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41. Anabolic Therapies for Osteoporosis in Postmenopausal Women: Effectiveness and Value

of independence (42%) and lost mobility (25%) as their top two concerns. 16 The primary concern among caregivers of patients with osteoporosis was that they would not be able to manage the care of their loved one (50%). Other notable findings included 60% of patients who had sustained a fracture reported not being referred for a bone density test, and fewer than half (47%) were prescribed a medication for osteoporosis. Among those prescribed a medication, 38% said that they never took it, primarily because

2017 California Technology Assessment Forum

42. Screening for Hepatitis C Virus: A Systematic Review

of screening for hepatitis C virus (HCV) infection in asymptomatic, non-pregnant, treatment-naive adults; and (2) to assess the published research evidence on the ability of available antibody (Ab) and antigen (Ag) screening tests to identify people in the general population with chronic HCV infection. Methods Literature Search Strategy The literature search was performed by an information specialist using a peer-reviewed search strategy according to the PRESS checklist. Published literature was identified (...) ) who represented a cross-section of the general population. For the question on the clinical validity of screening with Ab and Ag tests to identify people with chronic HCV infection, screening tests of interest included Ab tests (e.g., enzyme-linked immunoassay [ELISA], chemiluminescent immunoassays [CLIA], chemiluminescent microparticle immunoassays [CMIA], microparticle enzyme immunoassays [MEIA]), and Ag tests (alone or combination Ab and Ag assays). The diagnostic test for active HCV infection

2017 CADTH - Health Technology Assessment

43. Implementing tools to support evidence-based practice: a survey and brief intervention study of the National Elf Service across Oxford Health NHS Foundation Trust

at any time. To learn more about how we use cookies, please see our . Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Implementing tools to support evidence-based practice: a survey (...) , presentations were delivered by the same person for each team, this being the director of the NES, André Tomlin. Procedure Prior to the intervention, mental health professionals from the AMHTs and EIS were asked to complete the baseline survey. The baseline survey was distributed in team business meetings, which all members of staff are required to attend and therefore it was hoped a large number of staff would be reached. The NES intervention was systematically rolled out across the selected teams

2018 Evidence-Based Mental Health

44. Pacing as a Treatment for Reflex-Mediated (Vasovagal, Situational, or Carotid Sinus Hypersensitivity) Syncope: A Systematic Review for the 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American Coll

of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 March 2019 March 2019 March 2019 March 2019 February 2019 February 2019 February 2019 February 2019 January 2019 January 2019 January 2019 January 2019 January 2019 This site uses cookies. By continuing to browse this site you are agreeing to our use of cookies. Free (...) ). The reasons for implantation were recurrence of syncope, alone or in association with minor symptoms (n=15), or frequent recurrence of distressing severe or mild dizziness (n=4). Claesson JE, 2007 Syncope type: CSS Aim: To examine the effect on symptoms in pts with induced cardioinhibitory CSS when treated with pacemaker or without this treatment. Study type: RCT Size: Randomized (n=60) Inclusion criteria: Pts were included if they had a positive carotid sinus stimulation test at enrollment and at least 1

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2017 American Heart Association

45. Screening for Atrial Fibrillation: 2017 European Heart Rhythm Association (EHRA) Consensus Document

-specific modi- fiers, comorbidities, and issues of patient preference that might influ- ence the choice of particular tests or therapies were considered, as were frequency of follow-up and cost effectiveness. In controversial areas, or with regard to issues without evidence other than usual clin- ical practice, a consensus (with at least 85% agreement) was achieved by agreement of the expert panel. This document was prepared by the Task Force with representation from EHRA, Heart Rhythm Society (HRS (...) of stroke (because of the asymp- tomatic nature of AF) might thus even be more effective than what might be expected. Epidemiologicalconsiderations Effectiveness of screening depends on the target population, the test’s diagnostic accuracy, and cost-effectiveness. 31,32 Prevalence and incidence vary by baseline characteristics. It is thus of crucial import- ance to target the most at risk population to increase the screening efficiency. Two different strategies could theoretically be proposed: screening

2017 Heart Rhythm Society

46. Benign Paroxysmal Positional Vertigo (BPPV)

and neck extended 20° with the affected ear down, and (2) treat, or refer to a clinician who can treat, patients with posterior canal BPPV with a canalith repositioning procedure. The update group made a strong recommendation against postprocedural postural restrictions after canalith repositioning procedure for posterior canal BPPV. The update group made recommendations that the clinician should (1) perform, or refer to a clinician who can perform, a supine roll test to assess for lateral semicircular (...) : View or download all content the institution has subscribed to. Society If you have access to journal via a society or associations, read the instructions below Members of _ can log in with their society credentials below Username (required) Password (required) Society (required) Access to society journal content varies across our titles. If you have access to a journal via a society or association membership, please browse to your society journal, select an article to view, and follow

2017 American Academy of Otolaryngology - Head and Neck Surgery

47. Formative assessment and design of a complex clinical decision support tool for pulmonary embolism

support tool for pulmonary embolism Sundas Khan , Lauren McCullagh , Anne Press , Manish Kharche , Andy Schachter , Salvatore Pardo , Thomas McGinn Statistics from Extract Electronic health record (EHR)-based clinical decision support (CDS) tools are rolled out with the urgency to meet federal requirements without time for usability testing and refinement of the user interface. As part of a larger project to design, develop and integrate a pulmonary embolism CDS tool for emergency (...) Formative assessment and design of a complex clinical decision support tool for pulmonary embolism Formative assessment and design of a complex clinical decision support tool for pulmonary embolism | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your username and password For personal

2016 Evidence-Based Medicine (Requires free registration)

48. Recommended Dietary Pattern to Achieve Adherence to the American Heart Association/American College of Cardiology (AHA/ACC) Guidelines: A Scientific Statement From the American Heart Association

Recommended Dietary Pattern to Achieve Adherence to the American Heart Association/American College of Cardiology (AHA/ACC) Guidelines: A Scientific Statement From the American Heart Association Recommended Dietary Pattern to Achieve Adherence to the American Heart Association/American College of Cardiology (AHA/ACC) Guidelines: A Scientific Statement From the American Heart Association | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search October 2019 (...) -Style Dietary Patterns: Specific and Well-Documented Across Age, Sex, and Ethnically Diverse Groups The DASH dietary pattern was developed as part of a study to test the effects of modifying the whole diet on BP. The DASH dietary pattern emphasizes fruits, vegetables, and low-fat dairy products; includes whole grains, poultry, fish, and nuts; and is reduced in SFAs, red meat, sweets, and beverages containing added sugars. This dietary pattern is broadly effective in lowering BP and is particularly

2016 American Heart Association

49. Diagnosis, Staging and Treatment of Patients with Prostate Cancer

cancer The diagnosis, staging and treatment of patients with prostate cancer requires multidisciplinary care in an acute hospital setting. The majority of patients will require diagnostic tests (radiology, pathology) and depending on the treatment plan may require surgery, chemotherapy and radiation therapy. A proportion of patients may also require palliative care. A recent population-based cost analysis (Luengo-Fernandez et al., 2013) illustrated the economic burden of cancer on the European Union (...) to the guideline recommendations’. 1.7 Patient advocacy A collaborative approach is used in the development of the NCCP patient information, clinical guidelines and other national projects. All NCCP booklets are submitted to the National Adult Literacy Agency (NALA) ( for the Plain English Award. This is to ensure comprehension and readability are in line with health literacy best practice standards. Service user testing is a key part of the process, and includes liaising with the HSE Patient Forum

2016 National Clinical Guidelines (Ireland)

50. Adjunctive colposcopy technologies for assessing suspected cervical abnormalities: the DYSIS colposcope with DYSISmap and the ZedScan I

screening through the NHSCSP . In HPV primary screening, the sample is tested for high-risk HPV first. If the results are positive, a cytology test is routinely done on the residual sample. People with either low- or high-grade abnormalities are referred for colposcopy. Those whose cytology results are negative are asked to come back in 12 months. HPV primary screening has now been adopted as the standard of care in several sites in England where it was piloted. Full roll out of this pathway is expected (...) 1 Recommendations 4 2 Clinical need and practice 5 The problem addressed 5 The condition 6 The diagnostic and care pathways 6 3 The diagnostic tests 9 The interventions 9 The comparator 11 4 Evidence 12 Diagnostic accuracy 12 Clinical effectiveness 20 Implementation 20 Cost effectiveness 22 5 Committee discussion 32 Current practice 32 Diagnostic accuracy and clinical effectiveness 32 Cost effectiveness 35 Research considerations 38 6 Recommendations for further research 41 7 Implementation 42 8

2018 National Institute for Health and Clinical Excellence - Diagnostics Guidance

51. Obesity: working with local communities

be helpful. The local coordinator and public health teams should ensure the results of all monitoring and evaluation are made available to all those who can use them to inform their work, both in the local community and nationally. For example, log evaluation reports in the Obesity Learning Centre or healthy places databases, or the NICE shared learning database. The local coordinator and communications leads should ensure information from monitoring and evaluation is accessible and easy to use (...) that the impact on inequalities can be considered. All of the above should use simple tests to assess value for money (such as resources saved by working in partnership). All of the above should encourage a reflective

2012 National Institute for Health and Clinical Excellence - Clinical Guidelines

52. Pulmonary Rehabilitation for Postacute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): A Cost-Effectiveness and Budget Impact Analysis

is rather low, the relatively wide 95% prediction interval (0.11, 1.21) of IRR (in comparison to the 95% CI) and the heterogeneity test results (I 2 = 40%) reflect the inconsistency of effects across studies. Pulmonary Rehabilitation for Postacute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): A Cost-Effectiveness and Budget Impact Analysis. February 2015; pp. 1-47 20 Figure 2: Effect of PR on Reduction of Rehospitalization Rate Abbreviations: CI, confidence interval; IRR, incidence rate (...) details of the parameter inputs for the PSA are available on request. Pulmonary Rehabilitation for Postacute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): A Cost-Effectiveness and Budget Impact Analysis. February 2015; pp. 1-47 21 Table 4: Distributions of Parameters Parameter Distribution Unit cost of professional time Uniform Effectiveness of PR program, incidence rate ratio of PR vs. usual care Log normal Cost of hospitalization for acute exacerbation Gamma Rehospitalization rate

2015 Health Quality Ontario

53. Self-management of psychological distress for people with cancer

sample size, however, 10 of the 12 participants logged in weekly. Positive feedback for the program was provided by 11 participants. Another Australian online program was the recently published My Road Ahead (MRA) website (, developed for and tested on men with prostate cancer. 28 The 142 participants were randomised to one of three groups: The MRA website, an online moderated forum, or MRA plus the forum. MRA consisted of online cognitive behavioural therapy, providing psycho (...) and anxious preoccupation) At three months, the intervention group had lower levels of traumatic stress, helplessness/hopelessness, cognitive avoidance than control group. Intervention was more effective for women with higher levels of distress. However intervention group had poorer body image than control which was still significant at six months Beatty 2011 27 Australia 12 adults receiving or recently completed curative treatment for breast, gynaecological, lymphoma or bowel cancer Pre-test/post-test

2015 Sax Institute Evidence Check

54. A guide to understanding the implications of the Ionising Radiation (Medical Exposure) Regulations in diagnostic and interventional radiology

and provides a framework intended to protect individuals from the hazards associated with medical exposures involving ionising radiation. Breaches of IR(ME)R can result in civil or criminal proceedings, including the serving of Improvement or Prohibition notices (civil action). If the notice is not complied with, this may proceed to prosecution (a criminal activity). To date, IR(ME)R compliance has not been tested in the courts. As a definitive interpretation of the law can only be established (...) the referrer provides the required information for the practitioner to justify the procedure ? Providing a record of all requested procedures which can assist the audit process. These systems rely on a user log-in to identify the referrer rather than a signature. RCR guidance suggests the trust’s procedures should ensure it is a disciplinary offence to request a procedure using someone else’s log-in, just as it is to request a procedure on a pre-signed request card.’ 18 Users should receive appropriate

2015 Royal College of Radiologists

55. Orthotics and prosthetics workforce planning

Health Professions Australia AIHW Australian Institute of Health and Welfare ALS Artificial Limb Service AOPA Australian Orthotic Prosthetic Association Ltd CAD Computer-aided design CASP Critical Appraisal Skills Programme CNC Computer Numerical Controlled CPD Continuing Professional Development DVA Department of Veterans Affairs HARP Hospital Admission Risk Program HECS Higher Education Contribution Scheme HRF High risk foot HRFS High risk foot services IELTS International English Language Testing (...) practice for certain patient groups resulting in OPs having to retain a diverse skill set. • Diabetic foot (a High Risk Foot disorder) is a leading cause of non-traumatic lower extremity amputation. The evidence indicates prevalence of diabetes in Australia is rising, which will lead to a commensurate increase in demand for services provided by High Risk Foot (HRF) clinics. • The National Disability Insurance Scheme (NDIS), being rolled out across NSW in 2018, will provide more access to orthotic

2015 Sax Institute Evidence Check

56. Sleep problems in dementia: a promising treatment?

if an intervention is feasible and acceptable before testing whether it actually works, because there is no point in further investigating and rolling out a treatment that people won’t engage with in real life. The authors concluded that DREAMS-START was both feasible and acceptable , and it would therefore be worth investing in a larger trial to see if it was effective. We cannot say anything meaningful about whether an intervention works in a clinical trial if every therapist does it differently, so the high (...) , and being awake at night then tends to make them sleepy during the day (Zhao et al., 2016). This sleep disruption can cause a lot of stress for their carers (Kyle, Espie & Morgan, 2010). Available treatments for this problem do not appear to be very effective. The current study tests a new intervention called DREAMS-START (Dementia RElAted Manual for Sleep; STrAtegies for RelaTives), which is delivered to carers over six sessions to help them cope with and improve sleep problems. The researchers wanted

2019 The Mental Elf

57. FDA Recalls More Generic Blood Pressure Meds: Where Are Your Medications Manufactured?

of any Irbesartan, Losartan, and Valsartan unless the manufacturer has certified that it has tested all of its lots for these three chemicals. Rolling recalls are not helpful. BAN THIS GARBAGE. Because it is about the money, NOTHING WILL CHANGE unless consumers ASK THEIR PHARMACIST to see the manufacturer’s label and where the drug was made (NOT where the distributor is based). Solco/Prinston is the US distributor for the Chinese company ZHP. Nice cover, but consumers must educate themselves (...) is recalling lots of valsartan-containing medication that tested positive for NDEA above the interim level of 0.083 parts per million. The agency continues to investigate and test all angiotensin II receptor blockers (ARBs) for the presence of NDEA and N-Nitrosodimethylamine (NDMA) and is taking swift action when it identifies these impurities that are above interim acceptable daily intake levels. FDA also updated the and the . FDA reminds patients taking any recalled ARB to continue taking their current

2019 The Skeptical Cardiologist

58. Pulling back the curtain on ‘The Doctors’ and ‘The Dr. Oz Show:’ What our analysis revealed

of the suggested treatments were often overlooked. And, the hosts on the show frequently hawked products made by companies that advertise on the show. How we collected information My colleague Dr. Jeffrey Weinfeld, medical librarian Michele Malloy, and I enlisted a group of medical students to tape and view all episodes of “The Doctors” and “The Dr. Oz Show” airing during a full month. Our students logged all the health recommendations made on the shows, and noted whether harms or costs were discussed (...) . A scene from “The Doctors” TV show. Our results lent further support to the general feeling among many scientists and clinicians of the shows’ sub-par level of evidence and low quality of information. Many of the studies we identified as potentially providing support for the claims made on the shows were problematic–with only a few people enrolled, or they were animal-based, or “test tube” studies. If these sources we found are indeed the sources of information used for the shows, then it appears

2018 HealthNewsReview

59. Stephen Colbert sells out to Gwyneth Paltrow and Goop

brand, and her In Goop Health summit. It starts with a softball question of why she started her Goop lifestyle brand, in which she basically brags how she started the brand out of curiosity and wondering whether she could “get answers” and actually launch a company and now has 150 people working for her. The next softball is a the question, “What do you say to people who roll their eyes at a catalog where you can buy an island in Belize?” My reaction was: WTF? The Goop catalog features an island you (...) understand that- like the guy described above- it’s much easier to dispense knowledge rather than to await reception of it and actively absorb it but that’s reality. None of us know very much in the scheme of things in the universe BUT we can learn more if we are honest about our own level of expertise in designated areas. For example, I suppose that I might be expert in certain areas in psychology and the arts BECAUSE I studied them formally and have been tested many, many times, pursuing degrees

2018 Respectful Insolence

60. Budesonide (Jorveza) - to treat adults with eosinophilic oesophagitis

- complete and independent application. The application submitted is composed of administrative information, complete quality data, non-clinical and clinical data based on applicants’ own tests and studies and/or bibliographic literature substituting/supporting certain test(s) or study(ies). Information on Paediatric requirements Not applicable Information relating to orphan market exclusivity Similarity Pursuant to Article 8 of Regulation (EC) No. 141/2000 and Article 3 of Commission Regulation (EC (...) . The Applicant provided furthermore one study investigating potential pharmacokinetic drug-drug interactions via the P-gp (MDR-1), BCRP (ABCG2), OATP1B1, OATP1B3 transporters (BUB-5/DM0104). Budesonide´s influence on P-gp and BCRP was tested with adequate marker substances to a budesonide concentration up to 100 µM. The influence on OATP1B1 and OATP1B3 was tested up to 300 nM budesonide. At the highest concentration tested, budesonide inhibited P-gp and BCRP to 92.7 and 62.5%. The calculated IC 50 values

2018 European Medicines Agency - EPARs

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