Guidelines in Pulmonary Medicine

Hackner, Dani; Tu, George; Weingarten, Scott; Mohsenifar, Zab

doi:10.1378/chest.116.4.1046

Cited by 17 publications

(9 citation statements)

References 92 publications

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“…Third, asthma has been an early target for standardization via guidelines. 15 In addition to multiple local protocols, the U.S. National Asthma Education Program of the National Institutes of Health's (NIH's) National Heart, Lung, and Blood Institute (NHLBI) convened expert panels to publish a first set of guidelines in 1991, a second set in 1997, and an update in 2002 (referred to, respectively, as EPR I, EPR II, and Update 2002). Finally, recent studies show that from more than 100 different pediatric guidelines, asthma guidelines are among the best known.…”

Section: Experience With Guidelinesmentioning

confidence: 99%

The Promises And Pitfalls Of Evidence-Based Medicine

Timmermans¹,

2005

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Evidence-based medicine (EBM) aims to address the persistent problem of clinical practice variation with the help of various tools, including standardized practice guidelines. While advocates welcome the stronger scientific foundation of such guidelines, critics fear that they will lead to "cookbook medicine." Studies show, however, that few guidelines lead to consistent changes in provider behavior. The hopes, fears, and mixed record of EBM are rooted in the traditional professional perspective of the clinician as sole decisionmaker. Multifaceted implementation strategies that take the collaborative nature of medical work into consideration promise more effective changes in clinical practice. E v i d e nc e -b a se d m e di c i n e (EBM) is commonly defined as "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients."1 The term is loosely used and can refer to anything from conducting a statistical meta-analysis of accumulated research, to promoting randomized clinical trials, to supporting uniform reporting styles for research, to a personal orientation toward critical self-evaluation. EBM was initially defined in opposition to clinical experience, but later definitions have emphasized its complementary character and have aimed to improve clinical experience with better evidence.2 One common implementation of EBM involves the use of clinical practice guidelines during medical decision making to encourage effective care. The Institute of Medicine (IOM) defines clinical guidelines as "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances."3 An expert committee does the work of sifting through the scientific literature for clinicians and offers coherently sequenced recommendations based on the best available evidence aimed at everyday decision-making situations. Guidelines can be applied to any aspect of clinical care: how and when to order diagnostic or screening tests, when to provide certain medical services, how these should be performed, and how long 1 8 J a n u a r y / F e b r u a r y 2 0 0 5 H i s t o r y & C o n t e x t

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Section: Experience With Guidelinesmentioning

confidence: 99%

The Promises And Pitfalls Of Evidence-Based Medicine

Timmermans¹,

2005

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“…COPD was also the sixth leading cause of overall male disease burden, and ninth in the overall female disease burden 2 . Hospital admissions for COPD are mainly due to disease exacerbations and respiratory failure 3 . Hospitalization for COPD is potentially avoidable with appropriate management (including supervision of adherence to treatment), although the actual proportion of avoidable admissions is unknown.…”

Section: Introductionmentioning

confidence: 99%

“…2 Hospital admissions for COPD are mainly due to disease exacerbations and respiratory failure. 3 Hospitalization for COPD is potentially avoidable with appropriate management (including supervision of adherence to treatment), although the actual proportion of avoidable admissions is unknown. Hence, COPD has been identified as an ambulatory care-sensitive condition (ACSC).…”

Section: Introductionmentioning

confidence: 99%

Variations in hospitalizations for chronic obstructive pulmonary disease in rural and urban Victoria, Australia

Ansari

Dunt²,

Dharmage

2007

Respirology

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“…Among the numerous causes of death in HIV patients with primary pulmonary pathology, bacterial pneumonia has and continues to rank the highest [24]; although, many other types of [24][25][26][27][28][29][30][31][32].…”

Section: Overviewmentioning

confidence: 99%

HIV and Respiratory Disease: A Contemporary Perspective

Holt¹,

Turenne²,

Slonim³

2005

CRMR

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Human immunodeficiency virus (HIV) infection first manifested itself as Acquired Immune Deficiency Syndrome (AIDS) in the early 1980s when young, previously healthy homosexual men presented with Pneumocystis carinii pneumonia (PCP). Since the discovery of HIV and AIDS, many different respiratory infections (common, uncommon and opportunistic), as well as different malignancies such as Kaposi's sarcoma, and destructive lung processes, such as emphysema have been shown to occur more commonly in the setting of HIV. Alterations in the CD4+/CD8+ lymphocyte composition and changes in the function of B cells compromise host defenses and predispose an HIV infected individual to respiratory infections. Highly Active Antiretroviral Therapy (HAART) has dramatically altered the course of HIV infection through suppression of viral replication, a reconstitution of CD4+ cells, and the resultant decrease in opportunistic infections, including PCP. This manuscript provides a contemporary review of the respiratory diseases of patients with HIV.

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Guidelines in Pulmonary Medicine

Cited by 17 publications

References 92 publications

The Promises And Pitfalls Of Evidence-Based Medicine

The Promises And Pitfalls Of Evidence-Based Medicine

Variations in hospitalizations for chronic obstructive pulmonary disease in rural and urban Victoria, Australia

HIV and Respiratory Disease: A Contemporary Perspective

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