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Insight and Judgement

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163. Different knowledge, different styles of reasoning: a challenge for guideline development

. GRADE Evidence to Decision (EtD) Frameworks Guidance. Version 1.1 . 2015 . Verkerk K , Van Veenendaal H , Severens JL , et al . Considered judgement in evidence-based guideline development . Moreira T . Diversity in clinical guidelines: the role of repertoires of evaluation . Calderón C , Rotaeche R , Etxebarria A , et al . Gaining insight into the Clinical Practice Guideline development processes: qualitative study in a workshop to implement the GRADE proposal in Spain . Barnett-Page E , Thomas J (...) , we can be “usually” right (eg, 95% of the time)’ as long as events or cases are frequent enough. Frequency-based reasoning relies on basic assumptions that have some drawbacks. First, this line of reasoning assumes that reality is dice like and that we—eg, scientists guideline developers and healthcare professionals—are rolling the same dice (online ). Frequency-type reasoning presupposes adequate framing and defining of what is similar and what is not, which is always based on judgement

2018 Evidence-Based Medicine

164. Approaches to promote handwashing and sanitation behaviour change in low? and middle?income countries: a mixed method systematic review (Full text)

and sanitation behaviour change outcomes was relevant and timely. The objective of this systematic review is to identify promotional elements and those factors in the implementation process that influence behaviour change. This study objective is answered by a mixed‐methods systematic review: findings from quantitative studies that identify effective promotional approaches (quantitative arm) were enriched with insights from qualitative studies that explore factors that hinder or facilitate the implementation

2017 Campbell Collaboration PubMed abstract

167. Shared responsibility for health

choices, for example in relation to rising levels of overweight and obesity in the population and preventing or delaying the onset and progression of chronic diseases. Understanding that ‘the patient is the most important primary care provider’ (Sobel cited in ) is essential to accelerate progress in the direction we have argued for. This simple insight is a reminder that the decisions each of us makes has a profound influence on our health and wellbeing. Making a reality of this insight by supporting (...) on people accessing the support they needed to ‘make informed judgements about how to reduce their risk of ill health’. Wanless argued that there should be a new relationship between health professionals and the public ‘based on the twin planks of public and patient rights and responsibilities’. As we noted at the outset, the fully engaged scenario has not been realised and there are growing concerns about the ability of the NHS to respond to the needs of people with type 2 diabetes and other long-term

2018 The King's Fund

168. WHO recommendations: non-clinical interventions to reduce unnecessary caesarean sections

studies. Judgements about values, acceptability, equity, resource implications and feasibility of interventions were informed by three systematic reviews of 49 qualitative studies. The certainty of evidence on safety and effectiveness outcomes was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Confidence in the qualitative findings was assessed using Confidence in the Evidence from Reviews of Qualitative research (CERQual). The framework for Developing

2018 World Health Organisation Guidelines

169. What constitutes an effective and efficient package of services for the prevention, diagnosis, treatment and care of tuberculosis among refugees and migrants in the WHO European Region? Themed issues on migration and health

from persecution in his or her country of origin due to factors such as race, religion or politics (26,27). Refugee: an individual who has been granted asylum or has been successful in overturning a previous judgement that ruled against an asylum application (26,28). Political instability: A unified, whole-of-government approach to noncommunicable disease prevention is the best way to ensure sustained and stable funding, resources and public health and research priorities (4). Therefore, political (...) of an appropriate confidential space • limited funding • poor communication between services and laboratories • lack of coordination across services, and • time constraints. A number of facilitators to improving screening uptake in migrant communities have been identified: • well-trained and dedicated screening staff: • culturally sensitive and appropriate services • trust and respect for the judgement of staff • interviews conducted by a health care worker in a migrant's native language (47), and • language

2018 WHO Health Evidence Network

173. ECDC tool for the prioritisation of infectious disease threats

of their importance, ideally using additional quantitative analyses. A sensitivity analysis may be performed to assess the impact of the assumptions on the results [11]. The process itself may be lengthy and requires time and effort, but provides useful insights thanks to the discovered data and the input from the disease experts. Best practice recommendation: ? Ensure that the impact of the risk-ranking results is evaluated. ECDC tool for the prioritisation of infectious disease threats – Handbook and manual (...) , for example, a consideration of key emerging threats is incomplete without also considering societal and public health vulnerabilities, coping capacities, and social factors which could either mitigate or exacerbate the impacts of a given outbreak. Second, it must be stressed that soliciting expert judgement is best suited where there is incomplete scientific evidence. There are many uncertainties inherent to a risk ranking exercise, and the representativeness of all experts needs to be accounted

2017 European Centre for Disease Prevention and Control - Technical Guidance

176. Advancing Care - Research with care homes

and residents provided valuable insights into the needs and concerns of the people they care for. They described how people with dementia sometimes refuse to wear their glasses, and frequently break or lose them, or often end up wearing someone else’s glasses. The challenges around improving vision for people with dementia, therefore, aren’t only about access to sight tests and glasses, but also about understanding people’s choices and behaviour and the practical challenges that arise from living (...) . This is being tested in a multi-centre study reporting soon. reAd MOre (Study 33) Many researchers have noted the importance of context in care home research. indeed, there is a call for new approaches to applied research in this area. This includes recent thinking on the challenges around psychosocial interventions in dementia care (vernooij-dassen and Moniz-cook, 2014) and insights from other researchers working in and around care homes research (see researching Well, page 22).RESEARCHING WELL – A REAlITy

2017 Publication 4887694

177. Mental health care in the perinatal period: Australian clinical practice guideline

of that reproduction. Apart from any use as permitted under the Copyright Act 1968 and this notice, all other rights are expressly reserved. Inquiries Requests and inquiries concerning reproduction and rights should be sent to Communications Branch, Department of Health, GPO Box 9848, Canberra ACT 2601 or copyright@health.gov.au Disclaimer This is a general guide to appropriate practice, to be followed subject to the relevant clinician’s judgement in each individual case. COPE has taken all reasonable steps

2018 Clinical Practice Guidelines Portal

178. Near Infrared Spectroscopy for Detecting Brain Hematoma

. Unfortunately, studies of NIRS to date have almost exclusively focused on demonstrating the technical feasibility of the device and its diagnostic accuracy in series of patients who are referred for a CT scan. These studies therefore provide little insight on how use of NIRS impacts clinical decision-making, patient outcomes, and healthcare utilization. Moreover, it is unknown how NIRS performs in older nursing home patients with mild injury after falls because this type of use has not been studied. Only (...) of 7.7% in the text, but Figure 2 supports a lower rate of 3.96%. We contacted the authors for clarification, but they did not respond by the publication date of this report. Evidence Brief: Spectroscopy for Brain Hematoma Evidence-based Synthesis Program 5 suspicion for a hematoma is low to provide reassurance to patients and clinicians that a hematoma is not present and thereby prevent unnecessary ED visits and CTs. NIRS has not been intended to be used as a substitute for clinical judgement

2017 Veterans Affairs Evidence-based Synthesis Program Reports

179. Principles and guidance for interpretive external quality assessment schemes in laboratory medicine

wish to obtain RCPath approval for their schemes 16 Appendix: Background and purpose of interpretive EQA 17 The history of evaluating the quality of responses 18 History of the governance of interpretive EQA schemes 19 Prof 131017 3 V1 1 Scope of this guidance This guidance relates only to external quality assessment (EQA) schemes where the participant is an individual pathologist, not a whole department, and where the participant is expected to make a professional judgement about the meaning (...) or significance of the material circulated, rather than making a measurement. Compliance with this guidance is a requirement for any such scheme that wishes to obtain approval from the RCPath Interpretive EQA Steering Committee as a scheme suitable to provide input to medical appraisal and revalidation. Schemes currently exist which ask for professional judgement from a laboratory rather than from an identifiable individual; or where no attempt is made to feed back an objective report on personal performance

2017 Royal College of Pathologists

180. Guidelines for the investigation of chronic diarrhoea in adults

anthraquinones and rhubarb turn the stool red, bisacodyl turns it purple-blue), are not of sufficient sensitivity and should be abandoned. A screen for ‘laxative abuse’ should include the detection of anthraqui- nones, bisacodyl and phenolphthalein in urine and magnesium and phosphate in stool, and should be carried out in a specialist r ecommendations ? Faecal impaction with overflow diarrhoea should be considered especially in the elderly. We recommend clinical judgement rather than marker studies

2018 British Society of Gastroenterology

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