2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings. EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise . The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included. The full document can be downloaded for free on the website of this journal: http://www.rhinologyjournal.com.

/pdf/european-position-paper-on-rhinosinusitis-and-nasal-polyps-mj734vsl7p.pdf

European Position Paper on Rhinosinusitis and Nasal Polyps 2020

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(18)30489-6.pdf

Prevention and treatment of low back pain: evidence, challenges, and promising directions.

The opioid epidemic and national guidelines for opioid therapy for chronic noncancer pain: a perspective from different continents.

Quality improvement initiatives take many forms, from the creation of standards for health professionals, health technologies and health facilities, to audit and feedback, and from fostering a patient safety culture to public reporting and paying for quality. For policymakers who struggle to decide which initiatives to prioritise for investment, understanding the potential of different quality strategies in their unique settings is key.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.Quality of care is a political priority and an important contributor to population health. This book acknowledges that “quality of care” is a broadly defined concept, and that it is often unclear how quality improvement strategies fit within a health system, and what their particular contribution can be. This volume elucidates the concepts behind multiple elements of quality in healthcare policy (including definitions of quality, its dimensions, related activities, and targets), quality measurement and governance and situates it all in the wider context of health systems research. By so doing, this book is designed to help policy-makers prioritize and align different quality initiatives and to achieve a comprehensive approach to quality improvement.

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

https://www.mdpi.com/2227-9032/4/3/36/pdf

Barriers and Strategies in Guideline Implementation-A Scoping Review

Purpose
To test whether or not adults assign the same values to hypothetical health states that describe health in adults as when those same descriptions refer to the health of a child.

/pdf/can-adult-weights-be-used-to-value-child-health-states-dz1z5z0zes.pdf

Can adult weights be used to value child health states? Testing the influence of perspective in valuing EQ-5D-Y.

With the shift towards patient-centered healthcare, patient- and person-reports of health-related factors, including outcomes, are seen as important determinants for evaluating and improving healthcare. However, a comprehensive, systematic categorization of patient- and person-reports is currently lacking in the literature. This study aims at developing a new classification system with well-defined constructs for patients’ and persons’ self-reports on health and healthcare. A literature research and evaluation by the Reported Health Outcomes (RHO) Group were used to develop this classification system. The new classification system includes patient- and person-reported preferences, outcomes, experiences, and satisfaction related to healthcare and health outcomes. Moreover, the most constitutive methods to measure these four categories – preferences, outcomes, experiences, and satisfaction – have been described in this article. Even though the value of patients’ and persons’ perspectives on healthcare is increasingly being recognized, its measurement and implementation presents a lasting challenge to researchers, clinicians, patients, and the general population.

/pdf/patient-and-person-reports-on-healthcare-preferences-2psaccctft.pdf

Patient- and person-reports on healthcare: preferences, outcomes, experiences, and satisfaction – an essay

[Valuation of health-related quality of life and utilities in health economics].

Hintergrund: Leitlinien stellen systematisch entwickelte Entscheidungshilfen fur das arztliche Handeln dar. Aus den Empfehlungen vieler Leitlinien werden Qualitatsindikatoren abgeleitet, um zum einen die Implementierung der Leitlinie zu fordern und zum anderen die Qualitatssicherung sowohl der Leitlinie als auch der Versorgung zu ermoglichen. Ziel der Arbeit: Das Ziel der vorliegenden Arbeit besteht darin, die Bedeutung der Lebensqualitat als Qualitatsindikator in der Leitlinienentwicklung im deutschen Kontext aufzuzeigen. Methoden: Es wurde ein systematischer Literaturreview in der Datenbank PubMed durchgefuhrt, um den aktuellen Stand der Diskussion uber die Nutzung von Qualitatsindikatoren in der Leitlinienentwicklung herauszuarbeiten. In den Review wurden 90 Artikel eingeschlossen. Ergebnisse: Der Schwerpunkt der Evaluationen von medizinischen Leitlinien hat sich uber die Zeit von der Evaluation der methodischen Qualitat hin zu einer Evaluation der Wirkung der Leitlinien, insbesondere der Prozess- aber auch der Ergebnisqualitat, gewandelt. In vielen Artikeln erfolgte lediglich ein Hinweis darauf, dass die Verbesserung der Lebensqualitat – ebenso wie Morbiditats- und Mortalitatsreduktion – ein Outcomeparameter ist. Insgesamt wurde deutlich, dass die Lebensqualitat bislang noch nicht als Qualitatsindikator in der Leitlinienentwicklung berucksichtigt wird. Schlussfolgerung: Eine patientenorientierte Betrachtungsweise, die auch die subjektive Einschatzung der Lebensqualitat durch den Patienten und nicht nur Faktoren der Mortalitat und Morbiditat berucksichtigt, wird immer starker gefordert. Deshalb sollte Lebensqualitat sowohl in den Leitlinien zugrundeliegenden Primarstudien als auch als Qualitatsindikator berucksichtigt werden.

Kristina Klose

Papers

Barriers and Strategies in Guideline Implementation-A Scoping Review

Can adult weights be used to value child health states? Testing the influence of perspective in valuing EQ-5D-Y.

Patient- and person-reports on healthcare: preferences, outcomes, experiences, and satisfaction – an essay

[Valuation of health-related quality of life and utilities in health economics].

Bedeutung der Lebensqualität als Qualitätsindikator in der Leitlinienentwicklung