| 1. |
- Arlien-Soborg, Mai C., et al.
(författare)
-
Acromegaly management in the Nordic countries: A Delphi consensus survey
- 2024
-
Ingår i: Clinical Endocrinology. - : WILEY. - 0300-0664 .- 1365-2265.
-
Tidskriftsartikel (refereegranskat)abstract
- ObjectiveAcromegaly is associated with increased morbidity and mortality if left untreated. The therapeutic options include surgery, medical treatment, and radiotherapy. Several guidelines and recommendations on treatment algorithms and follow-up exist. However, not all recommendations are strictly evidence-based. To evaluate consensus on the treatment and follow-up of patients with acromegaly in the Nordic countries.MethodsA Delphi process was used to map the landscape of acromegaly management in Denmark, Sweden, Norway, Finland, and Iceland. An expert panel developed 37 statements on the treatment and follow-up of patients with acromegaly. Dedicated endocrinologists (n = 47) from the Nordic countries were invited to rate their extent of agreement with the statements, using a Likert-type scale (1-7). Consensus was defined as >= 80% of panelists rating their agreement as >= 5 or <= 3 on the Likert-type scale.ResultsConsensus was reached in 41% (15/37) of the statements. Panelists agreed that pituitary surgery remains first line treatment. There was general agreement to recommend first-generation somatostatin analog (SSA) treatment after failed surgery and to consider repeat surgery. In addition, there was agreement to recommend combination therapy with first-generation SSA and pegvisomant as second- or third-line treatment. In more than 50% of the statements, consensus was not achieved. Considerable disagreement existed regarding pegvisomant monotherapy, and treatment with pasireotide and dopamine agonists.ConclusionThis consensus exploration study on the management of patients with acromegaly in the Nordic countries revealed a relatively large degree of disagreement among experts, which mirrors the complexity of the disease and the shortage of evidence-based data.
|
|
| 2. |
- Arlien-Søborg, Mai C., et al.
(författare)
-
Acromegaly management in the nordic countries : a Delphi consensus survey
- 2024
-
Ingår i: Clinical Endocrinology. - : John Wiley & Sons. - 0300-0664 .- 1365-2265.
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Acromegaly is associated with increased morbidity and mortality if left untreated. The therapeutic options include surgery, medical treatment, and radiotherapy. Several guidelines and recommendations on treatment algorithms and follow-up exist. However, not all recommendations are strictly evidence-based. To evaluate consensus on the treatment and follow-up of patients with acromegaly in the Nordic countries.Methods: A Delphi process was used to map the landscape of acromegaly management in Denmark, Sweden, Norway, Finland, and Iceland. An expert panel developed 37 statements on the treatment and follow-up of patients with acromegaly. Dedicated endocrinologists (n = 47) from the Nordic countries were invited to rate their extent of agreement with the statements, using a Likert-type scale (1−7). Consensus was defined as ≥80% of panelists rating their agreement as ≥5 or ≤3 on the Likert-type scale.Results: Consensus was reached in 41% (15/37) of the statements. Panelists agreed that pituitary surgery remains first line treatment. There was general agreement to recommend first-generation somatostatin analog (SSA) treatment after failed surgery and to consider repeat surgery. In addition, there was agreement to recommend combination therapy with first-generation SSA and pegvisomant as second- or third-line treatment. In more than 50% of the statements, consensus was not achieved. Considerable disagreement existed regarding pegvisomant monotherapy, and treatment with pasireotide and dopamine agonists.Conclusion: This consensus exploration study on the management of patients with acromegaly in the Nordic countries revealed a relatively large degree of disagreement among experts, which mirrors the complexity of the disease and the shortage of evidence-based data.
|
|
| 3. |
- Similä, Heidi, et al.
(författare)
-
Focus group evaluation of scenarios for fall risk assessment and fall prevention in two countries
- 2013
-
Ingår i: Ambient assisted living and active aging. - Cham : Springer. - 9783319030913 - 9783319030920 ; , s. 39-46
-
Konferensbidrag (refereegranskat)abstract
- Information and communication technologies (ICT) provide means for developing new tools for preventing falls. To enhance adherence to fall prevention interventions, end users need to be engaged from the early phases of the development process. This paper reports the focus group evaluation of five scenarios related to fall risk assessment and fall prevention. There were four focus groups with older adults in both Finland and Spain; 58 participants in all. The most interesting features for the interviewees were usage of intelligent gym equipment, the possibility of peer support and multi-factorial fall risk assessment. The scenario with intelligent gym equipment rose above the others among Finnish participants, while the scenarios were ranked more evenly by Spanish correspondents. The analysis showed that a personal history of falls and a connection to current habits and routines affected the reception of the proposed solutions.
|
|
