5561. Documented Pain Diagnoses in Adults Prescribed Opioids: Results From the National Ambulatory Medical Care Survey, 2006-2015.
Medical use of opioids has increased dramatically over the past 2 decades (1, 2), far exceeding increases in the prevalence of pain (–5). This discrepancy may reflect efforts to address undertreatment of pain but has raised concerns about the appropriateness of physicians’ prescribing practices and whether patients’ medical indications justify opioid therapy. We therefore examined the indications associated with opioid prescriptions in ambulatory care between 2006 and 2015 to determine the proportion of prescriptions written for conditions causing pain.
5562. World Health Organization Guidelines on Medicines for Diabetes Treatment Intensification: Commentary From the American College of Physicians High Value Care Committee.
作者: Linda L Humphrey.;Devan Kansagara.;Amir Qaseem.; .;Robert Centor.;Douglas M DeLong.;Heather E Gantzer.;Carrie A Horwitch.;Janet A Jokela.;Joseph Ming Wah Li.;Robert H Lohr.;Ana María López.;Robert M McLean.
来源: Ann Intern Med. 2018年169卷6期398-400页 5564. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation.
作者: Andrea C Tricco.;Erin Lillie.;Wasifa Zarin.;Kelly K O'Brien.;Heather Colquhoun.;Danielle Levac.;David Moher.;Micah D J Peters.;Tanya Horsley.;Laura Weeks.;Susanne Hempel.;Elie A Akl.;Christine Chang.;Jessie McGowan.;Lesley Stewart.;Lisa Hartling.;Adrian Aldcroft.;Michael G Wilson.;Chantelle Garritty.;Simon Lewin.;Christina M Godfrey.;Marilyn T Macdonald.;Etienne V Langlois.;Karla Soares-Weiser.;Jo Moriarty.;Tammy Clifford.;Özge Tunçalp.;Sharon E Straus.
来源: Ann Intern Med. 2018年169卷7期467-473页
Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers, publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater understanding of relevant terminology, core concepts, and key items to report for scoping reviews.
5565. Medicines for Treatment Intensification in Type 2 Diabetes and Type of Insulin in Type 1 and Type 2 Diabetes in Low-Resource Settings: Synopsis of the World Health Organization Guidelines on Second- and Third-Line Medicines and Type of Insulin for the Control of Blood Glucose Levels in Nonpregnant Adults With Diabetes Mellitus.
The World Health Organization developed these guidelines to provide guidance on selection of medicines for treatment intensification in type 2 diabetes and on use of insulin (human or analogue) in type 1 and 2 diabetes. The target audience includes clinicians, policymakers, national diabetes program managers, and medicine procurement officers. The target population is adults with type 1 or 2 diabetes in low-resource settings in low- or high-income countries. The guidelines also apply to disadvantaged populations in high-income countries.
5567. Parkinson Disease.
Parkinson disease is a common neurodegenerative disorder that causes progressive motor and nonmotor disability. It is diagnosed clinically and requires a detailed history and neurologic examination to exclude alternative diagnoses. Although disease-modifying therapies do not exist for Parkinson disease, effective symptomatic therapies, including dopaminergic medications and surgery, allow patients to maintain good quality of life for many years. Nonmotor symptoms, including mood, cognitive, sleep, autonomic, and gastrointestinal symptoms, should be managed by a multidisciplinary team of clinicians. Recent advances include new diagnostic criteria from the Movement Disorder Society and the addition of new symptomatic therapies for treating motor complications and nonmotor symptoms in advanced disease.
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