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  • Key words: Clinical practice guidelines — Consensus development conference — Literature search — Publication bias — Retrieval bias  (1)
  • Key words: Common bile duct stones — Gallbladder — Bile duct calculi — Laparoscopic cholecystectomy — Endoscopic retrograde cholangiopancreaticography  (1)
  • Key words: Consensus development conference — Diverticulitis — Contrast enema — Hartmann resection — Laparoscopic colectomy — Intraabdominal infections  (1)
Source
Material
Years
Keywords
  • 1
    Electronic Resource
    Electronic Resource
    Diagnosis and treatment of common bile duct stones (CBDS) (1998)
    Springer
    Surgical endoscopy and other interventional techniques 12 (1998), S. 856-864 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Common bile duct stones — Gallbladder — Bile duct calculi — Laparoscopic cholecystectomy — Endoscopic retrograde cholangiopancreaticography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Common bile duct stones (CBDS) are a frequent problem (10–15%) in patients with symptomatic cholecystolithiasis. Over the last decade, new diagnostic and surgical techniques have expanded the options for their management. This report of the Consensus Development Conference is intended to summarize the current state of the art, including principal guidelines and an extensive review of the literature. Methods: An international panel of 12 experts met under the auspices of the European Association of Endoscopic Surgery (EAES) to investigate the diagnostic and therapeutic alternatives for gallstone disease. Prior to the conference, all the experts were asked to submit their arguments in the form of published results. All papers received were weighted according to their scientific quality and relevance. The preconsensus document compiled out of this correspondence was altered following a discussion of the external evidence made available by the panel members and presented at the public conference session. The personal experiences of the participants and other aspects of individualized therapy were also considered. Results: Our panel of experts agreed that the presence of common bile duct stones should be investigated in all patients with symptomatic cholecystolithiasis. Based on preoperative noninvasive diagnostics, either endoscopic retrograde cholangiopancreaticography (ERCP) or intraoperative cholangiography should be employed for detecting CBDS. Eight of the 12 panelists recommended treating any diagnosed CBDS. For patients with no other extenuating circumstances, several treatment options exist. Stones can be extracted during ERCP, or either before or (in exceptional cases) after laparoscopic or open surgery. Bile duct clearance should always be combined with cholecystectomy. Evidence for further special aspects of CBDS treatment is equivocal and drawn from nonrandomized trials only. Conclusions: The management of common bile duct stones is currently undergoing some major changes. Many diagnostic and therapeutic strategies need further study.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900729
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Diagnosis and treatment of diverticular disease (1999)
    Springer
    Surgical endoscopy and other interventional techniques 13 (1999), S. 430-436 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Consensus development conference — Diverticulitis — Contrast enema — Hartmann resection — Laparoscopic colectomy — Intraabdominal infections
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: With the aim of resolving the current controversy over the diagnosis and treatment of diverticular disease, this consensus development conference set out to summarize the actual state of the art. Methods: A multidisciplinary panel of international experts (n= 16) was selected to take part in the consensus process. Prior to the conference, all experts were asked to answer a series of questions on diverticular disease. The consensus statement compiled out of these evaluations was modified during a joint meeting of the panel members, then presented for discussion in a public session, and finally revised by the expert panel. The finalized statement was mailed to all panel members for approval (Delphi method). Results: Asymptomatic diverticulosis, diverticular disease (with actual or recurrent symptoms), and complicated diverticular disease were defined separately. No agreement was reached on whether barium enema or colonoscopy is the better choice as an initial diagnostic tool in uncomplicated cases. In complicated cases, computed tomography is recommended for diagnosis. After two attacks of diverticular disease, elective resection should be considered. For patients in whom a concomitant carcinoma cannot be excluded and those with chronic complications (fistula, stenosis, or bleeding) surgery is also indicated. Laparoscopic sigmoid colectomy is recommended only for uncomplicated and, after percutaneous drainage of abscesses, Hinchey stage I and II cases. Conclusions: Laparoscopic surgery has already begun to influence the management of diverticular disease, but the randomized controlled trials needed to support therapy decisions are largely missing.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649901007
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Consensus conferences must include a systematic search and categorization of the evidence (2000)
    Springer
    Surgical endoscopy and other interventional techniques 14 (2000), S. 908 -910 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Clinical practice guidelines — Consensus development conference — Literature search — Publication bias — Retrieval bias
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Ideally, a consensus panel combines expert knowledge with external evidence derived from the literature. To date, many consensus conferences do not use a structured approach to search the literature, but simply compile an add-on reference list from all papers cited by the panelists. This study examined how well such panelists retrieved the relevant literature. Methods: We used the reference lists of nine surgeons who took part in a consensus conference on common bile duct stones. We included all papers that were referred to as randomized controlled trials (RCTs). We then compared this list with a database search in order to calculate sensitivity and specificity. Results: The nine experts cited between 35 and 518 papers, but only eight papers on average were RCTs. Of the 49 papers that the experts believed to be RCTs, only 23 actually were RCTs. The sensitivity resp. specificity for correctly identifying an RCT was 0.21 (95% Cl, 0.11–0.30) resp. 0.80 (95% Cl; 0.64–0.95). RCTs that included the word ``randomized'' in their title were significantly more likely to be identified (relative risk, 1.31; 95% Cl, 1.18–1.45). Conclusion: Our data indicate that consensus panelists usually do not perform systematic literature searches, but simply use their favorite papers to back up their arguments. Because this may lead to a biased selection of the evidence base on which the consensus statements are founded, a systematic search of all relevant articles should become a mandatory task in any consensus or guideline process.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004640000283
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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