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The process of hypothesis testing based on the traditional method includes calculating the critical value, testing the value of the test statistic using the sample data, and interpreting these values.
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[Acute liver failure].

Intensivmedizin + Notfallmedizin : Organ der Deutschen und der Osterreichischen Gesellschaft fur internistische Intensivmedizin, der Sektion Neurologie der DGIM und der Sektion Intensivmedizin im Berufsverband Deutscher Internisten e.V·2020
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Evidence-Based Follow-up for Adults With Cancer.

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[Updated S2k-Guideline "Complications of liver cirrhosis". German Society of Gastroenterology (DGVS)].

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[Updated S2k-Guideline "Complications of liver cirrhosis". German Society of Gastroenterology (DGVS)].

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[Elevated liver enzymes].

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[Choosing wisely - perspectives: what are the key questions?]

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    |July 14, 2020
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    Summary

    Choosing Wisely recommendations (CWR) in gastroenterology should guide appropriate use of diagnostic tests, drugs, and procedures. This includes optimizing imaging, laboratory tests, and endoscopic interventions for better patient outcomes and reduced healthcare costs.

    Area of Science:

    • Gastroenterology
    • Clinical Practice Guidelines
    • Health Services Research

    Background:

    • Gastroenterology presents numerous opportunities for "Choosing Wisely" recommendations (CWR) to optimize patient care.
    • Current practices show underuse or overuse of diagnostic tools, drug therapies, and endoscopic interventions.
    • Emerging issues like non-alcoholic fatty liver disease linked to obesity necessitate new CWRs.

    Purpose of the Study:

    • To identify key areas in gastroenterology where "Choosing Wisely" recommendations can improve evidence-based practice.
    • To highlight the need for CWRs addressing both diagnostic and therapeutic interventions.
    • To emphasize the importance of CWRs for conditions like non-alcoholic fatty liver disease and colorectal cancer screening.

    Main Methods:

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  • Review of current gastroenterology practice and published guidelines.
  • Identification of diagnostic tests (laboratory, imaging) and interventions (drugs, endoscopy) with suboptimal application.
  • Analysis of the relationship between lifestyle factors (obesity) and gastrointestinal diseases.

    • Main Results:

    • Specific CWRs are needed for laboratory tests (e.g., amylase, lipase, CEA) and imaging (CT vs. ultrasound).
    • Guidelines for upper endoscopy in asymptomatic individuals and underutilization of colonoscopy for colorectal cancer screening were noted.
    • The rise in non-alcoholic fatty liver disease due to obesity requires targeted CWRs and public health measures.

    Conclusions:

    • Developing CWRs for gastroenterology is crucial for promoting evidence-based practice and reducing unnecessary healthcare utilization.
    • CWRs should address diagnostic testing, pharmacotherapy, endoscopic procedures, and public health issues like obesity.
    • Future CWRs must be based on interdisciplinary expert consensus and robust scientific evidence.