellbeing. ? The impact of deprivation and poverty. ? The specific issues facing migrant/ refugee/ asylum seeker families. This section also provides some insight into the reasons why parents might not engage with the Service (research question 5). Social isolation and lack of confidence Almost all

2019 Glasgow Centre for Population Health

46. Diagnosis of chronic thromboembolic pulmonary hypertension: A Canadian Thoracic Society clinical practice guideline update

and mortality ofCTEPH,and issues of risk,burden on a patient to adhere, and cost effectiveness of an intervention or treatment (implementability factors categorized under the “Contextualizations and Deliberations” domain of guidelines 12 ). These discussions and the resulting synthesis of evidence and summary clinical judgement are presented for each recommendation. Figure 1. PRISMA Diagram. 10 Footnote: The Canadian Thoracic Society chronic thromboembolic pulmonary hypertension (CTS CTEPH) guideline panel

2019 Canadian Thoracic Society

47. Coexisting severe mental illness and substance misuse: community health and social care services

responsibility our responsibility The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make (...) 1.6). 1.6 Maintaining contact between services and people with coexisting severe mental illness and substance misuse who use them 1.6.1 Recognise that even though building a relationship with the person and seeing even small improvements may take a long time, it is worth persevering. It involves: showing empathy and using a non-judgemental approach to listen, identify and be responsive to the person's needs and goals providing consistent services, for example, if possible keeping the same staff

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

48. Community engagement: improving health and wellbeing and reducing health inequalities

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances (...) to help identify their needs and tackle the root causes. This support comes from statutory organisations. Community-based participatory research – to provide collaborations and partnerships with background knowledge and insights into the nature of the community they are working with. Area-based initiatives – to work with local communities to improve local health and education and support urban regeneration and development to tackle social or economic disadvantage. Co-production methods – to ensure

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

49. The Foyer model for homeless youth: a systematic mapping review

of this, no judgements about the effectiveness of the model can be drawn from the present systematic mapping review. Further research on the Foyer model seems warranted. 13 5BPreface Preface The Housing Directorate in Norway (Husbanken) commissioned the unit for social wel- fare research in the Norwegian Institute of Public Health to map out all existing re- search on the Foyer model for young people who are homeless or at-risk of becoming homeless in the transition to independent living and adulthood

2018 Norwegian Institute of Public Health

50. Tools to aid the clinical identification of end of life

outside a setting in which a comprehensive range of these measures is readily available. 6 TOOLS TO AID CLINICAL IDENTIFICATION OF END OF LIFE | SAX INSTITUTE • Does the tool require subjective clinical judgement? Some tools use clinical judgement, such as the ‘surprise question’. Other tools use only objective measures. • Can the tool be implemented without a computer to undertake calculations? Several of the tools require the application of an algorithm that calculates a risk score based on various (...) ? This issue was not specifically identified in the literature. However, the review did reveal the range of tools available for specific cohorts of patients. • In what settings will the implementation of relevant tools have the greatest impact? Would it be best to advocate implementation of a single preferred tool in these settings? The literature reviewed did not provide clear insights into these two questions. However, the settings in which tools have been implemented were analysed to provide information

2018 Sax Institute Evidence Check

51. Specialist dementia care units

by the SDCU (i.e. dementia with extreme or very severe BPSD). Applicability is an assessment of the extent to which the evidence is relevant to the Australian system of health and aged care. 17 Clinical impact is an assessment of the likely benefit of applying the evidence to the target population and is based on a judgement that is necessarily quite subjective. 17 Given the nature of this Evidence Check, impact is potentially broader than just clinical impact, involving consideration of the impact (...) and discharge • Appendix E: Organisational characteristics. Appendix C provides additional information to facilitate judgements about generalisability and applicability. No papers were excluded based on the quality of what was reported. The review includes studies published between 2005 and 2017. The number of participants in individual studies varied from 16 to 6299. No studies identified a particular special needs group. 4.2 Patient flow — admission criteria, occupancy, lengths of stay and discharge

2018 Sax Institute Evidence Check

52. Use of licensed medicines for unlicensed applications in psychiatric practice (2nd edition)

) with greater experience or expertise if the medicine to be used does not have an extensive evidence base to support its use for the proposed indication, or if you have particular concerns, or if you feel insufficiently expert in this field. Consider the anticipated risks and benefits of treatment, giving particular thought in vulnerable groups such as children and adolescents, women of child-bearing age, elderly patients, physically ill patients, and patients with impaired insight and judgement

2018 Royal College of Psychiatrists

54. New and emerging technologies in neurophysiology and operating theatres

as emerging techniques are adopted. Novel methods of nerve conduction assessment, measuring muscle responses to nerve stimulation and vestibular system tests are all likely to be widely adopted within the next 10 years. This will improve assessment of certain conditions and also facilitate new insights, particularly in relation to lesser understood conditions. In operating theatres, advances in technologies are likely to improve and/or automate the way in which patients are monitored, and anaesthetics (...) the technologies and the specialised workforce skills required for the safe and efficient use of these technologies in practice. This rapid review seeks to highlight technological and procedural issues related to these workforces and provide insight into supply and demand drivers that may influence these workforces in future. 12 TECHNOLOGY IN NEUROPHYSIOLOGY AND OPERATING THEATRES | SAX INSTITUTE Methods Peer reviewed literature Various distinct searches of the PubMed database were conducted in August 2017

2018 Sax Institute Evidence Check

55. Management of Irritable Bowel Syndrome (IBS)

-abstract/doi/10.1093/jcag/gwy071/5290372 by guest on 22 January 2019Therefore, the consensus group concluded that routine colo - noscopy is generally not warranted in IBS patients <50 years of age, and alarm symptoms do not appear to increase the risk of CRC sufficiently to warrant routine colonoscopy. However, clinical judgement is important, and colonoscopy and flexible sigmoidoscopy would continue to play a role to investigate specific indications such as a high clinical suspicion of IBD

2019 Canadian Association of Gastroenterology

56. International evidence-based guideline for the assessment and management of polycystic ovary syndrome (PCOS)

-analysis where appropriate. Recommendations were formulated using the considered judgement process in the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework [15] across the quality of available evidence, integrating clinical expertise and consumer preference, and considering the applicability, feasibility, equity, cost effectiveness, implementation and value for consumers and health professionals through the GRADE framework. Implementation issues and international (...) development group. CPP Clinical Practice Points: Evidence not sought. A practice point has been made by the guideline development group where important issues arose from discussion of evidence-based or clinical consensus recommendations. The recommendation terms include “should”, “could” and “should not”. These terms are informed by the nature of the recommendation (evidence or consensus), the GRADE framework and evidence quality and are independent descriptors reflecting the judgement

2018 European Society of Human Reproduction and Embryology

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