Abstract:
:This article describes the methodology for the Seventh American College of Chest Physicians (ACCP) Conference on Antithrombotic and Thrombolytic Therapy: Evidence-Based Guidelines. Guideline authors began by specifying the population, the intervention and alternative, and the outcomes for each clinical question, and defined the criteria for eligible articles, including methodological criteria, for each recommendation. Librarians, in collaboration with guideline authors and methodologists, conducted systematic searches for evidence. Guideline authors systematically evaluated the evidence, considered the full range of benefits, risks, inconvenience, and costs associated with alternative management strategies, considered patients' underlying values and preferences, and made recommendations accordingly. To increase the likelihood that the recommendations adequately represent patient values and preferences, the development process included a review of recommendations by research methodologists, practicing generalists, and specialists. Chapters are organized so that evidence is clearly linked to the relevant recommendations, and that recommendations particularly sensitive to underlying values and preferences are explicitly identified. Authors paid careful attention to the strength of the underlying evidence and to the balance between risks and benefits, which are both reflected in the grades of recommendations. Thus, improvements to the process of making recommendations for the ACCP guidelines include the explicit definition of questions, transparent eligibility criteria for including studies, and the specification of values and preferences underlying recommendations where they are particularly relevant. In combination with our previous practice of grading recommendations according to their strength, and the methodological quality of the supporting studies, these innovations establish our guidelines as, by and large, evidence based.
journal_name
Chestjournal_title
Chestauthors
Schünemann HJ,Munger H,Brower S,O'Donnell M,Crowther M,Cook D,Guyatt Gdoi
10.1378/chest.126.3_suppl.174Ssubject
Has Abstractpub_date
2004-09-01 00:00:00pages
174S-178Sissue
3 Suppleissn
0012-3692issn
1931-3543pii
S0012-3692(15)31489-6journal_volume
126pub_type
杂志文章相关文献
CHEST文献大全abstract:BACKGROUND:Mepolizumab was the first licensed anti-IL5 monoclonal antibody for severe eosinophilic asthma (SEA). To date there are few data to confirm its efficacy in the real-world setting or assessment of baseline characteristics associated with response. RESEARCH QUESTION:How do patients with severe eosinophilic as...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2020.03.042
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:A pulmonary right-to-left shunt (RLS) carries the risk of cerebral paradoxical embolization and severe neurologic complications. Recognizing patients at risk is important to facilitate appropriate management strategies, but a direct relation between pulmonary shunt size and risk of complications remains cont...
journal_title:Chest
pub_type: 杂志文章,多中心研究
doi:10.1378/chest.12-1599
更新日期:2013-08-01 00:00:00
abstract::A patient had accelerated attacks of chest pain associated with transient ST elevation or depression in the anterior leads. Coronary angiogram revealed severe multi-vessel disease. Anginal attacks with conspicuous ST depression were induced repeatedly by both oral and sublingual administration of nifedipine. Among var...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.81.5.646
更新日期:1982-05-01 00:00:00
abstract::A review of the incidence and severity of hemolysis in the aortic prosthesis is presented. The noncloth-covered Starr-Edwards prosthetic series 1000, 1200, and 1260 had a 2 percent (1/54) incidence of anemia. The cloth-covered Starr-Edwards aortic prosthetic series 2300 was associated with anemia in 61 percent (28/46)...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.69.1.56
更新日期:1976-01-01 00:00:00
abstract:OBJECTIVE:Fractional flow reserve (FFR) is a valid surrogate for hemodynamic significance in stenotic native coronary arteries, but its validity in patients with coronary stent restenosis is unknown. DESIGN:Prospective. SETTING:University hospital. PATIENTS:We studied 42 patients (mean age +/- 1 SD, 62 +/- 10 years)...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.128.3.1645
更新日期:2005-09-01 00:00:00
abstract:STUDY OBJECTIVES:The findings from conventional imaging modalities, such as chest CT, are frequently unreliable in patients with lung cancer. This study was designed to compare the relative diagnostic accuracies and utility of the two most widely used functional imaging examinations, F-18-2-fluoro-2-deoxyglucose (FDG) ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.125.2.494
更新日期:2004-02-01 00:00:00
abstract::Forty patients with atrial fibrillation and 20 patients with congestive heart failure and sinus rhythm were studied. Patients were divided into two groups. Group A consisted of 20 patients with atrial fibrillation in whom systolic time intervals were measured. Twenty to 50 beats were analyzed. Five of the patients had...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.74.6.629
更新日期:1978-12-01 00:00:00
abstract::Photoradiation therapy is a new technique being investigated for the treatment of solid malignant tumors. In this study, 17 patients with advanced, recurrent, biopsy-proven malignant lesions of the trachea or main-stem bronchus were treated by photoradiation therapy. Patients received hematoporphyrin derivative intrav...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.85.1.29
更新日期:1984-01-01 00:00:00
abstract:OBJECTIVES:To investigate the time course and the relation to prognosis of coagulation and fibrinolytic abnormalities in patients with septic shock. PATIENTS AND METHODS:Forty-eight consecutive patients admitted to the medical ICU with the diagnosis of septic shock (diagnosed by defined criteria) were studied. Mortali...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.103.5.1536
更新日期:1993-05-01 00:00:00
abstract::Survival from reversible forms of severe pulmonary insufficiency remains dismal despite the development of artificial oxygenators. We hypothesized that an intraabdominal heterotopic lung could help maintain adequate oxygenation during acute pulmonary insufficiency. Five mongrel dogs underwent an acute heterotopic lung...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.106.1.257
更新日期:1994-07-01 00:00:00
abstract::Heterozygous familial type II hyperlipoproteinemia (F type II) is primarily manifested in hypercholesterolemia (due to low density lipoprotein-cholesterol [LDL-C] elevation) and premature coronary heart disease (CHD). We studied sequentially the effects of low cholesterol-low saturated fat-low simple carbohydrate diet...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.79.3.286
更新日期:1981-03-01 00:00:00
abstract::A median sternotomy approach was used for closure of patent ductus arteriosus associated with a hypoplastic right lung. The anterior approach to the left ductus is indicated if left thoracotomy is contraindicated. ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.69.6.785
更新日期:1976-06-01 00:00:00
abstract::Medical malpractice with its associated costs, including insurance premiums, impact on practice, consequences for career and insurability, and emotional toll, is a reality of practicing medicine in the United States. Understanding the types of claims that may be asserted, the issues to consider when securing insurance...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.08-0186
更新日期:2008-11-01 00:00:00
abstract:STUDY OBJECTIVES:To determine the effect of tumor diameter on the long-term survival of patients with stage I non-small cell lung cancer (NSCLC) within a large multi-institutional database, and to assess the accuracy of the T-descriptor threshold of 3 cm. DESIGN AND PATIENTS:A total of 9,191 patients > or = 20 years o...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.128.5.3255
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:Increased right ventricular afterload leads to left ventricular diastolic dysfunction due to ventricular interdependence. Increased right ventricular afterload is frequently present in patients with COPD. The purpose of this study was to determine whether left ventricular diastolic dysfunction could be detec...
journal_title:Chest
pub_type: 临床试验,杂志文章
doi:10.1378/chest.07-2685
更新日期:2008-06-01 00:00:00
abstract::Acute hypoxemic respiratory failure (AHRF) can result from diverse lung insults. Toxic oxygen metabolites have been implicated in this clinical condition and in animal models of pulmonary edema. Hydrogen peroxide (H2O2), an oxygen metabolite, mediates tissue injury. We measured H2O2 levels by a spectrophotometric tech...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.96.3.606
更新日期:1989-09-01 00:00:00
abstract:STUDY OBJECTIVE:To determine how the volume and severity of emphysema measured by CT morphometry (CTM) before and after lung volume reduction surgery (LVRS) relates to the functional status of patients after LVRS. DESIGN:A histologically validated CT algorithm was used to quantify the volume and severity of emphysema ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.118.5.1240
更新日期:2000-11-01 00:00:00
abstract::Liquid silicone is an inert material that is utilized for cosmetic procedures by physicians as well as illegally by nonmedical personnel. We present a case report and collated clinical findings of 32 other patients who were hospitalized after illegal silicone injections. Symptoms and signs of the "silicone syndrome" i...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.127.6.2276
更新日期:2005-06-01 00:00:00
abstract::Significant concentrations of asbestos fibers have been found in samples of laryngeal tissue from two patients with past exposure to asbestos and associated asbestosis. In one case, there was a polyp on a vocal cord and in the other one a laryngeal carcinoma. These findings could provide an indication of a local carci...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.76.6.697
更新日期:1979-12-01 00:00:00
abstract::We studied 15 nonsmoking, clinically stable asthmatic subjects aged 27 to 39 years to evaluate the potential cardiotoxic effects of combined use of a beta-adrenergic agonist drug and theophylline in the treatment of asthma. Subjects underwent a one-week washout period followed by two one-week periods of study receivin...
journal_title:Chest
pub_type: 临床试验,杂志文章
doi:10.1378/chest.90.1.45
更新日期:1986-07-01 00:00:00
abstract::Tracheal extubation after laryngotracheal reconstruction in children may be complicated by postoperative tracheal edema and pulmonary dysfunction. The replacement of a tracheal tube in this situation may exacerbate the existing injury to the tracheal mucosa, complicating subsequent attempts at tracheal extubation. We ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.116.1.260
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:Although alveolar epithelial injury is a major determinant of outcome in patients with acute lung injury, there is no reliable biological marker of alveolar epithelial injury. The primary objective was to determine whether elevated levels of the receptor for advanced glycation end products (RAGE), a marker o...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.08-0919
更新日期:2009-02-01 00:00:00
abstract::The purpose of this study was to rationalize the choice of injector and bronchoscope sizes during bronchoscopy under general anesthesia using the Sanders attachment technique. Arterial Po2 and Pco2, FIo2, and peak inspiratory pressure at the tip of the bronchoscope were plotted against the ratio (RI/B) of the internal...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.81.5.596
更新日期:1982-05-01 00:00:00
abstract::Urticaria with systemic effects occurred in a patient being treated with propranolol and was reproducible upon rechallenge with the drug; Successful beta-adrenergic blocking therapy was achieved using a new agent, tolamolol, with no evidence of any adverse effects. ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.67.4.496
更新日期:1975-04-01 00:00:00
abstract:OBJECTIVES:To evaluate the additional information provided by pulse transit time (PTT), a noninvasive tool, when using during polysomnography for the diagnosis of sleep breathing disorders in a pediatric population. MAIN FINDINGS:Respiratory and microarousals events were scored twice. The first scoring was performed u...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.127.3.722
更新日期:2005-03-01 00:00:00
abstract::Colloid osmotic pressure (COP) was measured serially in 81 critically ill neonates with hyaline membrane disease (HMD) during the first five days of life, and these changes were correlated with the birth weight, gestational age, serum protein level, clinical status, and outcome. Colloid osmotic pressure correlated bet...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.83.5.776
更新日期:1983-05-01 00:00:00
abstract::Cough and wheezing are frequent side effects of inhaling beclomethasone dipropionate aerosol (BA) in patients with asthma. Twenty percent of our outpatient asthmatic subjects are unable to take BA due to these side effects. Twelve patients with history of severe cough and wheezing after inhaling BA were tested. Three ...
journal_title:Chest
pub_type: 临床试验,杂志文章
doi:10.1378/chest.91.2.207
更新日期:1987-02-01 00:00:00
abstract::The issue of tobacco industry responsibility for population health problems and compensation for their treatment has been growing since the 1960s. In 1999, the state attorneys general collectively launched the largest class action lawsuit in US history and sued the tobacco industry to recover the costs of caring for s...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.09-0982
更新日期:2010-03-01 00:00:00
abstract::A number of general observations can be made from these recent studies. Lactate is a ubiquitous substance that is produced and removed from the body at all times, even at rest, both with and without the availability of oxygen. It is now recognized that lactate accumulates in the blood for several reasons, not just the...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.111.3.787
更新日期:1997-03-01 00:00:00
abstract::Several reports have implicated pregnancy as a cause of deterioration in patients with pulmonary arteriovenous fistulas. We report a 27-year-old woman with multiple pulmonary arteriovenous fistulas who required coil spring embolotherapy in her 24th week of pregnancy due to a spontaneous hemothorax and hypoxemia. ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.98.6.1522
更新日期:1990-12-01 00:00:00