Clinical Practice Guidelines and Recommendations
Accumulated Short Bouts of Physical Activity Are Associated With Reduced Premature All-Cause Mortality: Implications for Physician Promotion of Physical Activity and Revision of Current US Government Physical Activity GuidelinesCurrent physical activity (PA) guidelines issued by the US Department of Health and Human Services recommend that adults engage in 150 min/wk or more of moderate to vigorous PA (MVPA). Stated in the guidelines, this dose of MVPA is to occur in bouts lasting at least 10 minutes; thus, a brisk 6-minute MVPA walk from the car to the office would not count toward the 150 min/wk goal.
In reply–Clinical Practice Guidelines: Still Miles to Go…We thank Khan et al for their interest in our article assessing practice guidelines in interventional medical specialties1 and strongly agree that the issues with guidelines go beyond just those of the interventional subspecialties. In fact, we have already reported the results of other studies citing the limited evidence among gastroenterology2 and inflammatory bowel disease3 guidelines, and others have shown similar results for cardiology,4 infectious diseases,5 and liver diseases.6
Clinical Practice Guidelines: Still Miles to Go…In their article published in the January 2014 issue of Mayo Clinic Proceedings, Feuerstein et al1 reported that only a relatively small number of the guidelines from interventional subspecialty societies are based on evidence derived from randomized controlled trials. This scenario is not limited to guidelines developed by interventional medicine societies; guidelines developed by other professional organizations are also largely based on low levels of evidence.2-4 This factor is largely related to lack of research focused toward bridging gaps in the evidence base.
Clinical Practice: American College of Physicians Guidelines and U.S. Preventive Services Task Force RecommendationsA compilation of evidence-based American College of Physicians (ACP) guidelines for management of chronic diseases, ACP guidelines for antibiotic use in adult upper respiratory tract infection, and U.S. Preventive Services Task Force (USPSTF) guidelines for screening for common conditions.
Parkinson's Disease and Movement Disorders: Diagnosis and Treatment Guidelines for the Practicing PhysicianType of Book: A multiauthored hardbound textbook on Parkinson disease and other movement disorders.
Handbook of Venous Disorders: Guidelines of the American Venous ForumType of Book: A comprehensive multiauthored text on venous and lymphatic disorders.
Dosage Guidelines for Pediatric HypertensionThe comprehensive review of the clinical aspects of pediatric hypertension by Lieberman in the November 1994 issue of the Mayo Clinic Proceedings (pages 1098 to 1107) contains some dosage guidelines for medications used in the treatment of hypertensive emergencies that bear analysis, specifically those for diazoxide and labetalol hydrochloride. The risks associated with bolus diazoxide therapy have been well described.1 The efficacy of “minibolus” doses (1 to 3 mg/kg) was first demonstrated in 1979,2 although the use of smaller doses in children was described by Boerth and Long in 1977.
The Ocular Fundus: A Photographic Documentation Atlas With Diagnostic and Therapeutic GuidelinesBecause of the rapid expansion of scientific information in many medical specialties, primary-care physicians, as well as medical students, have found it difficult to glean a basic understanding of many disease processes from the increasingly complex subspecialty literature. Recently, numerous atlases and textbooks have been published to aid the busy medical student or clinician in attaining this basic knowledge. Any specialist who wishes to enlighten others about his specialty, however, faces the difficult assignment of determining which facts at his disposal are of interest and value to his primary-care colleagues and which will only burden or bore them.
Cancer in Pregnancy: Therapeutic GuidelinesOlder statistics indicated that cancer occurred in approximately 1 in 1,000 pregnant women; because women now often wait until later years to have children, an increase in the number of pregnant women with cancer might be expected. This book deals with the problems of most of the common malignant lesions seen during pregnancy.