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.
Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.
Precision medicine is a disruptive innovation with a fast-evolving pace in the healthcare ecosystem. Precision medicine enables precise diagnosis and targeted treatment by considering individual variability in the abnormalities of causative genes and molecular drivers behind biochemical mechanisms. A vast amount of data created by advanced omics technologies is a foundation of precision medicine’s success, and the implications of the findings from these technologies can potentially improve clinical outcomes. Recent Advances in Molecular and Translational Medicine: Updates in Precision Medicine presents essential information of molecular and translational research in precision medicine, with a specific focus on pediatrics. This book provides an accessible introduction to omics technologies, gives a detailed explanation of bioinformatics workflows to interpret high-throughput omics profiles for molecular diagnosis, and collects some of the cutting-edge research for precise therapeutics. Contributions to the book have been provided by experts in biomedical engineering and clinical practice, thus, bringing an informed perspective to the reader on each topic. The book is a valuable resource for postgraduate students, researchers, data scientists and clinicians interested in precision medicine, as well as researchers in the field of genetics and pediatrics who are interested in understanding the role of precision medicine in clinical practice.
This report is structured in five parts: national framework for traditional and complementary medicine (T&CM); product regulation; practices and practitioners; the challenges faced by countries; and finally the country profiles. Apart from the section on practices and practitioners the report is consistent with the format of the report of the first global survey in order to provide a useful comparison. The section on practices and practitioners which covers providers education and health insurance is a new section incorporated to reflect the emerging trends in T&CM and to gather new information regarding these topics at a national level. All new information received has been incorporated into individual country profiles and data graphs. The report captures the three phases of progress made by Member States; that is before and after the first WHO Traditional Medicine Strategy (1999?2005) from the first global survey to the second global survey (2005?2012) and from the second survey to the most recent timeline (2012?2018).
Since 2007 the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) have recommended voluntary medical male circumcision (VMMC) as an important strategy for the prevention of heterosexually acquired HIV in men in settings where the prevalence of heterosexually transmitted HIV is high. Over 25 million men and adolescent boys in East and Southern Africa have been reached with VMMC services. These new guidelines update earlier WHO recommendations to maximize the HIV prevention impact of safe VMMC services and aim to guide the transition to the sustained provision of interventions with a focus on the health and well-being of both adolescent boys and men.
This report presents the recommendations of the WHO Expert Committee responsible for updating the WHO Model List of Essential Medicines. The first part contains a progress report on the new procedures for updating the Model List and the development of the WHO Essential Medicines Library. It continues with a section on changes made in revising the Model List followed by a review of some sections such as hypertensive medicines and fast track procedures for deleting items. Annexes include the 13th version of the Model List and items on the list sorted according to their 5-level Anatomical Therapeutic Chemical classification codes.
From Editor’s Desk Perhaps in no other situation a physician experiences the same magnitude of agony and ecstasy as while attending an emergency. Though initially one tends to be ‘down in the dumps’ after being unsuccessful in a case or being euphoric over a successful management of a dire emergency, in due course one develops an attitude of equanimity. This attitude is essential so that our own emotions do not affect our management plans. I have chosen two aphorisms in Medicine, ‘Primum non nocere’ and ‘Primum succurere’. While attending to a patient, if we are not able to cure him or relieve him it is excusable but we have to do our best not to harm the patient in the process and if we happen to be in the vicinity of any one in need of urgent medical attention, we shall hasten to attend to him, are the respective connotations of these aphorisms. Sometimes, we have hesitation in attending to a patient in need of medical attention when the given situation does not belong to our expertise lest we err in the management, like a physician at the site of a road traffic accident. The Supreme Court has ruled that a medical professional should not hesitate on such grounds and must try to provide whatever care he can provide in such cases. That exactly is what ‘Primum succurere’ means. Emergencies in medicine include many sub specialities but to restrict the number of pages and the size of the Monograph, we are concentrating mainly on topics we face in our steady clinical practice as physicians. I have attempted to present the management of the medical emergencies in different scenarios, such as situations where no assistance or special tools are available to situation where all types of assistance and tools are available as in an intensive care unit. We have also included topics on the role of alternative medicine in emergency handling of cases. This emergency medicine, a new branch of medicine has become so indispensable presently that the MCI (Medical Council of India) and its BOG (Board of Governors) in their notification on November 14, 2019 state as follows. “No MBBS course nod to medical colleges in the country without emergency department (ED)”. The measures call for all medical colleges to have freely functional ED as per the MCI norms by 31th march 2022, adding that all new medical colleges seeking LOP (Letter of Permission) w.e.f. 2021—2022 MBBS batch should ensure that a freely functional ED is in existence as per the MCI norms. Hubballi, 01/01/2020 Karnataka
