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BMJ best practice

Louis Gerber, Abdullah E Laher, Callistus O A Enyuma, Jared McDowall, Sunday J Aigbodion, Sean Buchanan, Ahmed Adam
Objectives: An incidental and sometimes humorous finding on an Antero-Posterior (AP) pelvis X-ray view is that of the John Thomas Sign (JTS), which is defined as positive, when the penile shadow points towards the side of a hip or pelvic fracture in male patients. Despite previous research reports and studies performed on the JTS sign, uncertainty with regards to its clinical relevance still remains. The objective of this review was to assess the clinical validity and accuracy of this sign by performing a systematic review and meta-analysis...
January 2019: Journal of Clinical Orthopaedics and Trauma
V P Bastiaenen, I Hovdenak Jakobsen, R Labianca, A Martling, D G Morton, J N Primrose, P J Tanis, S Laurberg
AIM: It is common clinical practice to follow patients for a period of years after curative intent treatment of non-metastatic colorectal cancer, but follow-up strategies vary widely. The aim of this systematic review was to provide an overview of recommendations in guidelines from ESCP member countries on this topic, with supporting evidence. METHODS: A systematic search of Medline, Embase and guidelines databases Tripdatabase, BMJ Best Practice and Guidelines International Network was performed...
November 30, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Callistus O A Enyuma, Ahmed Adam, Sunday J Aigbodion, Jared McDowall, Louis Gerber, Sean Buchanan, Abdullah E Laher
BACKGROUND: Intestinal volvulus is a potentially life-threatening condition that occurs when loops of bowel twist around its supporting mesentery and associated vasculature. Clinicians often rely on various radiological investigations for prompt diagnosis to avoid complications such as bowel infarction. This review assesses the clinical reliability of the ultrasonographic whirlpool sign (WS) in the diagnosis of intestinal volvulus. METHODS: In adherence with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses) statement, a systematic search of BMJ Best Practice, Cochrane Database of Systematic Reviews, EMBASE, Google Scholar, PubMed, Scopus and Web of Science databases was performed (August 2017), using relevant search terms...
November 2018: ANZ Journal of Surgery
Kieran Walsh
PURPOSE: There is a growing interest in the use of point-of-care clinical decision support resources as a form of continuing medical education (CME). This paper models various cost and value outcomes that might emerge from the use of a clinical decision support tool (BMJ Best Practice) as CME. METHODS: BMJ Best Practice is the clinical decision support tool of the BMJ. Healthcare professionals can use it to do self-directed CME. We modeled the use of clinical decision support as a component of CME and evaluated the potential impact of this use on costs...
January 2018: Annali Dell'Istituto Superiore di SanitĂ
Corey Joseph, Marie Garrubba, Julian A Smith, Angela Melder
Pulmonary artery catheters (PACs) were introduced in 1970. Since then, their use has steadily increased. However, there have been questions raised regarding their efficacy for multiple clinical scenarios. The purpose of this systematic review was to determine the safety and effectiveness of routine use of PACs post cardiac surgery on mortality, complications, days in intensive care unit, days in hospital, and costs in patients undergoing cardiac surgery, or patients who end up in an intensive care unit. METHODS: Medline, All EBM, EMBASE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched using predetermined search terms...
August 2018: Heart, Lung & Circulation
Jared McDowall, Ahmed Adam, Louis Gerber, Callistus O A Enyuma, Sunday J Aigbodion, Sean Buchanan, Abdullah E Laher
PURPOSE: A positive whirlpool sign (WS) is defined as the presence of a spiral-like pattern when the spermatic cord is assessed during ultrasonography (US), using standard, high-resolution ultrasonography (HRUS) and/or color Doppler sonography (CDS), in the presence of testicular torsion. The objective of this review was to assess the validity and accuracy of this sign by performing a comprehensive systematic literature review and meta-analysis. METHODS: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, a comprehensive literature search was performed (August, 2017), using the following databases: BMJ Best Practice, Cochrane Library, Embase, PubMed, Scopus, and Web of Science...
June 2018: Emergency Radiology
W A A Borstlap, S E van Oostendorp, C E L Klaver, D Hahnloser, C Cunningham, E Rullier, W A Bemelman, J B Tuynman, P J Tanis
BACKGROUND: The high morbidity associated with radical resection for rectal cancer is an incentive for surgeons to adopt strategies aimed at organ preservation, particularly for early disease. There are a number of different approaches to achieve this. In this study we have collated current national and international guidelines to produce a synopsis to support this changing practice. METHODS: The databases PubMed, Embase, Trip database, national guideline clearinghouse, BMJ Best practice were interrogated...
November 14, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Lingling He, Xiaoli Liu, Yalin Zhao, Shuan Zhang, Yuyong Jiang, Xianbo Wang, Zhiyun Yang
Aim. To determine whether nucleot(s)ide analogs therapy has survival benefit for patients with HBV-related HCC after unresectable treatment. Method. A systematic search was conducted through seven electronic databases including PubMed, OVID, EMBASE, Cochrane Databases, Elsevier, Wiley Online Library, and BMJ Best Practice. All studies comparing NA combined with unresectable treatment versus unresectable treatment alone were considered for inclusion. The primary outcome was the overall survival (OS) after unresectable treatment for patients with HBV-related HCC...
2017: Disease Markers
Caryn Easterling
As deglutologists, we strive to use the best evidence available in the treatment of swallowing disorders. Evidence-based medicine is a bottom-up approach that thoughtfully combines the best external evidence with individual clinical expertise and the patients' choice reflective of their clinical state and preferences for their specific care plan. Evidence-based medicine is not restricted to randomized clinical trials and meta-analyses; rather, evidence-based medicine includes our ability to discriminate the best external evidence with which to answer clinical questions and then skillfully and appropriately being able to apply this evidence in the care and treatment of our patients (Sackett et al...
February 2017: Dysphagia
C E L Klaver, H Groenen, D G Morton, S Laurberg, W A Bemelman, P J Tanis
AIM: This systematic review aimed to provide an overview of (inter)national guidelines on the treatment of peritoneal metastases of colorectal cancer origin (PMCRC) and to determine the degree of consensus and available evidence with identification of topics for future research. METHOD: A systematic search of MEDLINE, Embase, PubMed as well as Tripdatabase, National Guideline Clearinghouse, BMJ Best Practice and Guidelines International Network was performed to identify (inter)national guidelines and consensus statements from oncological or surgical societies on PMCRC...
March 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Thomas D O'Brien, Jane Noyes, Llinos Haf Spencer, Hans-Peter Kubis, Richard P Hastings, Rhiannon Whitaker
AIM: To perform a systematic review establishing the current evidence base for physical activity and exercise interventions that promote health, fitness and well-being, rather than specific functional improvements, for children who use wheelchairs. DESIGN: A systematic review using a mixed methods design. DATA SOURCES: A wide range of databases, including Web of Science, PubMed, BMJ Best Practice, NHS EED, CINAHL, AMED, NICAN, PsychINFO, were searched for quantitative, qualitative and health economics evidence...
2016: BMJ Open Sport & Exercise Medicine
Phang Koh Ni, Serena Koh Siew Lin
BACKGROUND: Maternal postpartum health is a neglected area both in research and practice. This aspect warrants more attention as the health of postpartum mothers has a considerable influence on her infant and also other family members. Social support provided by family and friends has been identified as a buffer against the many stressors faced by the women. Outcomes such as self-esteem, stress, postnatal depression, breastfeeding levels, infant care, and maternal adaptation have been studied and found to be significantly related to social support...
2011: JBI Library of Systematic Reviews
Charlotte Vrinten, Jane Wardle
OBJECTIVES: Despite improved outcomes, cancer remains widely feared, often because of its association with a long and protracted death as opposed to the quick death that people associate with that other common cause of adult mortality: heart disease. Former editor-in-chief of the BMJ Richard Smith's view that 'cancer is the best way to die' therefore attracted much criticism. We examined middle-aged and older adults' agreement with this view and compared their attitudes towards dying from cancer versus heart disease in terms of which was a good death...
March 2016: European Journal of Cancer
Kathryn Hopkins, Paul Crosland, Nicole Elliott, Susan Bewley
This is one of a series of BMJ summaries of new guidelines based on the best available evidence; they highlight important recommendations for clinical practice, especially where uncertainty or controversy exists.
February 2016: British Journal of Sports Medicine
Jude Kivlin, Harith Altemimi
The Queen Elizabeth Hospital in King's Lynn, Norfolk is a 488 bed hospital providing services to approximately 331,000 people across 750 square miles. In 2012 a need was recognised for documentation (pathways) in a practical format to increase usage of national guidelines and facilitate adherence to best practice (gold standards of care) that could be easily version controlled, auditable and provide support in clinical decision-making by junior doctors. BMJ Action Sets[1] fulfilled the brief with expert knowledge, version control and support, though they were deemed too lengthy and unworkable in fast paced settings like the medical assessment unit; they formed the base creation of concise care bundles (CCB)...
2015: BMJ Quality Improvement Reports
Jared M Campbell, Kandiah Umapathysivam, Yifan Xue, Craig Lockwood
OBJECTIVE: Clinicians and other healthcare professionals need access to summaries of evidence-based information in order to provide effective care to their patients at the point-of-care. Evidence-based practice (EBP) point-of-care resources have been developed and are available online to meet this need. This study aimed to develop a comprehensive list of available EBP point-of-care resources and evaluate their processes and policies for the development of content, in order to provide a critical analysis based upon rigor, transparency and measures of editorial quality to inform healthcare providers and promote quality improvement amongst publishers of EBP resources...
December 2015: Worldviews on Evidence-based Nursing
Andrew Booth, Christopher Carroll
Increasing recognition of the role and value of theory in improvement work in healthcare offers the prospect of capitalising upon, and consolidating, actionable lessons from synthesis of improvement projects and initiatives. We propose that informed use of theory can (i) provide a mechanism by which to collect and organise data from a body of improvement work, (ii) offer a framework for analysis and identification of lessons learnt and (iii) facilitate an evaluation of the feasibility, effectiveness and acceptability of improvement programmes...
November 2015: BMJ Quality & Safety
Kerrie Noonan
: A recent article in the BMJ highlighted the role of social media has in changing the way we talk about and respond to death and dying. There are so many social media channels do you know which ones are best for communicating about your work? for networking with peers? participating in journal clubs? disseminating research with the international community? What about your local community- how do you increase engagement online to promote your work and events? How can you use social media to source and access interesting content and information about the public health approach? This workshop is designed as a beginner level and new user workshop and is suitable for anyone wanting to be more active in social media...
April 2015: BMJ Supportive & Palliative Care
Aileen Barrett, Rose Galvin, Yvonne Steinert, Albert Scherpbier, Ann O'Shaughnessy, Mary Horgan, Tanya Horsley
BACKGROUND: Workplace-based assessments were designed to facilitate observation and structure feedback on the performance of trainees in real-time clinical settings and scenarios. Research in workplace-based assessments has primarily centred on understanding psychometric qualities and performance improvement impacts of trainees generally. An area that is far less understood is the use of workplace-based assessments for trainees who may not be performing at expected or desired standards, referred to within the literature as trainees 'in difficulty' or 'underperforming'...
2015: Systematic Reviews
R Green, A Banigo, I Hathorn
BACKGROUND: Chronic rhinosinusitis is a significant health problem, and the optimal postoperative treatment regime for patients post functional endoscopic sinus surgery has been a topic debated for years. OBJECTIVE OF REVIEW: To systematically review and critically evaluate the evidence relating to postoperative debridement of the nasal cavity following functional endoscopic sinus surgery to guide best practice. SEARCH STRATEGY: A search of the following databases was performed: Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effectiveness, and Cochrane Central Register of Control Trials...
February 2015: Clinical Otolaryngology
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