The EPAGE internet guideline as a decision support tool for determining the appropriateness of colonoscopy

Background: Few studies have examined how physicians perceive guidelines, much less their perceptions of an Internet presentation of such guidelines. This study assessed physicians' acceptance ofan Internet-based guideline on the appropriateness of colonoscopy. Methods: Gastroenterologists participating in an international observational study consulted an Internet-based guideline for consecutive patients referred for colonoscopy. The guideline was produced by the European Panel on the Appropriateness of Gastrointestinal Endoscopy (EPAGE), using a validated method (RAND). Through the use of questionnaires, physicians were asked their opinions and perspectives of the guideline and website. Results: There were 289 patients included in the study. The mean time for consulting the website was 1.8 min, and it was considered easy to use by 86% of physicians. The recommendations were easily located for 82% of patients and physicians agreed with the appropriateness in 86% of cases. According to the EPAGE criteria, colonoscopy was appropriate, uncertain, and inappropriate in 59, 28, and 13% of patients, respectively. Conclusions: The EPAGE guideline was considered acceptable and user-friendly and the use, usefulness and relevance of the website were considered acceptable. However, its actual use will depend on the removal of certain organizational and cultural obstacles. [Ed.]]]> Colonoscopy ; Decision Support Systems, Clinical ; Guideline Adherence ; Internet ; Practice Guidelines as Topic oai:serval.unil.ch:BIB_05FB84362D0C 2022-01-08T02:10:05Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_05FB84362D0C Ein Tonmodel aus Kaiseraugst Wachter, R. Kaufmann-Heinimann, A. Peter, M. Müller, U. info:eu-repo/semantics/article article 2008 JbAK, no. 29, pp. 287-298 ger oai:serval.unil.ch:BIB_05FBCD424B3F 2022-01-08T02:10:05Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_05FBCD424B3F Handbook of Theoretical and Quantitative Geography urn:isbn:9782940368082 info:eu-repo/semantics/altIdentifier/isbn/9782940368082 Bavaud, F. (ed.) Mager, C. (ed.) info:eu-repo/semantics/book book 2009-12 eng https://serval.unil.ch/resource/serval:BIB_05FBCD424B3F.P001/REF.pdf http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_05FBCD424B3F6 info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_05FBCD424B3F6 info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/openAccess Copying allowed only for non-profit organizations https://serval.unil.ch/disclaimer application/pdf oai:serval.unil.ch:BIB_05FBE03A411B 2022-01-08T02:10:05Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_05FBE03A411B Image guided critical screw placement precision in the cervical spine : important or incidental? : results of a series of 91 consecutive cases using OVEM Duff, J. M. Université de Lausanne, Faculté de biologie et médecine info:eu-repo/semantics/doctoralThesis phdthesis 2015 <![CDATA[Study design: A retrospective study of image guided cervical implant placement precision. Objective: To describe a simple and precise classification of cervical critical screw placement. Summary of Background Data: "Critical" screw placement is defined as implant insertion into a bone corridor which is surrounded circumferentially by neurovascular structures. While the use of image guidance has improved accuracy, there is currently no classification which provides sufficient precision to assess the navigation success of critical cervical screw placement. Methods: Based on postoperative clinical evaluation and CT imaging, the orthogonal view evaluation method (OVEM) is used to classify screw accuracy into grade I (no cortical breach), grade la (screw thread cortical breach), grade II (internal diameter cortical breach) and grade III (major cortical breach causing neural or vascular injury). Grades II and III are considered to be navigation failures, after accounting for bone corridor / screw mismatch (minimal diameter of targeted bone corridor being smaller than an outer screw diameter). Results: A total of 276 screws from 91 patients were classified into grade I (64.9%), grade la (18.1%), and grade II (17.0%). No grade III screw was observed. The overall rate of navigation failure was 13%. Multiple logistic regression indicated that navigational failure was significantly associated with the level of instrumentation and the navigation system used. Navigational failure was rare (1.6%) when the margin around the screw in the bone corridor was larger than 1.5 mm. Conclusions: OVEM evaluation appears to be a useful tool to assess the precision of critical screw placement in the cervical spine. The OVEM validity and reliability need to be addressed. Further correlation with clinical outcomes will be addressed in future studies