NIH Consensus and State of the Science Statements This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

NIH state-of-the-science statement on management of the clinically inapparent adrenal mass ("incidentaloma").
CONCLUSIONS: The management of clinically inapparent adrenal masses is complicated by limited studies of incidence, prevalence, and natural history, including the psychologic impact on the patient who is informed of the diagnosis. Improvements in the resolution of abdominal imaging techniques combined with increased use of abdominal imaging suggest that the prevalence of clinically inapparent adrenal masses will continue to escalate. The low prevalence of adrenal cortical carcinomas and the relatively low incidence of progression to hyperfunction call into question the advisability of the current practice of intense, long-...
Source: NIH Consensus and State of the Science Statements - November 16, 2014 Category: American Health Tags: NIH Consens State Sci Statements Source Type: research

NIH state-of-the-science statement on endoscopic retrograde cholangiopancreatography (ERCP) for diagnosis and therapy.
CONCLUSIONS: In the diagnosis of choledocholithiasis, magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasound (EUS), and ERCP have comparable sensitivity and specificity. Patients undergoing cholecystectomy do not require ERCP preoperatively if there is low probability of having choledocholithiasis. Laparoscopic common bile duct exploration and postoperative ERCP are both safe and reliable in clearing common bile duct stones. ERCP with endoscopic sphincterotomy (ES) and stone removal is a valuable therapeutic modality in choledocholithiasis with jaundice, dilated common bile duct, acute pancreatitis, or c...
Source: NIH Consensus and State of the Science Statements - November 16, 2014 Category: American Health Tags: NIH Consens State Sci Statements Source Type: research

NIH Consensus Statement on Management of Hepatitis C: 2002.
CONCLUSIONS: The incidence of newly acquired hepatitis C infection has diminished in the United States. This decline is largely due to a decrease in cases among IDUs for reasons that are unclear and, to a lesser extent, to testing of blood donors for HCV. The virus is transmitted by blood and such transmission now occurs primarily through injection drug use, sex with an infected partner or multiple partners, and occupational exposure. The majority of infections become chronic, and therefore the prevalence of HCV infections is high, with about 3 million Americans now estimated to be chronically infected. HCV is a leading ca...
Source: NIH Consensus and State of the Science Statements - November 16, 2014 Category: American Health Tags: NIH Consens State Sci Statements Source Type: research

NIH State-of-the-Science Statement on symptom management in cancer: pain, depression, and fatigue.
CONCLUSIONS: Too many cancer patients with pain, depression, and fatigue receive inadequate treatment for their symptoms. Clinicians should use brief assessment tools routinely to ask patients about pain, depression, and fatigue and to initiate evidence-based treatments. Current evidence to support the concept of cancer symptom clusters is insufficient, and additional theoretically driven research is warranted. Research is needed on the definition, occurrence, assessment, and treatment of pain, depression, and fatigue alone and together through adequately funded prospective studies. Fear of cancer and its consequences must...
Source: NIH Consensus and State of the Science Statements - November 16, 2014 Category: American Health Tags: NIH Consens State Sci Statements Source Type: research

NIH State-of-the-Science Conference Statement on improving end-of-life care.
CONCLUSIONS: (1) Circumstances surrounding end of life are poorly understood, leaving many Americans to struggle through this life event. (2) The dramatic increase in the number of older adults facing the need for end-of-life care warrants development of a research infrastructure and resources to enhance that care for patients and their families. (3) Ambiguity surrounding the definition of end-of-life hinders the development of science, delivery of care, and communications between patients and providers. (4) Current end-of-life care includes some untested interventions that need to be validated. (5) Subgroups of race, ethn...
Source: NIH Consensus and State of the Science Statements - November 16, 2014 Category: American Health Tags: NIH Consens State Sci Statements Source Type: research

NIH State-of-the-Science Conference Statement on manifestations and management of chronic insomnia in adults.
CONCLUSIONS: Chronic insomnia is a major public health problem affecting millions of individuals, along with their families and communities. Little is known about the mechanisms, causes, clinical course, comorbidities, and consequences of chronic insomnia. Evidence supports the efficacy of cognitive-behavioral therapy and benzodiazepine receptor agonists in the treatment of this disorder, at least in the short term. Very little evidence supports the efficacy of other treatments, despite their widespread use. Moreover, even for those treatments that have been systematically evaluated, the panel is concerned about the mismat...
Source: NIH Consensus and State of the Science Statements - November 16, 2014 Category: American Health Tags: NIH Consens State Sci Statements Source Type: research

NIH State-of-the-Science Conference Statement on management of menopause-related symptoms.
CONCLUSIONS: Menopause is the permanent cessation of menstrual periods that occurs naturally in women, usually in their early 50s. Many women have few or no symptoms; these women are not in need of medical treatment. Premenopausal or perimenopausal women who have menopause induced by surgery, chemotherapy, or radiation are more likely to experience bothersome and even disabling symptoms. These women need safe and effective treatment. It is difficult to differentiate those symptoms that are truly associated with menopause from those due to aging. Hot flashes, night sweats, and vaginal dryness are clearly tied to the menopau...
Source: NIH Consensus and State of the Science Statements - November 16, 2014 Category: American Health Tags: NIH Consens State Sci Statements Source Type: research

NIH Consensus Statement on total knee replacement.
CONCLUSIONS: The success of primary TKR in most patients is strongly supported by more than 20 years of followup data. There appears to be rapid and substantial improvement in the patient's pain, functional status, and overall health-related quality of life in about 90 percent of patients; about 85 percent of patients are satisfied with the results of surgery. Short-term outcomes, as documented by functional outcome scales, are generally substantially improved after TKR. Functional outcome is improved after TKR for people across the spectrum of disability status. Technical factors in performing surgery may influence both t...
Source: NIH Consensus and State of the Science Statements - November 16, 2014 Category: American Health Tags: NIH Consens State Sci Statements Source Type: research

NIH State-of-the-Science Conference Statement on preventing violence and related health-risking social behaviors in adolescents.
CONCLUSIONS: The panel highlights the following findings and recommendations: (1) Violence affects all of us at some level and represents an issue of vital national and international importance; (2) Some interventions have been shown by rigorous research to reduce violence precursors, violence, and arrest. However, many interventions aimed at reducing violence have not been sufficiently evaluated or proven effective, and a few widely implemented programs have been shown to be ineffective and perhaps harmful; (3) Programs that seek to prevent violence through fear and tough treatment appear ineffective. Intensive programs t...
Source: NIH Consensus and State of the Science Statements - November 16, 2014 Category: American Health Tags: NIH Consens State Sci Statements Source Type: research

NIH Consensus Development Conference on Celiac Disease.
CONCLUSIONS: Celiac disease is an immune-mediated intestinal disorder with protean manifestations. Celiac disease is common, affecting 0.5 to 1.0 percent of the general population of the United States, but is greatly underdiagnosed. There are now specific and sensitive serologic tests available to aid in diagnosis that need to be more widely applied. The treatment of celiac disease remains a lifelong gluten-free diet, which results in remission for most individuals. The classic presentation of diarrhea and malabsorption is less common, and atypical and silent presentations are increasing. Most individuals are being seen by...
Source: NIH Consensus and State of the Science Statements - November 16, 2014 Category: American Health Tags: NIH Consens State Sci Statements Source Type: research

NIH State-of-the-Science Conference Statement on cesarean delivery on maternal request.
CONCLUSIONS: The incidence of cesarean delivery without medical or obstetric indications is increasing in the United States, and a component of this increase is cesarean delivery on maternal request. Given the tools available, the magnitude of this component is difficult to quantify. There is insufficient evidence to evaluate fully the benefits and risks of cesarean delivery on maternal request as compared to planned vaginal delivery, and more research is needed. Until quality evidence becomes available, any decision to perform a cesarean delivery on maternal request should be carefully individualized and consistent with e...
Source: NIH Consensus and State of the Science Statements - November 16, 2014 Category: American Health Tags: NIH Consens State Sci Statements Source Type: research

NIH State-of-the-Science Conference Statement on Tobacco Use: Prevention, Cessation, and Control.
CONCLUSIONS: Tobacco use remains a very serious public health problem. Coordinated national strategies for tobacco prevention, cessation, and control are essential if the United States is to achieve the Healthy People 2010 goals. Most adult smokers want to quit, and effective interventions exist. However, only a small proportion of tobacco users try treatment. This gap represents a major national quality-of-care problem. Many cities and states have implemented effective policies to reduce tobacco use; public health and government leaders should learn from these experiences. Because smokeless tobacco use may increase in the...
Source: NIH Consensus and State of the Science Statements - November 16, 2014 Category: American Health Tags: NIH Consens State Sci Statements Source Type: research

NIH State-of-the-Science Conference Statement on Multivitamin/Mineral Supplements and Chronic Disease Prevention.
CONCLUSIONS: Use of multivitamins/minerals (MVMs) has grown rapidly over the past several decades, and dietary supplements are now used by more than half of the adult population in the United States. In general, MVMs are used by individuals who practice healthier lifestyles, thus making observational studies of the overall relationship between MVM use and general health outcomes difficult to interpret. Despite the widespread use of MVMs, we still have insufficient knowledge about the actual amount of total nutrients that Americans consume from diet and supplements. This is at least in part due to the fortification of foods...
Source: NIH Consensus and State of the Science Statements - November 16, 2014 Category: American Health Tags: NIH Consens State Sci Statements Source Type: research

NIH state-of-the-science conference statement on prevention of fecal and urinary incontinence in adults.
CONCLUSIONS: (1) Fecal incontinence and urinary incontinence will affect more than one fourth of all U.S. adults during their lives. The natural history of fecal incontinence is unknown, and the natural history of urinary incontinence over several years is not well described. (2) Fecal incontinence and urinary incontinence often have serious effects on the lives of the many individuals who suffer physical discomfort, embarrassment, stigma, and social isolation, and on family members, caregivers, and society. Financial costs are substantial and may be underestimated because of underreporting. (3) Routine episiotomy is the m...
Source: NIH Consensus and State of the Science Statements - November 16, 2014 Category: American Health Tags: NIH Consens State Sci Statements Source Type: research

NIH consensus development statement on hydroxyurea treatment for sickle cell disease.
Authors: Brawley OW, Cornelius LJ, Edwards LR, Gamble VN, Green BL, Inturrisi CE, James AH, Laraque D, Mendez MH, Montoya CJ, Pollock BH, Robinson L, Scholnik AP, Schori M Abstract National Institutes of Health consensus and state-of-the-science statements are prepared by independent panels of health professionals and public representatives on the basis of (1) the results of a systematic literature review prepared under contract with the Agency for Healthcare Research and Quality (AHRQ), (2) presentations by investigators working in areas relevant to the conference questions during a 2-day public session, ...
Source: NIH Consensus and State of the Science Statements - November 16, 2014 Category: American Health Tags: NIH Consens State Sci Statements Source Type: research