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The landscape for advanced prostate cancer has significantly evolved over the past decade. However, there remains a notable lack of robust evidence across various facets of clinical practice. The Taiwan Urological Association organized the 2022 Taiwan Advanced Prostate Cancer Consensus Conference (TAPCCC) to address specific topics designed to augment existing guidelines. The TAPCCC 2022 questionnaire was designed based on the Advanced Prostate Cancer Consensus Conference 2022 held by the Advanced Prostate Cancer Society and tailored to regional characteristics and medical practice in Taiwan. The questionnaire involved 7 areas of advanced prostate cancer: high-risk and locally advanced prostate cancer, biochemical recurrence, management of metastatic hormone-sensitive prostate cancer, management of nonmetastatic castration-resistant prostate cancer, importance of lifestyle and prevention of complications in advanced prostate cancer, management of metastatic castration-resistant prostate cancer, and oligometastatic and oligoprogressive prostate cancer. The panel experts voted anonymously on 93 predefined questions before and after the conference following a modified Delphi process. A consensus was defined as ≥75% agreement of answer options and strong consensus was defined as ≥90% agreement of answer options. A total of 61 Taiwanese panel experts were involved. Of the 93 questions asked, 40 (43.0%) achieved consensus and 14 (15.1%) reached a strong consensus. In addition, 18 questions (19.4%) demonstrated a ≥75% agreement while combining answer options. The voting results were presented alongside the most recent guidelines and evidence found in the literature, a detailed report of which is included in Supplementary Materials, http://links.lww.com/URSC/A51. In conclusion, the TAPCCC 2022 successfully identified salient issues, and the consensus answer options arising from the conference merit thorough evaluation for integration into clinical practice. The voting results offer guidance for clinicians navigating the management of advanced prostate cancer, particularly in situations where there is a paucity of robust evidence. [ABSTRACT FROM AUTHOR]

Introduction Objective Methods Results Conclusion The Geriatric Emergency Care Applied Research Network 2.0‐Advancing Dementia Care (GEAR 2.0‐ADC) aims to advance research efforts to improve the emergency care of persons living with dementia (PLWDs).To support this objective, GEAR 2.0‐ADC convened a virtual consensus conference to prioritize emergency care research opportunities for PLWDs inclusive of perspectives of PLWDs to ensure identification of research gaps in response to their experiences and priorities. Inclusion of PLWDs as research partners is increasingly recognized as a best practice, however, approaches to facilitating consensus participation are lacking.Best practices for supporting the engagement of PLWDs in a consensus conference, applied across its three phases (pre‐conference, during the conference, and post‐conference), include: establishing a learning environment focused on research priorities before the event, presenting information in ways that align with participants' learning preferences while accommodating cognitive impairments, and providing multiple opportunities and methods for gathering post‐conference feedback from PLWDs.These strategies were identified by PLWDs and care partners (CPs) through semi‐structured interviews, who were involved in the convening process, aimed at exploring ways to enhance facilitation techniques for participants.Additionally, these summarized insights aim to encourage the use of community‐engaged approaches in discussions and consensus‐building around research priorities in emergency care, particularly for PLWDs and their CPs. [ABSTRACT FROM AUTHOR]

Food waste is a major source of avoidable greenhouse gas emissions. Responsible research and innovation (RRI) should contribute to meeting urgent challenges like climate change. This paper discusses collaborative innovations to reduce food waste and analyses this from the perspective of RRI, understood as purpose and process requirements. We study to what extent the focus on a responsible innovation outcome in Norwegian food supply chain collaboration corresponds with respecting the process dimensions of RRI, based on interviews and a consensus conference process. This contributes to understanding whether an urgent purpose can facilitate or is a barrier to the process dimensions of RRI. We find that besides aiming for a good outcome, the food companies intend to innovate in an inclusive and reflective way. The sustainability agenda as an important purpose for innovation, and the urgency of the goal of reducing food waste, is in our study well aligned with RRI.

Introduction and hypothesis: The International Urogynecological Association (IUGA) brought together senior and junior members actively engaged in scholarly and educational activities for a consensus conference centered on developing a strategy for sustainable training of the next generation of mechanistic researchers in female pelvic medicine. Methods: Four a priori identified major foci were explored in a half-day virtual consensus conference. Participants included representatives from various countries and disciplines with diverse backgrounds—clinicians, physician-scientists, and basic scientists in the fields of urogynecology, biomechanical engineering, and molecular biology. Following a keynote address, each focus area was first tackled by a dedicated breakout group, led by the Chair(s) of the most relevant IUGA committees. The break-out sessions were followed by an iterative discussion among all attendees to identify mitigating strategies to address the shortage of mechanistic researchers in the field of female pelvic medicine. Results: The major focus areas included: research priorities for IUGA basic science scholar program; viable strategies for sustainable basic science mentorship; core competencies in basic science training; and the challenges of conducting complex mechanistic experiments in low-resource countries. Key gaps in knowledge and core competencies that should be incorporated into fellowship/graduate training were identified, and existing training modalities were discussed. Recommendations were made for pragmatic approaches to increasing the exposure of trainees to learning tools to enable sustainable training of the next generation of basic science researchers in female pelvic medicine worldwide. Conclusions: The attendees presented multiple perspectives to gain consensus regarding critical areas of need for training future generations of mechanistic researchers. Recommendations for a sustainable Basic Science Scholar Program were developed using IUGA as a platform. The overarching goal of such a program is to ensure a successful bench-to-bedside-and-back circuit in Urogynecology and Pelvic Reconstructive Surgery, ultimately improving lives of millions of women worldwide through scientifically rational effective preventative and therapeutic interventions. [ABSTRACT FROM AUTHOR]

This forum summarizes the proceedings of the joint European Surgical Association (ESA)/American Surgical Association (ASA) symposium on Quality and Outcome Assessment for Surgery that took place in Bordeaux, France, as part of the celebrations of the 30th anniversary of the ESA. Three presentations focused on a) the main messages from the Outcome4Medicine Consensus Conference, which took place in Zurich, Switzerland, in June 2022, b) the patient perspective, and c) benchmarking were hold by ESA members and discussed by ASA members in a symposium attended by members of both associations. [ABSTRACT FROM AUTHOR]

Aim: To obtain input from multiple stakeholders and generate agreement on essential outcomes in implant dentistry using the Delphi methodology and incorporate them into an international consensus defining a core outcome set. Materials and Methods: Candidate outcomes in implant dentistry were generated from scientific evidence through five commissioned systematic reviews and from people with lived experience in dental implants (PWLE) through four international focus groups. A steering committee identified stakeholders among representatives from dental professionals, industry‐related experts and PWLE. Participants underwent a three‐round Delphi survey using a multi‐stakeholder approach; they assessed candidate outcomes and additional outcomes identified in the first Delphi round. The process followed the COMET methodology. Results: From the 665 potential outcomes identified in the systematic reviews and 89 in the PWLE focus group, the steering committee selected 100 and organized them into 13 categories, to be included in the first‐round questionnaire as candidate outcomes. A total of 99 dental experts, 7 dental‐industry‐related experts and 17 PWLE participated in the first round, and 11 additional outcomes were added to the second round. There was no attrition between the first and second rounds, where 61 (54.9%) outcomes exceeded the pre‐established threshold of agreement. PWLE and experts participated in the third round that applied "a priori" standard filters to distil a list of candidate essential outcomes. Conclusion: This Delphi study utilized a standardized, transparent and inclusive methodology and preliminarily validated 13 essential outcomes organized into four core areas. These results informed the final stage of the ID‐COSM consensus. [ABSTRACT FROM AUTHOR]

Aim: Lack of consistently reported outcomes limits progress in evidence‐based implant dentistry and quality of care. The objective of this initiative was to develop a core outcome set (COS) and measurements for implant dentistry clinical trials (ID‐COSM). Materials and Methods: This Core Outcome Measures in Effectiveness Trials (COMET)‐registered international initiative comprised six steps over 24 months: (i) systematic reviews of outcomes reported in the last 10 years; (ii) international patient focus groups; (iii) a Delphi project with a broad range of stakeholders (care providers, clinical researchers, methodologists, patients and industry representatives); (iv) expert group discussions organizing the outcomes in domains using a theoretical framework and identifying the COSs; (v) identification of valid measurement systems to capture the different domains and (vi) final consensus and formal approval involving experts and patients. The methods were modified from the best practice approach following the Outcome Measures in Rheumatoid Arthritis Clinical Trial and COMET manuals. Results: The systematic reviews and patient focus groups identified 754 (665 + 89, respectively) relevant outcome measures. After elimination of redundancies and duplicates, 111 were formally assessed in the Delphi project. By applying pre‐specified filters, the Delphi process identified 22 essential outcomes. These were reduced to 13 after aggregating alternative assessments of the same features. The expert committee organized them into four core outcome areas: (i) pathophysiology, (ii) implant/prosthesis lifespan, (iii) life impact and (iv) access to care. In each area, core outcomes were identified to capture both the benefits and harms of therapy. Mandatory outcome domains included assessment of surgical morbidity and complications, peri‐implant tissue health status, intervention‐related adverse events, complication‐free survival and overall patient satisfaction and comfort. Outcomes deemed mandatory in specific circumstances comprised function (mastication, speech, aesthetics and denture retention), quality of life, effort for treatment and maintenance and cost effectiveness. Specialized COSs were identified for bone and soft‐tissue augmentation procedures. The validity of measurement instruments ranged from international consensus (peri‐implant tissue health status) to early identification of important outcomes (patient‐reported outcomes identified by the focus groups). Conclusions: The ID‐COSM initiative reached a consensus on a core set of mandatory outcomes for clinical trials in implant dentistry and/or soft tissue/bone augmentation. Adoption in future protocols and reporting on the respective domain areas by currently ongoing trials will contribute to improving evidence‐informed implant dentistry and quality of care. [ABSTRACT FROM AUTHOR]

This commentary aims to highlight pros and cons of the evidence-based approach to psychotherapy research. Although the relevance of scientific evidence to the development of guidelines for psychological treatments, there are still some barriers to translate research results into routine clinical practice. The challenges are especially linked to the adoption of randomized controlled trials (RCT), which are not well suited to examine non-manualized psychotherapies and to test the effectiveness of treatments for patients with complex psychopathologies. Moreover, meta-analytic studies on the treatment for anxiety and depression showed that the quality of evidence of RCTs is limited, and recommending firm conclusions is still challenging. It is suggested that both psychotherapy research and evidencebased guidelines to psychological therapies should move towards personalizing treatments for anxiety and depression. [ABSTRACT FROM AUTHOR]

The document under discussion questions the entire scientific community and in particular those dedicated to the protection of physical and mental health. Which chosen method meets truly scientific criteria? What are the ethical and deontological implications? How much attention has been paid to the age of development, which is essential for the proper prevention and protection of future citizens? What understanding has been achieved regarding the pathological processes investigated? How effective is the tool defined as 'Consensus Conference' in informing and reaching out to citizens? The author carefully processes these aspects in the article and sends to the scientific community involved new questions that are indispensable for a lay approach (free of connotations and pre-judgments of specific psychological schools) but consistent with the scientific method, indispensable for the collective growth of knowledge. Her effort in commenting on this aspect aims not so much to point out what the author agrees with or disagrees with or to examine the merits of specific contents, but to point out crucial passages where the confusion between epistemological, theoretical, and technical levels generates slippage or the intertwining of levels risks distancing rather than bringing closer the goal that is proposed. [ABSTRACT FROM AUTHOR]

The aim of this work is to contribute to the ongoing debate on the Consensus Conference on Psychological Therapies for Anxiety and Depression. Taking a scientific approach to implement the guidelines of the Istituto Superiore di Sanità, I will frame my reflections in a peer-review format identifying five areas that might benefit from the review. Obviously, the opinions I express here may be faulty opinions that I will attempt to justify from the standpoint of existing scientific literature. [ABSTRACT FROM AUTHOR]

We evaluate whether people will outsource their opinion on public policy to consensus conference participants. The ideal consensus conference brings together a representative sample of citizens and introduces them to the range of perspectives and evidence related to some policy. The sample is given the opportunity to ask questions of experts and to deliberate. Attitudes about each policy are queried before and after the conference to see if the event has changed minds. In general, such conferences do produce opinion shifts. Our hypothesis is that the shift can be leveraged by simply communicating conference results – absent substantive information about the merits of the policies discussed – to scale up the value of conferences to the population at large. In five studies, we tell participants about the impact of a consensus conference on a sample of citizens' opinions for a range of policies without providing any new information about the inherent value of the policy itself. For several of the policies, we see a shift in opinion. We conclude that the value of consensus conferences can be scaled up simply by telling an electorate about its results. This suggests an economical way to bring evidence and rational argument to bear on citizens' policy attitudes. [ABSTRACT FROM AUTHOR]

Background/Aim: Differences between radiotherapy for metastases in Northern Germany and Southern Denmark were previously identified, which led to a consensus conference. Patients and Methods: A consensus conference was held between three centers to harmonize radiotherapy regimens for bone and brain metastases. Results: Centers agreed on 1×8 Gy for painful bone metastases in patients with poor or intermediate survival prognoses and 10×3 Gy for favorable-prognosis patients. For complicated bone metastases, 5-6×4 Gy was preferred for poorprognosis, 10×3 Gy for intermediate-prognosis, and longer-course radiotherapy for favorable-prognosis patients. For =5 brain metastases, centers agreed on whole-brain irradiation (WBI) with 5×4 Gy in poor-prognosis and longer-course regimens in other patients. For single brain lesions and patients with 2-4 lesions and intermediate/favorable prognoses, fractionated stereotactic radiotherapy (FSRT) or radiosurgery were recommended. No consensus was reached for 2-4 lesions in poor-prognosis patients; two centers preferred FSRT, one center WBI. Preferred radiotherapy regimens were similar for different age groups including elderly and very elderly patients, but age-specific survival scores were recommended. Conclusion: The consensus conference was successful, since harmonization of radiotherapy regimens was achieved for 32 of 33 possible situations. [ABSTRACT FROM AUTHOR]

Background: Health technology assessments (HTAs) of robotic assisted surgery (RAS) face several challenges in assessing the value of robotic surgical platforms. As a result of using different assessment methods, previous HTAs have reached different conclusions when evaluating RAS. While the number of available systems and surgical procedures is rapidly growing, existing frameworks for assessing MedTech provide a starting point, but specific considerations are needed for HTAs of RAS to ensure consistent results. This work aimed to discuss different approaches and produce guidance on evaluating RAS. Methods: A consensus conference research methodology was adopted. A panel of 14 experts was assembled with international experience and representing relevant stakeholders: clinicians, health economists, HTA practitioners, policy makers, and industry. A review of previous HTAs was performed and seven key themes were extracted from the literature for consideration. Over five meetings, the panel discussed the key themes and formulated consensus statements. Results: A total of ninety-eight previous HTAs were identified from twenty-five total countries. The seven key themes were evidence inclusion and exclusion, patient- and clinician-reported outcomes, the learning curve, allocation of costs, appropriate time horizons, economic analysis methods, and robotic ecosystem/wider benefits. Conclusions: Robotic surgical platforms are tools, not therapies. Their value varies according to context and should be considered across therapeutic areas and stakeholders. The principles set out in this paper should help HTA bodies at all levels to evaluate RAS. This work may serve as a case study for rapidly developing areas in MedTech that require particular consideration for HTAs. [ABSTRACT FROM AUTHOR]

BACKGROUND: Robot-based treatments are developing in neurorehabilitation settings. Recently, the Italian National Health Systems recognized robot-based rehabilitation as a refundable service. Thus, the Italian neurorehabilitation community promoted a national consensus on this topic. OBJECTIVE: To conceptualize undisclosed perspectives for research and applications of robotics for neurorehabilitation, based on a qualitative synthesis of reference theoretical models. METHODS: A scoping review was carried out based on a specific question from the consensus Jury. A foreground search strategy was developed on theoretical models (context) of robot-based rehabilitation (exposure), in neurological patients (population). PubMed and EMBASE® databases were searched and studies on theoretical models of motor control, neurobiology of recovery, human-robot interaction and economic sustainability were included, while experimental studies not aimed to investigate theoretical frameworks, or considering prosthetics, were excluded. RESULTS: Overall, 3699 records were screened and finally 9 papers included according to inclusion and exclusion criteria. According to the population investigated, structured information on theoretical models and indications for future research was summarized in a synoptic table. CONCLUSION: The main indication from the Italian consensus on robotics in neurorehabilitation is the priority to design research studies aimed to investigate the role of robotic and electromechanical devices in promoting neuroplasticity. [ABSTRACT FROM AUTHOR]

Considering growing deliberative turns within and beyond science communication coupled with calls for their systematic evaluations, this paper presents a legitimacy framework to analyze a recent consensus conference on the topic of genome editing. Drawing upon participant surveys (PSs) and interviews, it confirms difficulties of this deliberative method in achieving inclusive input from across society as well as conflicts between deliberative ideals, empirical communication practice, and ensuring impact on policy making. The case calls for more experimentation with hybrid online/offline approaches while staying aware of unequally distributed deliberation abilities and the need for unifying outputs. [ABSTRACT FROM AUTHOR]

Psoriasis is a complex disease often needing a multidisciplinary approach. In particular, the collaboration between dermatologist and rheumatologist is crucial for the management of patients suffering from both psoriasis (PSO) and psoriatic arthritis (PsA). Here we report a series of recommendations from a group of experts, as a result of a Consensus Conference, defining the circumstances in which it is preferable or even mandatory, depending on the available settings, to rely on the opinion of the two specialists, jointly or in a deferred manner. Indications are given on how to organize a 3rd level joint Dermatology- Rheumatology care unit, in connection with 1st and 2nd level clinicians of both specialties, GPs, and other specialists involved in the management of psoriasis. A potential patient journey is suggested, that can be used as a basis for future design and validation of national and/or local diagnostic therapeutic and assistance pathways.

As part of the formulation of the first National Water Plan (NWP) in Uruguay, a mini-public process called ‘Citizen Deliberation on Water (Deci Agua)’ was developed in 2016. While the draft of the plan was being discussed in the formal arenas of water governance (Basin Commissions and Regional Water Resources Councils), a University research team (led by the authors), in coordination with the national water authority, adapted the mechanism of consensus conferences in order to incorporate the citizens’ visions and to contribute to public understanding of the NWP challenges. This article analyses the main aspects of the developed participation strategy and discusses them regarding a set of quality criteria used to evaluate deliberative processes. Although the final version of the NWP (passed by decree in 2017) incorporated some of the contributions of the Citizen Panel, an in-depth analysis of the scope of the deliberative process of Deci Agua allows us to delve into some key aspects related to the quality of participation processes and the challenges. A mixed approach that combines stakeholder participation and lay citizens is novel and desirable in water governance since it increases the scope of participation, deepens the legitimacy of decision-making and improves the public debate. Highlights Deci Agua was a citizen deliberation process based on consensus conferences.; A Citizen Panel contributed to the formulation of Uruguay's first National Water Plan.; The inclusion of the ethical dimension of water management was the main contribution.; Mini-publics like Deci Agua collaborate with the public debate.; Processes of citizen participation can complement stakeholder participation forums.;

Abstract Background With the use of electronic health records (EHRs) increasing and causing unintended negative consequences, the medical scribe profession has burgeoned, but it has yet to be regulated. The purpose of this study was to describe scribe workflow as well as identify the threats and opportunities for the future of the scribe industry. Methods The first phase of the study used ethnographic methods consisting of interviews and observations by a multi-disciplinary team of researchers at five United States sites. In April 2019, a two-day conference of experts representing different stakeholder perspectives was held to discuss the results from site visits and to predict the future of medical scribing. An interpretive content analysis approach was used to discover threats and opportunities for the future of medical scribes. Results Threats facing the medical scribe industry were related to changes in the documentation model, EHR usability, different payment structures, the need to acquire disparate data during clinical encounters, and workforce-related changes relevant to the scribing model. Simultaneously, opportunities for medical scribing in the future included extension of their role to include workflow analysis, acting as EHR-related subject-matter-experts, and becoming integrated more effectively into the clinical care delivery team. Experts thought that if EHR usability increases, the need for medical scribes might decrease. Additionally, the scribe role could be expanded to allow scribes to document more or take on more informatics-related tasks. The experts also anticipated an increased use of alternative models of scribing, like tele-scribing. Conclusion Threats and opportunities for medical scribing were identified. Many experts thought that if the scribe role could be expanded to allow scribes to document more or take on more informatics activities, it would be beneficial. With COVID-19 continuing to change workflows, it is critical that medical scribes receive standardized training as tele-scribing continues to grow in popularity and new roles for scribes as medical team members are identified.

Scientification and technification of later life have pushed the very notion of ageing, embracing materiality as one of the co-producers of a continuous process of becoming. In this paper, we want to explore the role of materiality in a mechanism designed to allow older people to develop arguments regarding digitalization to inform public policies. To achieve this aim, we will employ a concept that will unfold the layers with which theories of ageing are configured in practice: infrastructuring. In our particular case study, this will highlight the coordinated effort among different agents needed to identify, negotiate and prove who can be considered a legitimate older citizen. Along this path, we will face three instances where the theory is challenged by practice: 1) the very sense of what an infrastructure is; 2) the theory about what a consensus conference is; and 3) what the definition of older person is. To conclude, we suggest the necessity to switch the very question about who can be considered an older person to how in a certain context a heterogeneous assemblage of (human and non-human) actors defines what an older person is.

This text is based on the recommendations accepted by the 4th Hungarian Consensus Conference on Breast Cancer, modified on the basis of the international consultation and conference within the frames of the Central-Eastern European Academy of Oncology. The recommendations cover non-operative, intraoperative and postoperative diagnostics, determination of prognostic and predictive markers and the content of cytology and histology reports. Furthermore, they address some specific issues such as the current status of multigene molecular markers, the role of pathologists in clinical trials and prerequisites for their involvement, and some remarks about the future.

Abstract Background and aims Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of non-operative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and peri-operative antibiotic therapy. Methods This executive manuscript summarizes the WSES guidelines for the diagnosis and treatment of AA. Literature search has been updated up to 2019 and statements and recommendations have been developed according to the GRADE methodology. The statements were voted, eventually modified, and finally approved by the participants to the consensus conference and by the board of co-authors, using a Delphi methodology for voting whenever there was controversy on a statement or a recommendation. Several tables highlighting the research topics and questions, search syntaxes, and the statements and the WSES evidence-based recommendations are provided. Finally, two different practical clinical algorithms are provided in the form of a flow chart for both adults and pediatric (< 16 years old) patients. Conclusions The 2020 WSES guidelines on AA aim to provide updated evidence-based statements and recommendations on each of the following topics: (1) diagnosis, (2) non-operative management for uncomplicated AA, (3) timing of appendectomy and in-hospital delay, (4) surgical treatment, (5) intra-operative grading of AA, (6) ,management of perforated AA with phlegmon or abscess, and (7) peri-operative antibiotic therapy.

Starting in 2012, the Academy of Osseointegration initiated the planning process for an AO Summit to develop clinical practice guidelines (CPGs) for management of the edentulous maxilla. Materials and Methods: A planning committee led by Professor Clark Stanford and Dr Ole Jensen created a work plan based on five domain areas to be addressed by the summit. The five domain areas were defined as: (1) role of grafting for ridge development for implant placement, (2) role of implant design and systems in management of the edentulous maxilla, (3) role of imaging to guide implant placement, (4) role of biologics to assist in ridge development, and (5) role of prosthetic management. Results: The summit was held in August 2014, and the results are presented in this overview. All of the supporting systematic reviews and the detailed CPGs are presented in this special edition of JOMI. Conclusion: While the evidence was observed to be weak in regard to the literature for most of the systematic reviews, the summit strived to establish the current best evidence and practical CPGs that will assist clinicians in practice. [ABSTRACT FROM AUTHOR]

The findings and recommendations of the 2019 consensus conference in organ donation, held in Kunming, China, are here reported. The main objective of the conference was to gather relevant information from experts involved in the field. The data and opinions provided allowed to propose a series of recommendations for "One Belt & One Road Countries" on how to achieve self‐sufficiency in organ donation. Leadership in organ donation should be results‐oriented and goal‐driven based on the principles of excellence, empowerment, and engagement, providing the means, resources, and strategies necessary to reach the goal in earnest. Management includes good governance and transparency of a national registry of patients in the waiting list, donors, transplants, transplant teams, quality, and safety programs with continuous educational training of health care professionals. Mandatory monitoring, auditing and evaluation of quality must be incorporated into donation practices as relevant points in innovation, as well as the adoption of already established and novel processes and technologies. Achievement of self‐sufficiency in organ donation is a crucial step to fight against transplant tourism and to prevent organ trafficking. Based on recommendations arising from the conference, each country could review and develop individualized action plans adjusted to its own circumstances and reality. [ABSTRACT FROM AUTHOR]

Background: With the use of electronic health records (EHRs) increasing and causing unintended negative consequences, the medical scribe profession has burgeoned, but it has yet to be regulated. The purpose of this study was to describe scribe workflow as well as identify the threats and opportunities for the future of the scribe industry.Methods: The first phase of the study used ethnographic methods consisting of interviews and observations by a multi-disciplinary team of researchers at five United States sites. In April 2019, a two-day conference of experts representing different stakeholder perspectives was held to discuss the results from site visits and to predict the future of medical scribing. An interpretive content analysis approach was used to discover threats and opportunities for the future of medical scribes.Results: Threats facing the medical scribe industry were related to changes in the documentation model, EHR usability, different payment structures, the need to acquire disparate data during clinical encounters, and workforce-related changes relevant to the scribing model. Simultaneously, opportunities for medical scribing in the future included extension of their role to include workflow analysis, acting as EHR-related subject-matter-experts, and becoming integrated more effectively into the clinical care delivery team. Experts thought that if EHR usability increases, the need for medical scribes might decrease. Additionally, the scribe role could be expanded to allow scribes to document more or take on more informatics-related tasks. The experts also anticipated an increased use of alternative models of scribing, like tele-scribing.Conclusion: Threats and opportunities for medical scribing were identified. Many experts thought that if the scribe role could be expanded to allow scribes to document more or take on more informatics activities, it would be beneficial. With COVID-19 continuing to change workflows, it is critical that medical scribes receive standardized training as tele-scribing continues to grow in popularity and new roles for scribes as medical team members are identified. [ABSTRACT FROM AUTHOR]

Introduction:  Evidence supporting best practice for long-gap esophageal atresia is limited. The European Reference Network for Rare Inherited Congenital Anomalies (ERNICA) organized a consensus conference on the management of patients with long-gap esophageal atresia based on expert opinion referring to the latest literature aiming to provide clear and uniform statements in this respect.Materials and Methods:  Twenty-four ERNICA representatives from nine European countries participated. The conference was prepared by item generation, item prioritization by online survey, formulation of a final list containing items on perioperative, surgical, and long-term management, and literature review. The 2-day conference was held in Berlin in November 2019. Anonymous voting was conducted via an internet-based system using a 1 to 9 scale. Consensus was defined as ≥75% of those voting scoring 6 to 9.Results:  Ninety-seven items were generated. Complete consensus (100%) was achieved on 56 items (58%), e.g., avoidance of a cervical esophagostomy, promotion of sham feeding, details of delayed anastomosis, thoracoscopic pouch mobilization and placement of traction sutures as novel technique, replacement techniques, and follow-up. Consensus ≥75% was achieved on 90 items (93%), e.g., definition of long gap, routine pyloroplasty in gastric transposition, and avoidance of preoperative bougienage to enable delayed anastomosis. Nineteen items (20%), e.g., methods of gap measurement were discussed controversially (range 1-9).Conclusion:  This is the first consensus conference on the perioperative, surgical, and long-term management of patients with long-gap esophageal atresia. Substantial statements regarding esophageal reconstruction or replacement and follow-up were formulated which may contribute to improve patient care. [ABSTRACT FROM AUTHOR]

Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is a rare autosomal recessive disease caused by TYMP mutations and thymidine phosphorylase (TP) deficiency. Thymidine and deoxyuridine accumulate impairing the mitochondrial DNA maintenance and integrity. Clinically, patients show severe and progressive gastrointestinal and neurological manifestations. The onset typically occurs in the second decade of life and mean age at death is 37 years. Signs and symptoms of MNGIE are heterogeneous and confirmatory diagnostic tests are not routinely performed by most laboratories, accounting for common misdiagnosis. Factors predictive of progression and appropriate tests for monitoring are still undefined. Several treatment options showed promising results in restoring the biochemical imbalance of MNGIE. The lack of controlled studies with appropriate follow‐up accounts for the limited evidence informing diagnostic and therapeutic choices. The International Consensus Conference (ICC) on MNGIE, held in Bologna, Italy, on 30 March to 31 March 2019, aimed at an evidence‐based consensus on diagnosis, prognosis, and treatment of MNGIE among experts, patients, caregivers and other stakeholders involved in caring the condition. The conference was conducted according to the National Institute of Health Consensus Conference methodology. A consensus development panel formulated a set of statements and proposed a research agenda. Specifically, the ICC produced recommendations on: (a) diagnostic pathway; (b) prognosis and the main predictors of disease progression; (c) efficacy and safety of treatments; and (f) research priorities on diagnosis, prognosis, and treatment. The Bologna ICC on diagnosis, management and treatment of MNGIE provided evidence‐based guidance for clinicians incorporating patients' values and preferences. [ABSTRACT FROM AUTHOR]

Introduction: Lumbar spinal stenosis (LSS) is a common degenerative disease that every spine surgeon will come across in daily practice. Despite this, the natural history and treatment have not been well established and standardized as yet, and there have been few guidelines published on this topic to date. The aim of the World Federation of Neurosurgical Society Spine Committee Consensus Conference is to define evidence-based and expert-based recommendations for the diagnosis and treatment of LSS, considering the different possibilities and facilities in countries worldwide. Methods: An international committee of spinal surgeons reunited to perform the Consensus Conference on the topic of LSS. The Delphi method was applied to administer a questionnaire and obtain a consensus on various topics. A multidisciplinary committee defined 6 panels: 1) natural course and diagnosis of LSS; 2) conservative treatment and follow-up; 3) percutaneous techniques; 4) decompressive surgery; 5) fusion surgery; 6) mobility preserving surgery. The statements and the literature review were presented and voted. Results: A total of 44 statements were stated and then voted by 16 experienced spine surgeons to obtain the final results. A total of 36 statements reached a consensus, of which 34 reached a positive consensus and 2 a negative consensus, whereas no consensus was reached in 8 cases. Conclusions: In the absence of evidence-based medicine, these recommendations offer support for all practitioners, independent from economic resources and personal experience. Obviously, further studies are needed and will be well accepted to support or modify these recommendations.

Introduction:  Improvements in care of patients with esophageal atresia (EA) and tracheoesophageal fistula (TEF) have shifted the focus from mortality to morbidity and quality-of-life. Long-term follow-up is essential, but evidence is limited and standardized protocols are scarce. Nineteen representatives of the European Reference Network for Rare Inherited Congenital Anomalies (ERNICA) from nine European countries conducted a consensus conference on the surgical management of EA/TEF.Materials and Methods:  The conference was prepared by item generation (including items of surgical relevance from the European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN)-The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) guidelines on follow-up after EA repair), item prioritization, formulation of a final list containing the domains Follow-up and Framework, and literature review. Anonymous voting was conducted via an internet-based system. Consensus was defined as ≥75% of those voting with scores of 6 to 9.Results:  Twenty-five items were generated in the domain Follow-up of which 17 (68%) matched with corresponding ESPGHAN-NASPGHAN statements. Complete consensus (100%) was achieved on seven items (28%), such as the necessity of an interdisciplinary follow-up program. Consensus ≥75% was achieved on 18 items (72%), such as potential indications for fundoplication. There was an 82% concordance with the ESPGHAN-NASPGHAN recommendations. Four items were generated in the domain Framework, and complete consensus was achieved on all these items.Conclusion:  Participants of the first ERNICA conference reached significant consensus on the follow-up of patients with EA/TEF who undergo primary anastomosis. Fundamental statements regarding centralization, multidisciplinary approach, and involvement of patient organizations were formulated. These consensus statements will provide the cornerstone for uniform treatment protocols and resultant optimized patient care. [ABSTRACT FROM AUTHOR]

Objectives: This paper outlines best practice recommendations for the clinical psychologist's role in inpatient settings and also presents a methodology for deriving evidence‐based recommendations, which may be replicated by health care professionals in other areas of service development. Methods: Twenty‐three, nationally drawn experts, deemed expert by profession and/or experience attended a one‐day conference. Participants were presented with findings from previous research and key unanswered questions in terms of how psychological services should be delivered in inpatient settings. Participants discussed the information presented within small groups and then independently responded to the questions posed. Responses to questions either involved ranking priorities or choosing the best possible option in terms of what or how aspects of the model should be delivered. Results: We were able to identify referral priorities for formulation, nurse‐led psychosocial interventions and psychological therapy using ranking questions. Consensus (defined as 70% agreement) was achieved within 1–3 voting rounds for all questions which involved selecting one of a range of possible options. These responses provided information about how to deliver formulation, supervision of nurse‐led psychosocial interventions, staff well‐being interventions, and one‐to‐one therapy, as well as psychologists' own training and supervisions needs. Conclusions: Findings provide recommendations relating to five different service areas for inpatient settings seeking to implement a psychological service model: formulation, nurse‐led interventions, one‐to‐one therapy, staff well‐being, and psychologist training and supervision. Additionally, we showcase a methodology for synthesizing knowledge and decision‐making that can be implemented by researchers and health care professionals seeking to design interventions or service models in other settings. Practitioner points: Psychologists working on inpatient wards should endeavour to develop a team formulation for each patient, prioritizing patients with longer length of stay, repeated admissions, and who staff find challenging.Psychologists should offer 1:1 therapy with patients who have complex needs that cannot be addressed by nurse‐led interventions.Reflective practice sessions should be a key component of the psychologist's role on inpatient wards with the function of improving staff well‐being.Consensus conferences are useful methodology to synthesize knowledge and undertaking decision‐making in relation to the design of interventions or service models. [ABSTRACT FROM AUTHOR]

Introduction:  Many aspects of the management of esophageal atresia (EA) and tracheoesophageal fistula (TEF) are controversial and the evidence for decision making is limited. Members of the European Reference Network for Rare Inherited Congenital Anomalies (ERNICA) conducted a consensus conference on the surgical management of EA/TEF based on expert opinions referring to the latest literature.Materials and Methods:  Nineteen ERNICA representatives from nine European countries participated in the conference. The conference was prepared by item generation, item prioritization by online survey, formulation of a final list containing the domains diagnostics, preoperative, operative, and postoperative management, and literature review. The 2-day conference was held in Berlin in October 2018. Anonymous voting was conducted via an internet-based system. Consensus was defined when 75% of the votes scored 6 to 9.Results:  Fifty-two items were generated with 116 relevant articles of which five studies (4.3%) were assigned as level-1evidence. Complete consensus (100%) was achieved on 20 items (38%), such as TEF closure by transfixing suture, esophageal anastomosis by interrupted sutures, and initiation of feeding 24 hours postoperatively. Consensus ≥75% was achieved on 37 items (71%), such as routine insertion of transanastomotic tube or maximum duration of thoracoscopy of 3 hours. Thirteen items (25%) were controversial (range of scores, 1-9). Eight of these (62%) did not reach consensus.Conclusion:  Participants of the conference reached significant consensus on the management of patients with EA/TEF. The consensus may facilitate standardization and development of generally accepted guidelines. The conference methodology may serve as a blueprint for further conferences on the management of congenital malformations in pediatric surgery. [ABSTRACT FROM AUTHOR]

Background and aims: Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of non-operative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and peri-operative antibiotic therapy. Methods: This executive manuscript summarizes the WSES guidelines for the diagnosis and treatment of AA. Literature search has been updated up to 2019 and statements and recommendations have been developed according to the GRADE methodology. The statements were voted, eventually modified, and finally approved by the participants to the consensus conference and by the board of co-authors, using a Delphi methodology for voting whenever there was controversy on a statement or a recommendation. Several tables highlighting the research topics and questions, search syntaxes, and the statements and the WSES evidence-based recommendations are provided. Finally, two different practical clinical algorithms are provided in the form of a flow chart for both adults and pediatric (< 16 years old) patients. Conclusions: The 2020 WSES guidelines on AA aim to provide updated evidence-based statements and recommendations on each of the following topics: (1) diagnosis, (2) non-operative management for uncomplicated AA, (3) timing of appendectomy and in-hospital delay, (4) surgical treatment, (5) intra-operative grading of AA, (6) ,management of perforated AA with phlegmon or abscess, and (7) peri-operative antibiotic therapy. [ABSTRACT FROM AUTHOR]

Aims: Anastomotic leakage is one of the most worrisome complications in colorectal surgery. An expert meeting was organized to discuss and find a consensus on various aspects of the surgical management of colorectal disease with a possible impact on anastomotic leakage. Methods: A three-step Delphi-method was used to find consensus recommendations. Results: Strong consensus was achieved for the use of mechanical bowel preparation and oral antibiotics prior to colorectal resections, the abundance of non-selective NSAIDs, the preoperative treatment of severe iron deficiency anemia, and for attempting to improve the patients' general performance in the case of frailty. Concerning technical aspects of rectal resection, there was a strong consensus in regard to routinely mobilizing the splenic flexure, to dividing the inferior mesenteric vein, and to using air leak tests to check anastomotic integrity. There was also a strong consensus on not to oversew the stapled anastomoses routinely, to use protective ileostomies for low rectal and intersphincteric, but not for high-rectal anastomoses. Furthermore, a consensus was reached in regard to using CT-scans with rectal contrast enema to evaluate suspected anastomotic leakage as well as measuring C-reactive protein routinely to monitor the postoperative course after colorectal resections. No consensus was found concerning the indication and technique for testing bowel perfusion, the routine use of endoscopy to check the integrity of the anastomosis, the placement of transanal drains for rectal anastomoses and the management of anastomotic leakage with peritonitis. Conclusion: Consensus could be found for several practice details in the perioperative management in colorectal surgery that might have an influence on anastomotic leakage. [ABSTRACT FROM AUTHOR]

In this paper, we offer a novel conceptual framework of some of the most important aims for science communication efforts found in the contemporary literature on science communication. We identify several distinct aims present in the literature such as generating public epistemic and moral trust, generating social acceptance, and enhancing democratic legitimacy, and we discuss some of the relations between the different aims. Finally, we examine whether and, if so, to what extent these different aims can be said to have been successfully reached in practice and find that the empirical literature regarding the evaluation of science communications efforts is scarce. We conclude by suggesting that science communicators be attentive to formulating their communicative aim(s) in more precise terms, as well as conduct systematic studies of the effectiveness of their communicative efforts.

Baltic Ossoeintegration Academy (BOA) together with the Lithuanian University of Health Sciences (LSMU) and Universities from Europe and USA organized their second Consensus Conference (CC) devoted to the topic of "Post-Extraction Bone Remodelling and Alveolar Ridge Preservation". BOA - LSMU consensus development group (CDG) was seeking to review the dental literature on a topical area in dental implantology and to produce high-quality, unbiased evidence-based guidelines and consensus statement (CS). CDG as the responsible body formulated the task of developing CS devoted to the topic of "Post-Extraction Bone Remodelling and Alveolar Ridge Preservation" to Gintaras Juodzbalys (Lithuania). CS Panel members were invited by the chairman. They are representatives of Universities, experts in a field and made every effort to produce nonbiased, independent, evidence-based clinical practice guidelines. Panel members had no conflicts of interest and signed a Panel Member Agreement (PMA). Working groups were established and following clinically relevant topics suitable for consensus discussion were identified: 1. Biological aspects of tooth extraction, socket healing and indications for socket preservation (group leader: Gintaras Juodzbalys) [1]. 2. Extraction socket preservation methods and dental implant placement outcomes within grafted sockets (group leader: Pablo Galindo-Moreno) [2].

In this paper we reflect on the looming question of what constitutes expertise in ethics. Based on an empirical program that involved qualitative and quantitative as well as participatory research elements we show that expertise in research ethics and integrity is based on experience in the assessment processes. We then connect traditional concepts of expertise as "improved performance" with deliberate practice activities and, based on our research findings, show that ethical assessment experience is a form of deliberate practice. This in our view has further ramifications in the design and recruitment processes of ethical assessment units performing research ethics and integrity assessment. [ABSTRACT FROM AUTHOR]

Reducing mortality is a key target in critical care and perioperative medicine. The authors aimed to identify all nonsurgical interventions (drugs, techniques, strategies) shown by randomized trials to increase mortality in these clinical settings. A systematic review of the literature followed by a consensus-based voting process. A web-based international consensus conference. Two hundred fifty-one physicians from 46 countries. The authors performed a systematic literature search and identified all randomized controlled trials (RCTs) showing a significant increase in unadjusted landmark mortality among surgical or critically ill patients. The authors reviewed such studies during a meeting by a core group of experts. Studies selected after such review advanced to web-based voting by clinicians in relation to agreement, clinical practice, and willingness to include each intervention in international guidelines. The authors selected 12 RCTs dealing with 12 interventions increasing mortality: diaspirin-crosslinked hemoglobin (92% of agreement among web voters), overfeeding, nitric oxide synthase inhibitor in septic shock, human growth hormone, thyroxin in acute kidney injury, intravenous salbutamol in acute respiratory distress syndrome, plasma-derived protein C concentrate, aprotinin in high-risk cardiac surgery, cysteine prodrug, hypothermia in meningitis, methylprednisolone in traumatic brain injury, and albumin in traumatic brain injury (72% of agreement). Overall, a high consistency (ranging from 80% to 90%) between agreement and clinical practice was observed. The authors identified 12 clinical interventions showing increased mortality supported by randomized controlled trials with nonconflicting evidence, and wide agreement upon clinicians on a global scale. [ABSTRACT FROM AUTHOR]

The authors aimed to identify interventions documented by randomized controlled trials (RCTs) that reduce mortality in adult critically ill and perioperative patients, followed by a survey of clinicians' opinions and routine practices to understand the clinicians' response to such evidence. The authors performed a comprehensive literature review to identify all topics reported to reduce mortality in perioperative and critical care settings according to at least 2 RCTs or to a multicenter RCT or to a single-center RCT plus guidelines. The authors generated position statements that were voted on online by physicians worldwide for agreement, use, and willingness to include in international guidelines. From 262 RCT manuscripts reporting mortality differences in the perioperative and critically ill settings, the authors selected 27 drugs, techniques, and strategies (66 RCTs, most frequently published by the New England Journal of Medicine [13 papers], Lancet [7], and Journal of the American Medical Association [5]) with an agreement ≥67% from over 250 physicians (46 countries). Noninvasive ventilation was the intervention supported by the largest number of RCTs (n = 13). The concordance between agreement and use (a positive answer both to "do you agree" and "do you use") showed differences between Western and other countries and between anesthesiologists and intensive care unit physicians. The authors identified 27 clinical interventions with randomized evidence of survival benefit and strong clinician support in support of their potential life-saving properties in perioperative and critically ill patients with noninvasive ventilation having the highest level of support. However, clinician views appear affected by specialty and geographical location. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder is associated with diverse social, educational, and occupational challenges. To date, no standardized, internationally accepted tools exist to assess autism spectrum disorder-related functioning. World Health Organization's International Classification of Functioning, Disability and Health can serve as foundation for developing such tools. This study aimed to identify a comprehensive, a common brief, and three age-appropriate brief autism spectrum disorder Core Sets. Four international preparatory studies yielded in total 164 second-level International Classification of Functioning, Disability and Health candidate categories. Based on this evidence, 20 international autism spectrum disorder experts applied an established iterative decision-making consensus process to select from the candidate categories the most relevant ones to constitute the autism spectrum disorder Core Sets. The consensus process generated I 11 second-level International Classification of Functioning, Disability and Health categories in the Comprehensive Core Set for autism spectrum disorder--one body structure, 20 body functions, 59 activities and participation categories, and 31 environmental factors. The Common Brief Core Set comprised 60 categories, while the age-appropriate core sets included 73 categories in the preschool version (0- to 5-year-old children), 81 in the schoolage version (6- to 16-year-old children and adolescents), and 79 in the older adolescent and adult version (3= 17-year-old individuals). The autism spectrum disorder Core Sets mark a milestone toward the standardized assessment of autism spectrum disorder-related functioning in educational, administrative, clinical, and research settings. [ABSTRACT FROM AUTHOR]

Stefano Tamburin,1 Stefano Paolucci,2 Francesca Magrinelli,1 Massimo Musicco,2,3 Giorgio Sandrini4,5 On behalf of the Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) 1Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona, 2Santa Lucia Foundation, IRCCS, Rome, 3Institute of Biomedical Technologies (IBT) National Research Council of Italy (CNR), Segrate, Milan, 4C. Mondino National Institute of Neurology Foundation, IRCCS, 5Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy Abstract: Pain is very common in the neurorehabilitation setting, where it may not only represent a target for treatment but can also negatively influence rehabilitation procedures directly or through the side effects of painkillers. To date, there are neither guidelines nor consensus on how to assess and treat pain in neurorehabilitation. Because of the very scanty pieces of evidence on this topic, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) was promoted under the auspices of different scientific societies. This article illustrates the rationale, methodology, and topics of the ICCPN. The recommendations of the ICCPN will offer some information on how to deal with pain in neurorehabilitation and may represent the starting point for further studies.Keywords: assessment, consensus conference, neurology, pain, rehabilitation, treatment

Objective: To produce recommendations for the design of reliable and informative clinical investigations in chronic wound infection. Method: A multidisciplinary panel of international experts from four countries (Italy, UK, Ireland and the US) were involved in a detailed, semi-structured discussion on how to better select and describe a target population, interventions and outcomes, and which infection-related criteria to apply in order to achieve a high-quality trial. Consent among the experts was measured using the Delphi method and GRADE Working Group suggestions. The project was fully supported by AISLeC 2016 (Italian Nursing Society for Wound Care Study). Results: In total, 37 recommendations achieved substantial agreement among the experts; 10 concerned the most appropriate description and selection of a target population, four related to interventions and 15 to outcomes. A further eight statements about critical methodological points were approved. Conclusion: Developing recommendations in a systematic manner through a representative group of experts could generate tools for improving the design of clinical trials in this challenging area. [ABSTRACT FROM AUTHOR]

Attention-deficit/hyperactivity disorder (ADHD) is associated with significant impairments in social, educational, and occupational functioning, as well as specific strengths. Currently, there is no internationally accepted standard to assess the functioning of individuals with ADHD. WHO’s International Classification of Functioning, Disability and Health—child and youth version (ICF) can serve as a conceptual basis for such a standard. The objective of this study is to develop a comprehensive, a common brief, and three age-appropriate brief ICF Core Sets for ADHD. Using a standardised methodology, four international preparatory studies generated 132 second-level ICF candidate categories that served as the basis for developing ADHD Core Sets. Using these categories and following an iterative consensus process, 20 ADHD experts from nine professional disciplines and representing all six WHO regions selected the most relevant categories to constitute the ADHD Core Sets. The consensus process resulted in 72 second-level ICF categories forming the comprehensive ICF Core Set—these represented 8 body functions, 35 activities and participation, and 29 environmental categories. A Common Brief Core Set that included 38 categories was also defined. Age-specific brief Core Sets included a 47 category preschool version for 0-5 years old, a 55 category school-age version for 6-16 years old, and a 52 category version for older adolescents and adults 17 years old and above. The ICF Core Sets for ADHD mark a milestone toward an internationally standardised functional assessment of ADHD across the lifespan, and across educational, administrative, clinical, and research settings. [ABSTRACT FROM AUTHOR]

This document presents the Bonn PRINTEGER Consensus Statement: Working with Research Integrity—Guidance for research performing organisations. The aim of the statement is to complement existing instruments by focusing specifically on institutional responsibilities for strengthening integrity. It takes into account the daily challenges and organisational contexts of most researchers. The statement intends to make research integrity challenges recognisable from the work-floor perspective, providing concrete advice on organisational measures to strengthen integrity. The statement, which was concluded February 7th 2018, provides guidance on the following key issues: Providing information about research integrityProviding education, training and mentoringStrengthening a research integrity cultureFacilitating open dialogueWise incentive managementImplementing quality assurance proceduresImproving the work environment and work satisfactionIncreasing transparency of misconduct casesOpening up researchImplementing safe and effective whistle-blowing channelsProtecting the alleged perpetratorsEstablishing a research integrity committee and appointing an ombudspersonMaking explicit the applicable standards for research integrity [ABSTRACT FROM AUTHOR]

Background: It is increasingly acknowledged that the outcomes of medical treatments are influenced by the context of the clinical encounter through the mechanisms of the placebo effect. The phenomenon of placebo analgesia might be exploited to maximize the efficacy of neurorehabilitation treatments. Since its intensity varies across neurological disorders, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCP) summarized the studies on this field to provide guidance on its use. Methods: A review of the existing reviews and meta-analyses was performed to assess the magnitude of the placebo effect in disorders that may undergo neurorehabilitation treatment. The search was performed on Pubmed using placebo, pain, and the names of neurological disorders as keywords. Methodological quality was assessed using a pre-existing checklist. Data about the magnitude of the placebo effect were extracted from the included reviews and were commented in a narrative form. Results: 11 articles were included in this review. Placebo treatments showed weak effects in central neuropathic pain (pain reduction from 0.44 to 0.66 on a 0-10 scale) and moderate effects in postherpetic neuralgia (1.16), in diabetic peripheral neuropathy (1.45), and in pain associated to HIV (1.82). Moderate effects were also found on pain due to fibromyalgia and migraine; only weak short-term effects were found in complex regional pain syndrome. Confounding variables might have influenced these results. Clinical implications: These estimates should be interpreted with caution, but underscore that the placebo effect can be exploited in neurorehabilitation programs. It is not necessary to conceal its use from the patient. Knowledge of placebo mechanisms can be used to shape the doctor-patient relationship, to reduce the use of analgesic drugs and to train the patient to become an active agent of the therapy. [ABSTRACT FROM AUTHOR]

Currently we observe a gap between theory and practices of patient engagement. If both scholars and health practitioners do agree on the urgency to realize patient engagement, no shared guidelines exist so far to orient clinical practice. Despite a supportive policy context, progress to achieve greater patient engagement is patchy and slow and often concentrated at the level of policy regulation without dialoguing with practitioners from the clinical field as well as patients and families. Though individual clinicians, care teams and health organizations may be interested and deeply committed to engage patients and family members in the medical course, they may lack clarity about how to achieve this goal. This contributes to a wide “system” inertia—really difficult to be overcome—and put at risk any form of innovation in this filed. As a result, patient engagement risk today to be a buzz words, rather than a real guidance for practice. To make the field clearer, we promoted an Italian Consensus Conference on Patient Engagement (ICCPE) in order to set the ground for drafting recommendations for the provision of effective patient engagement interventions. The ICCPE will conclude in June 2017. This document reports on the preliminary phases of this process. In the paper, we advise the importance of “fertilizing a patient engagement ecosystem”: an oversimplifying approach to patient engagement promotion appears the result of a common illusion. Patient “disengagement” is a symptom that needs a more holistic and complex approach to solve its underlined causes. Preliminary principles to promote a patient engagement ecosystem are provided in the paper.

A Consensus Conference on Specific Learning Disorders has been promoted by the Italian National Institute of Health (Istituto Superiore di Sanità, ISS). The Consensus Conference consisted in a systematic review of the international literature addressing the issues of diagnosis, risk factors and prognosis, treatment, service delivery and organizational models for Specific Learning Disorders (reading, spelling/writing, calculation). Selected papers were examined by a group of Evaluators and then discussed by a Scientific and Technical Committee, whose conclusions were examined and approved by a Jury Panel. The part on diagnostic issues is presented here, encompassing a systematic discussion of the use and appropriateness of diagnostic criteria, parameters, tasks and psychometric indexes as illustrated in the literature, and providing recommendations for clinical practice. Special attention has been devoted to the collection, analysis and discussion of published data concerning languages with transparent orthography. Controversial issues such as discrepancy criteria, role of reading comprehension and importance of accuracy and fluency are discussed.