This Viewpoint reviews recent progress and challenges in the evolution of clinical practice guidelines, from 2011 National Academy of Medicine (NAM) guidance for creation of trustworthy guidelines through the 2018 demise of the National Guideline Clearinghouse (NGC), and calls for increased…
Archivi categoria: letteratura
Nephrology is a complex discipline, including care of kidney disease, dialysis, and transplantation. While in Europe, about 1:10 individuals is affected by chronic kidney disease (CKD), 1:1000 lives thanks to dialysis or transplantation, whose costs are as high as 2% of all the health care budget. Nephrology has important links with surgery, bioethics, cardiovascular and internal medicine, and is, not surprisingly, in a delicate balance between specialization and comprehensiveness, development and consolidation, cost constraints, and competition with internal medicine and other specialties. This paper proposes an interpretation of the different systems of nephrology care summarising the present choices into three not mutually exclusive main models (“scientific”, “pragmatic”, “holistic”, or “comprehensive”), and hypothesizing an “ideal-utopic” prevention-based fourth one. The so-called scientific model is built around kidney transplantation and care of glomerulonephritis and immunologic diseases, which probably pose the most important challenges in our discipline, but do not mirror the most common clinical problems. Convers
Readability of Written Materials for CKD Patients: A Systematic Review – American Journal of Kidney Diseases
The “average” patient has a literacy level of US grade 8 (age 13-14 years), but this may be lower for people with chronic kidney disease (CKD). Current guidelines suggest that patient education materials should be pitched at a literacy level of around 5th grade (age 10-11 years). This study aims to evaluate the readability of written materials targeted at patients with CKD.
Screening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement | Cancer Screening, Prevention, Control | JAMA | JAMA Network
This 2018 updated Recommendation Statement from the US Preventive Services Task Force concludes that clinicians should not screen for prostate cancer in men aged 55 to 69 years who do not express a preference for screening (C recommendation) and recommends against PSA-based screening in men 70 years…