Clinical Practice Guidelines We Can Trust


Book Description

Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.




Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies


Book Description

This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.




Finding What Works in Health Care


Book Description

Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.




Comprehensive Review in Clinical Neurology


Book Description

This new review textbook, written by residents and an experienced faculty member from Cleveland Clinic, is designed to ensure success on all sorts of standardized neurology examinations. Presented in a comprehensive question-and-answer format, with detailed rationales, Comprehensive Review in Clinical Neurology is a must-have for both aspiring and practicing neurologists and psychiatrists preparation to take the RITE, the American Board of Psychiatry and Neurology written exams, and various recertification exams.




Clinical Review of Oral and Maxillofacial Surgery


Book Description

Organized around real patient scenarios, Clinical Review of Oral and Maxillofacial Surgery: A Case-based Approach, 2nd Edition, covers all the material you need to know for the board, in-service, and certification exams, while also preparing you to handle common patient situations in professional practice. Over 100 teaching cases are brought to life with an overview of the most common clinical presentations, physical examination findings, diagnostic tools, complications, treatments, and discussions of possible issues. This text covers the full scope of modern oral and maxillofacial surgery, while helping you focus on the conditions and disorders which are the most common, or have significant implications for modern clinical practice. "I would most definitely recommend this book." Reviewed by: N.Galligan, British Dental Journal Date: Jan 2015 Case-based approach incorporates teaching around real patient scenarios to actively engage and raise your interest and retention of the information. 103 cases, many of which are new, represent the full scope of modern oral and maxillofacial surgery practice to encompass the most common and significant implications for modern clinical practice, including content emphasized on OMS boards and training exams. Detailed illustrations including one or more radiographs, full-color clinical photographs, or drawings for the majority of cases provide a visual guide to conditions, techniques, diagnoses, and key concepts that will further enhance your understanding and retention of all content. Content that's perfect for all levels of study or practice covers both concepts and techniques that residents and pre-doctoral students can apply in the clinical setting, and the preparation tools necessary for oral and maxillofacial surgery boards and training/certification examinations. NEW! Full-color illustrations and photos give you a better pictures of common surgical techniques and pathology. NEW! Chapter 6: Dental Implant Surgery discusses the contemporary issues related to dental implants - specifically the routine placement of maxillary and mandibular implants, sinus augmentation, zygoma implants, treatment of edentulism, guided implant surgery, extraction socket preservation, and implantology for the esthetic zone. NEW! Section on cone beam computed tomography (CBCT) highlights the role of imaging from diagnosis to image guidance for many surgical procedures. NEW! Section on the advantages of computer assisted surgery highlights virtual surgical planning for a patient who presents for combined surgical and orthodontic correction of his facial asymmetry and apertognathia. NEW! Section on trigeminal neuralgia (TN) walks you through the diagnosis and possible treatments for a patient suffering from trigeminal neuralgia, the signs and symptoms that uniquely define the disorder, and the clinician's ability to recognize the specific diagnostic pattern. NEW! Section on neck dissection, an important aspect of head and neck cancer treatment, provides a case that involves a patient in which right selective neck dissection (I-III) was conducted on the right neck and a selective left neck dissection (I-V) was completed on the left side. NEW! Section on dentoalveolar trauma presents a new case that takes you through diagnosing and treating a patient who presents with anterior maxillary alveolar segment fractures involving teeth #7-9, with lateral luxation and Ellis class III fracture tooth of #9, and an intraoral laceration of the upper lip. NEW! Section on nasal septoplasty addresses a patient with a severely deviated nasal septum to the left, involving the quadrangular cartilage and the bony septum and how septoplasty can make a dramatic change in the patient's quality of life, by facilitating nasal airflow, allowing for better spontaneous drainage of the paranasal sinuses, possibly reducing mouth breathing, and reducing or eliminating the symptoms of snoring, and perhaps lessening the severity of the obstructive sleep apnea syndrome.




Surgery


Book Description

Surgery: A Case Based Clinical Review has proven to be the premiere resource to help prepare medical students for the surgical shelf exam and clinical wards. The second edition was conceived after listening to the feedback we received from students. We have added several new chapters and updated the others. This book continues to provide the reader with a comprehensive understanding of surgical diseases in one easy-to-use reference that combines multiple teaching formats. The book begins using a case based approach. The cases presented cover the diseases most commonly encountered on a surgical rotation. The cases are followed by a series of short questions and answers, designed to provide further understanding of the important aspects of the history, physical examination, differential diagnosis, diagnostic work-up and management, and questions that may arise on surgical rounds and on the shelf exam. The book is written in an easy-to-understand manner to help reinforce important surgical exam concepts. The second edition of Surgery: A Case Based Clinical Review will be of great utility for medical students when they rotate on surgery, as well as interns, physician assistant students, nursing students, and nurse practitioner students.




The Clinical Erik Erikson


Book Description

The twentieth century has been described as the time of man’s discovery of himself; few have contributed more to this cause than Erik Erikson. The Clinical Erik Erikson: A psychoanalytic method of engagement and activation highlights Erikson’s transforming contributions to the field of psychoanalysis and honors his legacy by providing unpublished clinical case illustrations of his psychotherapeutic work. The publication of case material—simple memorable fragments and clinical vignettes— brings the reader into Erikson’s consultation room, providing a portrait of his clinical technique and demonstrating how he actually worked. Stephen Schlein, an authority on Erikson, presents an illuminating account of Erikson’s pioneering work through an exhaustive search of his early monographs on child psychoanalysis, clinical writings, psychotherapeutic case studies, and participation at case conferences at The Austen Riggs Center. Erikson’s writings reveal a psychoanalytic method of extraordinary richness that emphasizes essential ingredients of an interpersonal-relational clinical method and articulates interactional dimensions that have restorative potential. His vision focuses on the interpersonal relationship, its powerful affects, and a belief that human beings have a potent capacity for real change. This book will be essential reading for psychoanalysts and psychoanalytic psychotherapists.




NCA Review for the Clinical Laboratory Sciences


Book Description

This easy to use resource prepares clinical laboratory scientists and clinical laboratory technicians for the certification and re-certifica tion examinations. An update of questions and answers reflects the mos t recent changes to the NCA exams. Organized by curriculum area, the b ook is sub-divided into review questions for CLT and questions for CLS, with answers accompanied by rationales directly follow the questions . The back of the book features two review tests for practice, for CLT and for CLS. An accompanying CD-ROM contains 500 practice questions.




The Clinical Review


Book Description




Improving Diagnosis in Health Care


Book Description

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.