Abstract | UNLABELLED: Guidelines for clinical practice are intended to suggest preferable approaches to particular medical problems as established by interpretation and collation of scientifically valid research, derived from extensive review of published literature. When data are not available that will withstand objective scrutiny, a recommendation may be made based on a consensus of experts. Guidelines are intended to apply to the clinical situation for all physicians without regard to specialty. Guidelines are intended to be flexible, not necessarily indicating the only acceptable approach, and should be distinguished from standards of care, which are inflexible and rarely violated. Given the wide range of choices in any health care problem, the physician should select the course best suited to the individual patient and the clinical situation presented. These guidelines are developed under the auspices of the American College of Gastroenterology and its practice parameters committee. These guidelines are also approved by the governing boards of American College of Gastroenterology and Practice Parameters Committee. Expert opinion is solicited from the outset for the document. Guidelines are reviewed in depth by the committee, with participation from experienced clinicians and others in related fields. The final recommendations are based on the data available at the time of the production of the document and may be updated with pertinent scientific developments at a later time. The following guidelines are intended for adults and not for pediatric patients. OBJECTIVE: METHOD: Randomized controlled trials published through October of 1993 were evaluated by members of the American College of Gastroenterology Practice Parameters Committee. Each paper was reviewed by three members of the committee and rated for quality of design by predetermined criteria. Meta-analysis of the studies for each treatment were evaluated for both outcome and quality of design and formed the basis for recommendations for treatment. Randomized controlled trials published between October of 1993 and August of 1995 have been added to update and modify the recommendations. The reader is referred to an excellent article by D'Amico et al. (The treatment of portal hypertension: A meta-analytic review. Hepatology 1995;22:332-354), which presents most of the meta-analyses reviewed by this committee. CONCLUSIONS:
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Authors | N D Grace |
Journal | The American journal of gastroenterology
(Am J Gastroenterol)
Vol. 92
Issue 7
Pg. 1081-91
(Jul 1997)
ISSN: 0002-9270 [Print] United States |
PMID | 9219775
(Publication Type: Guideline, Journal Article, Practice Guideline, Review)
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Topics |
- Acute Disease
- Combined Modality Therapy
- Diagnosis, Differential
- Endoscopy, Digestive System
- Esophageal and Gastric Varices
(complications, etiology)
- Gastrointestinal Hemorrhage
(diagnosis, drug therapy, etiology, therapy)
- Humans
- Hypertension, Portal
(complications, diagnosis, therapy)
- Ligation
- Portasystemic Shunt, Surgical
- Randomized Controlled Trials as Topic
- Recurrence
- Sclerotherapy
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