Consensus Statement

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.

Can health-care costs be reduced by increasing the overall level of physical activity? What part does heredity play in physical fitness? How does exercise affect the immune system? What is the relationship between physical activity and hypertension?

This is the first book of its kind to focus solely on the female athlete triad - its origins, its recognition, and most importantly, its management. Since the symptoms themselves cover a range of medical specialties, chapters are written by experts in a number of relevant fields - sports medicine, orthopedics, endocrinology, and pediatrics - with an eye toward overall care of the young female athlete. Additionally, each chapter includes suggestions on how to educate and communicate with young athletes and their parents, as well as trainers and coaches, on how to manage the illness outside of the direct clinical setting. The female athlete triad is often seen in sports where low body weight is emphasized, such as gymnastics, figure skating, and running, though it can appear in any sport or activity. The interrelated symptoms - eating disorders, amenorrhea, and low bone mass - exist on a spectrum of severity and are serious and potentially life-threatening if not properly treated. Psychological problems, in addition to medical ones, are not uncommon. The Female Athlete Triad: A Clinical Guide discusses all of these areas for a well-rounded and in-depth approach to the phenomenon and will be a useful reference for any clinician working with female athletes across the lifespan.

Considers medical technology consensus development programs in Canada, Denmark, Finland, Netherlands, Norway, Sweden, England and the United States.