المؤلفون: White, Heath, Turner, Tari, Beecher, Claire, Poole, Alex, McDonald, Steve, Hewitt, Jessie, Chakraborty, Samantha, Fraile‐Navarro, David, Cheyne, Saskia, Vogel, Joshua, Jeppesen, Britta Tendal, McGloughlin, Steve

المساهمون: Department of Health, State Government of Victoria, Ian Potter Foundation, Equity Trustees

المصدر: Clinical and Public Health Guidelines ; volume 1, issue 2 ; ISSN 2836-3973 2836-3973

الوصف: Living evidence methods, such as those used to produce living guidelines, can evolve over time as the context or evidence changes. In Australia, the National Clinical Evidence Taskforce has been developing living guidelines for the management and care of people with coronavirus disease 2019 (COVID‐19) since March 2020, undertaking daily searches, and producing over 130 updates of more than 200 recommendations. Over the 3 years of the guidelines, the methods have also been ‘living’. In this paper, we describe why, how and with what impact changes to our methods have been made. When changes were required to the methods, the Taskforce Evidence Team developed a ‘Methods Brief’ outlining the proposed changes, rationale and any risks. This was presented to the Guidelines Leadership Group for approval and to the Steering Committee for noting. Changes were then reflected in the online, publicly available description of our methods. Methods to develop the living guidelines evolved through five phases, reflecting changes in the availability of evidence, the degree and nature of clinical uncertainty and resource availability. Largely these changes were to the criteria we used to select evidence for inclusion, and our expected level of responsiveness to new evidence. In the initial phases, inclusion criteria were very broad, and as the evidence base stabilised our focus narrowed to areas of high clinical importance and evidence certainty. The rapidly evolving nature of the pandemic, understanding of the illness, clinical questions and evidence base during development of the living COVID‐19 guidelines, necessitated multiple changes to the methods used to produce the guidelines. In this context, the ongoing revision of the methods for living guideline production was a necessity and a strength of the living approach. Questions remain about how best to ensure rigour is maintained while methods evolve.

الإتاحة: https://doi.org/10.1002/gin2.12017Test

المؤلفون: Meneses-Echavez, Jose F., Bidonde, Julia, Montesinos-Guevara, Camila, Amer, Yasser S., Loaiza-Betancur, Andres Felipe, Tellez Tinjaca, Luis Andres, Fraile Navarro, David, Poklepović Peričić, Tina, Tokalić, Ružica, Bala, Malgorzata M., Storman, Dawid, Swierz, Mateusz, Zając, Joanna, Flórez, Ivan D., Schünemann, Holger, Flottorp, Signe, Alonso-Coello, Pablo

المصدر: Meneses-Echavez , J F , Bidonde , J , Montesinos-Guevara , C , Amer , Y S , Loaiza-Betancur , A F , Tellez Tinjaca , L A , Fraile Navarro , D , Poklepović Peričić , T , Tokalić , R , Bala , M M , Storman , D , Swierz , M , Zając , J , Flórez , I D , Schünemann , H , Flottorp , S & Alonso-Coello , P 2023 , ' Using evidence to decision frameworks led to guidelines of better quality and more credible and transparent recommendations ' , Journal ....

مصطلحات موضوعية: Decision making, Evidence-based practice, GRADE approach, Methods, Policy making, Practice guidelines

الوصف: Background and Objectives: To determine whether the use of Evidence to Decision (EtD) frameworks is associated to higher quality of both guidelines and individual recommendations. Methods: We identified guidelines recently published by international organizations that have methodological guidance documents for their development. Pairs of researchers independently extracted information on the use of these frameworks, appraised the quality of the guidelines using the Appraisal of Guidelines, Research and Evaluation II Instrument (AGREE-II), and assessed the clinical credibility and implementability of the recommendations with the Appraisal of Guidelines for REsearch & Evaluation Recommendations Excellence (AGREE-REX) tool. We conducted both descriptive and inferential analyses. Results: We included 66 guidelines from 17 different countries, published in the last 5 years. Thirty guidelines (45%) used an EtD framework to formulate their recommendations. Compared to those that did not use a framework, those using an EtD framework scored higher in all domains of both AGREE-II and AGREE-REX (P < 0.05). Quality scores did not differ between the use of the The Grading of Recommendations Assessment, Development and Evaluation–EtD framework (17 guidelines) or another EtD framework (13 guidelines) (P > 0.05). Conclusion: The use of EtD frameworks is associated with guidelines of better quality, and more credible and transparent recommendations. Endorsement of EtD frameworks by guideline developing organizations will likely increase the quality of their guidelines.

وصف الملف: application/pdf

الإتاحة: https://doi.org/10.1016/j.jclinepi.2023.07.013Test
https://researchers.mq.edu.au/en/publications/d1f9a2c4-3cb6-4538-b597-a7c296d6e7deTest
https://research-management.mq.edu.au/ws/files/347201943/Publisher_version_open_access_.pdfTest
http://www.scopus.com/inward/record.url?scp=85169796006&partnerID=8YFLogxKTest

المؤلفون: Cheyne, Saskia, Fraile Navarro, David, Buttery, Amanda K., Chakraborty, Samantha, Crane, Olivia, Hill, Kelvin, McFarlane, Emma, Morgan, Rebecca L., Mustafa, Reem A., Poole, Alex, Tunnicliffe, David, Vogel, Joshua P., White, Heath, Whittle, Samuel, Turner, Tari

المصدر: Cheyne , S , Fraile Navarro , D , Buttery , A K , Chakraborty , S , Crane , O , Hill , K , McFarlane , E , Morgan , R L , Mustafa , R A , Poole , A , Tunnicliffe , D , Vogel , J P , White , H , Whittle , S , Turner , T 2023 , ' Methods for living guidelines : early guidance based on practical experience. Paper 3: selecting and prioritizing questions for living guidelines ' , Journal of Clinical Epidemiology , vol. 155 , pp. 73-83 ....

مصطلحات موضوعية: Clinical practice guidelines, Decision-making, Guidelines, Living evidence, Living guidelines, Methods

الوصف: Objectives: This article is part of a series on methods for living guidelines, consolidating practical experiences from developing living guidelines. It focuses on methods for identification, selection, and prioritization of clinical questions for a living approach to guideline development. Study Design and Setting: Members of the Australian Living Evidence Consortium, the National Institute of Health and Care Excellence and the US Grading of Recommendations, Assessment, Development and Evaluations Network, convened a working group. All members have expertize and practical experience in the development of living guidelines. We collated methods, documents on prioritization from each organization's living guidelines, conducted interviews and held working group discussions. We consolidated these to form best practice principles which were then edited and agreed on by the working group members. Results: We developed best practice principles for (1) identification, (2) selection, and (3) prioritization, of questions for a living approach to guideline development. Several different strategies for undertaking prioritizing questions are explored. Conclusion: The article provides guidance for prioritizing questions in living guidelines. Subsequent articles in this series explore consumer involvement, search decisions, and methods decisions that are appropriate for questions with different priority levels.

وصف الملف: application/pdf

الإتاحة: https://doi.org/10.1016/j.jclinepi.2022.12.021Test
https://researchers.mq.edu.au/en/publications/e7ba7687-b219-4ac5-8aff-471a489f14dcTest
https://research-management.mq.edu.au/ws/files/256308092/Publisher_version_open_access_.pdfTest
http://www.scopus.com/inward/record.url?scp=85149669352&partnerID=8YFLogxKTest

المؤلفون: Fraile Navarro, David, Ijaz, Kiran, Rezazadegan, Dana, Rahimi-Ardabili, Hania, Dras, Mark, Coiera, Enrico, Berkovsky, Shlomo

المصدر: Fraile Navarro , D , Ijaz , K , Rezazadegan , D , Rahimi-Ardabili , H , Dras , M , Coiera , E & Berkovsky , S 2023 , ' Clinical named entity recognition and relation extraction using natural language processing of medical free text : a systematic review ' , International Journal of Medical Informatics , vol. 177 , 105122 , pp. 1-21 . https://doi.org/10.1016/j.ijmedinf.2023.105122Test

مصطلحات موضوعية: Of-the-art, Information extraction, Health, Normalization, Assertions, Model

الوصف: Background: Natural Language Processing (NLP) applications have developed over the past years in various fields including its application to clinical free text for named entity recognition and relation extraction. However, there has been rapid developments the last few years that there's currently no overview of it. Moreover, it is unclear how these models and tools have been translated into clinical practice. We aim to synthesize and review these developments. Methods: We reviewed literature from 2010 to date, searching PubMed, Scopus, the Association of Computational Linguistics (ACL), and Association of Computer Machinery (ACM) libraries for studies of NLP systems performing general-purpose (i.e., not disease- or treatment-specific) information extraction and relation extraction tasks in unstructured clinical text (e.g., discharge summaries). Results: We included in the review 94 studies with 30 studies published in the last three years. Machine learning methods were used in 68 studies, rule-based in 5 studies, and both in 22 studies. 63 studies focused on Named Entity Recognition, 13 on Relation Extraction and 18 performed both. The most frequently extracted entities were "problem", "test" and "treatment". 72 studies used public datasets and 22 studies used proprietary datasets alone. Only 14 studies defined clearly a clinical or information task to be addressed by the system and just three studies reported its use outside the experimental setting. Only 7 studies shared a pre-trained model and only 8 an available software tool. Discussion: Machine learning-based methods have dominated the NLP field on information extraction tasks. More recently, Transformer-based language models are taking the lead and showing the strongest performance. However, these developments are mostly based on a few datasets and generic annotations, with very few real-world use cases. This may raise questions about the generalizability of findings, translation into practice and highlights the need for robust clinical evaluation.

وصف الملف: application/pdf

الإتاحة: https://doi.org/10.1016/j.ijmedinf.2023.105122Test
https://researchers.mq.edu.au/en/publications/ab1dff19-2b7a-4de9-80fd-38fef0b0709cTest
https://research-management.mq.edu.au/ws/files/296419639/Publisher_version_open_access_.pdfTest
http://www.scopus.com/inward/record.url?scp=85161478506&partnerID=8YFLogxKTest

المؤلفون: Cheyne, Saskia, Fraile Navarro, David, Hill, Kelvin, McDonald, Steve, Tunnicliffe, David, White, Heath, Whittle, Samuel, Karpusheff, Justine, Mustafa, Reem, Morgan, Rebecca L., Sultan, Shahnaz, Turner, Tari

المصدر: Cheyne , S , Fraile Navarro , D , Hill , K , McDonald , S , Tunnicliffe , D , White , H , Whittle , S , Karpusheff , J , Mustafa , R , Morgan , R L , Sultan , S , Turner , T 2023 , ' Methods for living guidelines : early guidance based on practical experience. Paper 1: Introduction ' , Journal of Clinical Epidemiology , vol. 155 , pp. 84-96 . https://doi.org/10.1016/j.jclinepi.2022.12.024Test

مصطلحات موضوعية: Clinical practice guidelines, COVID-19, Decision-making, Guidelines, Living evidence, Methods

الوصف: Objectives: To introduce methods for living guidelines based on practical experiences by the Australian Living Evidence Consortium (ALEC), the National Institute of Health and Care Excellence (NICE), and the Infectious Diseases Society of America (IDSA), with methodological support from the US Grading of Recommendations, Assessment, Development and Evaluations (GRADE) Network. Study Design and Setting: Members of ALEC, NICE, and the US GRADE Network, convened a working group to share experiences of the methods used to develop living guidelines and outline the key differences between traditional and living guidelines methods. Results: The guidance includes the following steps: 1) deciding if the guideline is a priority for a living approach, 2) preparing for living guideline development, 3) literature surveillance and frequency of searching, 4) assessment and synthesis of the evidence, 5) publication and dissemination, and 6) transitioning recommendations out of living mode. Conclusion: This paper introduces methods for living guidelines and provides examples of the similarities and differences in approach across multiple organizations conducting living guidelines. It also introduces a series of papers exploring methods for living guidelines based on our practical experiences, including consumer involvement, selecting and prioritizing questions, search decisions, and methods decisions.

وصف الملف: application/pdf

الإتاحة: https://doi.org/10.1016/j.jclinepi.2022.12.024Test
https://researchers.mq.edu.au/en/publications/ca73da96-0963-4117-8c0a-963141f1b6aaTest
https://research-management.mq.edu.au/ws/files/256300896/Publisher_version_open_access_.pdfTest
http://www.scopus.com/inward/record.url?scp=85149863643&partnerID=8YFLogxKTest

المؤلفون: McDonald, Steve, Sharp, Steve, Morgan, Rebecca L., Murad, M. Hassan, Fraile Navarro, David

المصدر: Journal of Clinical Epidemiology ; volume 155, page 108-117 ; ISSN 0895-4356

الإتاحة: https://doi.org/10.1016/j.jclinepi.2022.12.023Test
https://api.elsevier.com/content/article/PII:S0895435622003481?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0895435622003481?httpAccept=text/plainTest

المؤلفون: Fraile Navarro, David, Cheyne, Saskia, Hill, Kelvin, McFarlane, Emma, Morgan, Rebecca L., Murad, M. Hassan, Mustafa, Reem A., Sultan, Shahnaz, Tunnicliffe, David J., Vogel, Joshua P., White, Heath, Turner, Tari

المصدر: Journal of Clinical Epidemiology ; volume 155, page 118-128 ; ISSN 0895-4356

الإتاحة: https://doi.org/10.1016/j.jclinepi.2022.12.022Test
https://api.elsevier.com/content/article/PII:S089543562200347X?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S089543562200347X?httpAccept=text/plainTest

المؤلفون: Fraile Navarro, David, Tempini, Niccolo, Teira, David

المصدر: Fraile Navarro, David and Tempini, Niccolo and Teira, David (2021) The Trade-off between Impartiality and Freedom in the 21st Century Cures Act. Philosophy of Medicine, 2 (1). pp. 1-17. ISSN 2692-3963

وصف الملف: text

العلاقة: https://philmed.pitt.edu/philmed/article/view/24Test

الوصول الحر: http://philsci-archive.pitt.edu/20758Test/

المؤلفون: Fraile Navarro, David, Azcoaga-Lorenzo, Amaya, Agrawal, Utkarsh, Jani, Bhautesh, Fagbamigbe, Adeniyi, Currie, Dorothy Bruce, Baldacchino, Alexander Mario, Sullivan, Francis

المصدر: Fraile Navarro , D , Azcoaga-Lorenzo , A , Agrawal , U , Jani , B , Fagbamigbe , A , Currie , D B , Baldacchino , A M & Sullivan , F 2022 , ' Development of an algorithm to classify Primary Care Electronic Health Records of alcohol consumption : experience using data-linkage from UK-Biobank and Primary Care electronic health data sources ' , BMJ Open , vol. 12 , no. 2 , e054376 . https://doi.org/10.1136/bmjopen-2021-054376Test

مصطلحات موضوعية: Health informatics, Primary care, Public health

الوصف: Objectives Develop a novel algorithm to categorise alcohol consumption using primary care electronic health records (EHRs) and assess its reliability by comparing this classification with self-reported alcohol consumption data obtained from the UK Biobank (UKB) cohort. Design Cross-sectional study. Setting The UKB, a population-based cohort with participants aged between 40 and 69 years recruited across the UK between 2006 and 2010. Participants UKB participants from Scotland with linked primary care data. Primary and secondary outcome measures Create a rule-based multiclass algorithm to classify alcohol consumption reported by Scottish UKB participants and compare it with their classification using data present in primary care EHRs based on Read Codes. We evaluated agreement metrics (simple agreement and kappa statistic). Results Among the Scottish UKB participants, 18 838 (69%) had at least one Read Code related to alcohol consumption and were used in the classification. The agreement of alcohol consumption categories between UKB and primary care data, including assessments within 5 years was 59.6%, and kappa was 0.23 (95% CI 0.21 to 0.24). Differences in classification between the two sources were statistically significant (p<0.001); More individuals were classified as ‘sensible drinkers’ and in lower alcohol consumption levels in primary care records compared with the UKB. Agreement improved slightly when using only numerical values (k=0.29; 95% CI 0.27 to 0.31) and decreased when using qualitative descriptors only (k=0.18;95% CI 0.16 to 0.20). Conclusion Our algorithm classifies alcohol consumption recorded in Primary Care EHRs into discrete meaningful categories. These results suggest that alcohol consumption may be underestimated in primary care EHRs. Using numerical values (alcohol units) may improve classification when compared with qualitative descriptors.

وصف الملف: application/pdf

العلاقة: https://research-portal.st-andrews.ac.uk/en/researchoutput/development-of-an-algorithm-to-classify-primary-care-electronic-health-records-of-alcohol-consumptionTest(a6280e12-1a53-49f1-85be-04c920e81a19).html

الإتاحة: https://doi.org/10.1136/bmjopen-2021-054376Test
https://research-portal.st-andrews.ac.uk/en/researchoutput/development-of-an-algorithm-to-classify-primary-care-electronic-health-records-of-alcohol-consumptionTest(a6280e12-1a53-49f1-85be-04c920e81a19).html
https://research-repository.st-andrews.ac.uk/bitstream/10023/24798/1/Fraile_Navarro_2022_Development_of_an_algorithm_BMJOpen_12_2_e054376_CC.pdfTest

المؤلفون: Cheyne, Saskia, Lindley, Richard I., Smallwood, Natasha, Tendal, Britta, Chapman, Michael, Fraile Navarro, David, Good, Phillip D., Jenkin, Peter, McDonald, Steve, Morgan, Deidre, Murano, Melissa, Millard, Tanya, Naganathan, Vasi, Srikanth, Velandai, Tuffin, Penelope, Vogel, Joshua, White, Heath, Chakraborty, Samantha P., Whiting, Elizabeth, William, Leeroy, Yates, Patsy M., Callary, Mandy, Elliott, Julian, Agar, Meera R., other, and

المصدر: Medical Journal Of Australia

مصطلحات موضوعية: COVID-19, Geriatrics, Guidelines as topic

الوصف: Introduction: Older people living with frailty and/or cognitive impairment who have coronavirus disease 2019 (COVID-19) experience higher rates of critical illness. There are also people who become critically ill with COVID-19 for whom a decision is made to take a palliative approach to their care. The need for clinical guidance in these two populations resulted in the formation of the Care of Older People and Palliative Care Panel of the National COVID-19 Clinical Evidence Taskforce in June 2020. This specialist panel consists of nursing, medical, pharmacy and allied health experts in geriatrics and palliative care from across Australia. Main recommendations: The panel was tasked with developing two clinical flow charts for the management of people with COVID-19 who are i) older and living with frailty and/or cognitive impairment, and ii) receiving palliative care for COVID-19 or other underlying illnesses. The flow charts focus on goals of care, communication, medication management, escalation of care, active disease-directed care, and managing symptoms such as delirium, anxiety, agitation, breathlessness or cough. The Taskforce also developed living guideline recommendations for the care of adults with COVID-19, including a commentary to discuss special considerations when caring for older people and those requiring palliative care. Changes in management as result of the guideline: The practice points in the flow charts emphasise quality clinical care, with a focus on addressing the most important challenges when caring for older individuals and people with COVID-19 requiring palliative care. The adult recommendations contain additional considerations for the care of older people and those requiring palliative care.

وصف الملف: application/pdf

العلاقة: https://eprints.qut.edu.au/227448/1/104447884.pdfTest; Cheyne, Saskia, Lindley, Richard I., Smallwood, Natasha, Tendal, Britta, Chapman, Michael, Fraile Navarro, David, Good, Phillip D., Jenkin, Peter, McDonald, Steve, Morgan, Deidre, Murano, Melissa, Millard, Tanya, Naganathan, Vasi, Srikanth, Velandai, Tuffin, Penelope, Vogel, Joshua, White, Heath, Chakraborty, Samantha P., Whiting, Elizabeth, William, Leeroy, Yates, Patsy M., Callary, Mandy, Elliott, Julian, Agar, Meera R., & other, and (2022) Care of older people and people requiring palliative care with COVID-19: guidance from the Australian National COVID-19 Clinical Evidence Taskforce. Medical Journal Of Australia, 216(4), pp. 203-208.; https://eprints.qut.edu.au/227448Test/; Centre for Healthcare Transformation; Cancer and Palliative Care Outcomes Centre; Faculty of Health

الإتاحة: https://doi.org/10.5694/mja2.51353Test
https://eprints.qut.edu.au/227448Test/