2007, Number 6
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Rev Mex Pediatr 2007; 74 (6)
A guideline for the diagnosis of ischaemic brain disease
Sosa-Maldonado J, Rendón-Macías ME, Ballesteros-del Olmo JC
Language: Spanish
References: 16
Page: 247-250
PDF size: 93.16 Kb.
ABSTRACT
Objective. To probe if use of guidelines for diagnosis of vascular ischemic brain disease (VIBD) improve with the use of guidelines. About the changing resources utilization and the increasing percentage diagnoses issued by the diagnostic guide application.
Methodology. The before and after study (with 6-8 weeks interval) was done in 19 medical doctors, using four guideline of the diagnosis of in children. The doctors responses the questions about diagnosis of VIBD using an interactive computer program which four hypothetical cases with this disease. Information collected was related to the medical doctor experience (years), guide use (yes/no), lab exams that they could be use: number/type, and the diagnosis that they issued.
Results. With and without assistance of guidelines, the correct diagnosis was found in 35% and 71% (chi square p ‹ 0.01) of the doctors. The studies that they ask, according the guideline were 52% an without 63%.
Conclusions. An increased in the rate of diagnosis was achieved with the guideline.
REFERENCES
Jackson R, Feder G. Guidelines for clinical guidelines: A simple, pragmatic strategy for guideline development. BMJ 1998; 317: 427-8.
Grilli R, Magrini N, Penna A, Mura G, Liberati A. Practice guidelines developed by speciality societies: the need for a critical appraisal. Lancet 2000; 355: 103-6.
Grol R. Personal paper: Beliefs and evidence in changing clinical practice. BMJ 1997; 315: 418-21.
Grol R, Dalhuijsen J, Thomas S, Veld C, Rutten G, Mokkink H. Attributes of clinical guidelines that influence use of guidelines in general practice: Observational study. BMJ 1998; 317: 858-61.
Jeffrey H. Development, use, and evaluation of clinical practice guideline. J Occup Environ Med 1997; 39: 23-34.
Woolf S. Practice guidelines, a new reality in medicine. Arch Inter Med 1992; 152: 946-52.
Thompson R, Lavender M, Madhok R. How to ensure that guidelines are effective. BMJ 1995; 311: 237-41.
Shekelle PG, Woolf S, Eccles M, Grimshaw J. Developing guidelines. BMJ 1999; 318: 593-6.
Elson BR. Adis international a Walters Kluwer company Ouktland, Chester, Hong Kong, Milan, Osaka, Paris, Philadelphia. Limited clinical practice guidelines the role of technology in perspective. 1998: 19-36.
Woolf S. Practice guidelines: A new reality in medicine. III Impact on patient care. Arch Inter Med 1993; 153: 2646-55.
Mc Donald C, Overhage M. Guidelines you can follow and can trust. An ideal and example. JAMA 1994; 27: 72-3.
Audet AM, Greenfield S, Field M. Medical practice guidelines: Current activities and futures directions. Ann Inter Med 1990; 113: 709-14.
Grill R, Magrini N, Penna A, Mura G, Liberati A. Practice guidelines developed by speciality societies: the need for a critical appraisal. Lancet 2000; 355: 103-5.
Wilson M, Tunis S, Hayward R, Bass E, Guyatt G. User’s guides to the medical literature. VIII How to use clinical practice guidelines. B. What are the recommendations and will they help you in caring for your patients? JAMA 1995; 724: 1630-2.
Peabody J, Luck J, Glassman P, Dresselhaus T, Lee M. Comparison of vignettes, standardized patients, and chart abstraction. A prospective validation study of 3 methods for measuring quality. JAMA 2000; 283: 1715-22.
Kassirer JP, Kopelman RI. Learning clinical reasoning. Baltimore: Williams and Wilkins. 1991.