Assessment of Intervention Fidelity and Recommendations for Researchers Conducting Studies on the Diagnosis and Treatment of Chronic Cough in the Adult: CHEST Guideline and Expert Panel Report

BACKGROUND: Successful management of chronic cough has varied in the primary research studies in the reported literature. One of the potential reasons relates to a lack of intervention fidelity to the core elements of the diagnostic and/or therapeutic interventions that were meant to be used by the investigators.

METHODS: We conducted a systematic review to summarize the evidence supporting intervention fidelity as an important methodologic consideration in assessing the effectiveness of clinical practice guidelines used for the diagnosis and management of chronic cough. We developed and used a tool to assess for five areas of intervention fidelity. Medline (PubMed), Scopus, and the Cochrane Database of Systematic Reviews were searched from January 1998 to May 2014. Guideline recommendations and suggestions for those conducting research using guidelines or protocols to diagnose and manage chronic cough in the adult were developed and voted upon using CHEST Organization methodology.

RESULTS: A total of 23 studies (17 uncontrolled prospective observational, two randomized controlled, and four retrospective observational) met our inclusion criteria. These articles included 3,636 patients. Data could not be pooled for meta-analysis because of heterogeneity. Findings related to the five areas of intervention fidelity included three areas primarily related to the provider and two primarily related to the patients. In the area of study design, 11 of 23 studies appeared to be underpinned by a single guideline/protocol; for training of providers, two of 23 studies reported training, and zero of 23 reported the use of an intervention manual; and for the area of delivery of treatment, when assessing the treatment of gastroesophageal reflux disease, three of 23 studies appeared consistent with the most recent guideline/protocol referenced by the authors. For receipt of treatment, zero of 23 studies mentioned measuring concordance of patient-interventionist understanding of the treatment recommended, and zero of 23 mentioned measuring enactment of treatment, with three of 23 measuring side effects and two of 23 measuring adherence. The overall average intervention fidelity score for all 23 studies was poor (20.74 out of 48).

CONCLUSIONS: Only low-quality evidence supports that intervention fidelity strategies were used when conducting primary research in diagnosing and managing chronic cough in adults. This supports the contention that some of the variability in the reporting of patients with unexplained or unresolved chronic cough may be due to lack of intervention fidelity. By following the recommendations and suggestions in this article, researchers will likely be better able to incorporate strategies to address intervention fidelity, thereby strengthening the validity and generalizability of their results that provide the basis for the development of trustworthy guidelines.

Role of Automated Open Source Systems in the Intelligence Analysis of a High-Level Domain Expert

The role of implicit theories in the formation of expert opinion in portuguese criminal law

Tese de doutoramento, Ciências e Tecnologias da Saúde (Medicina Legal e Ciências Forenses), Universidade de Lisboa, Faculdade de Medicina, 2014

Expert Insight into the Assessment of Competence in Cognitive–behavioural Therapy: a Qualitative Exploration of Experts' Experiences, Opinions and Recommendations

To offer insight into how cognitive–behavioural therapy (CBT) competence is defined, measured and evaluated and to highlight ways in which the assessment of CBT competence could be further improved, the current study utilizes a qualitative methodology to examine CBT experts’ (N = 19) experiences of conceptualizing and assessing the competence of CBT therapists. Semi-structured interviews were used to explore participants’ experiences of assessing the competence of CBT therapists. Interview transcripts were then analysed using interpretative phenomenological analysis in order to identify commonalities and differences in the way CBT competence is evaluated. Four superordinate themes were identified: (i) what to assess, the complex and fuzzy concept of CBT competence; (ii) how to assess CBT competence, selecting from the toolbox of assessment methods; (iii) who is best placed to assess CBT competence, expertise and independence; and (iv) pitfalls, identifying and overcoming assessment biases. Priorities for future research and ways in which the assessment of CBT competence could be further improved are discussed in light of these findings.

Transcatheter renal denervation for the treatment of resistant arterial hypertension: the Swiss expert consensus.

Transcatheter (or percutaneous) renal denervation is a novel technique developed for the treatment of resistant hypertension. So far, only one randomised controlled trial has been published, which has shown a reduction of office blood pressure. The Swiss Society of Hypertension, the Swiss Society of Cardiology, The Swiss Society of Angiology and the Swiss Society of Interventional Radiology decided to establish recommendations to practicing physicians and specialists for good clinical practice. The eligibility of patients for transcatheter renal denervation needs (1.) confirmation of truly resistant hypertension, (2.) exclusion of secondary forms of hypertension, (3.) a multidisciplinary decision confirming the eligibility, (4.) facilities that guarantee procedural safety and (5.) a long-term follow-up of the patients, if possible in cooperation with a hypertension specialist. These steps are essential until long-term data on safety and efficacy are available.

Catalogue d'une importante collection de vignettes par ou d'après Borel, Choffard, Eisen, Gravelot, Lebarbier, Marillier, Monnet, Moreau le jeune, Queverdo et autres, Portraits des XVIe, XVIIe et XVIIIe siècles, Estampes, dessins des XVIIIe et XIXe siècles, autographes, suites de figures, composant la collection de Mr H. de G. La vente aura lieu du lundi 27 février au mercredi 8 mars 1893... 28 rue des Bons-Enfants... / Me Maurice Delestre, commissaire-priseur ; [expert] M. Ch. Porquet, libraire, M. P. Roblin, marchand d'estampes

[Vente. Art. 1893-02-27 - 1893-03-08. Paris]

Catalogue d'une collection très importante de planches gravées en tous genres par les maîtres et artsites les plus célèbres du XVe au XIXe siècle, formant la 1re partie du fonds de commerce d'éditeur d'estampes de Mme veuve Auguste Jean, dont la vente, par cessation définitive de commerce, aura lieu... les lundi 2, mardi 3, mercredi 4 et jeudi 5 février 1846... Hôtel de ventes mobilières, place de la Bourse, 2... / Me Merlin, commissaire-priseur ; M. Vallée, expert, rue de Chartres-Saint-Honoré, n° 8...

[Vente. Art. 1846-02-02 - 1846-02-05. Paris]

Catalogue des planches gravées en tous genres par les plus célèbres graveurs du XVe au XIXe siècle, composant le fonds de commerce d'éditeur d'estampes de Mme Vve Auguste Jean. Deuxième partie dont la vente, par continuation et par suite de cessation de commerce, aura lieu les mardi 16, mercredi 17, jeudi 18 et vendredi 19 juin 1846 et le lundi suivant, 22 juin, pour les cartes géographiques... Hôtel de ventes mobilières, place de la Bourse, n° 2... / Me Merlin, commissaire-priseur ; M. J. Vallée, expert, rue de Chartres-Dt.-Honoré, 8

[Vente. Art. 1846-06-16 - 1846-06-22. Paris]

Catalogue des planches gravées en tous genres par les plus célèbres graveurs du XVe au XIXe siècle, composant le fonds de commerce d'éditeur d'estampes de Mme Vve Auguste Jean. Troisième partie dont la vente, par continuation et par suite de cessation de commerce, aura lieu les mardi 24, mercredi 25, jeudi 26, vendredi 27 et samedi 28 novembre 1846... Hôtel de ventes mobilières, place de la Bourse, n° 2... / Me Merlin, commissaire-priseur ; M. J. Vallée, expert, rue de Chartres-Dt.-Honoré, 8

[Vente (Art). 1846-11-24 - 1846-11-28. Paris]