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PHS 552 Population Health: CDC’s Sexually Transmitted Diseases

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Please reviews and comment and/or ask questions for the following threes students. Positive feedback and and ask questions

Student 1

I chose to review the Centers for Disease Control and Prevention’s (CDC) Sexually Transmitted Diseases Treatment Guidelines, 2015. I used the rapid critical appraisal checklist found in Melnyk and Fineout-Overholt (2015, p. 191) to evaluate the guidelines. Major findings included the literature review did not include the number of articles or what kind of articles were used. Some of the workgroup participants also had conflict of interest in that they were paid to do research on several of the topics covered in the guidelines. The CDC countered these conflicts of interest by ensuring that recommendations were approved by two separate panels of experts before final recommendations were given. The process for the guideline development was transparent in the report. The authors’ conflicts of interest were also transparent. Other than these findings, the guidelines were well written and easy to follow. They are also very relevant to my practice in public health.

Student 2

I reviewed the Centers for Disease Control and Prevention’s (CDC) Guideline for Prescribing Opioids for Chronic Pain (CDC, 2016). The guideline provides recommendations for 1) when to initiate or continue opioids for chronic pain; 2) opioid selection, dosage, duration, follow-up, and discontinuation; and 3) assessing risk and addressing harms of opioid use (CDC, 2016). I used the AGREE II tool. Overall, I found the guideline to be well-written with relevant recommendations. Here is a link (Links to an external site.)Links to an external site. to the short version with the recommendations. I think it is very relevant to NP practice since the target audience is primary care clinicians.

There is an abundance of user information for the AGREE II tool on the website. I found the practice exercise overview found here (Links to an external site.)Links to an external site. particularly helpful. The AGREE II tool is quite lengthy. It was a challenge for me to fit the entire paper in eight pages. I did a lot of editing to remove extraneous statements from my paper. 

Student 3

I reviewed the Diagnosis of Obstructive Sleep Apnea in Adults: A Clinical Practice Guideline utilizing the Rapid Critical Appraisal checklist. Definitions of OSA can be inconsistent and combined with the fact that diagnosis and treatment can be complicated, an evidence-based guideline can be vital for improved patient outcomes. The Rapid Critical Appraisal Checklist reveals that the OSA diagnosis guideline is credible and applicable. It is recommended that health care providers assess the risk and the symptoms of OSA in adult patients who report unexplained daytime sleepiness. Polysomnography diagnostic testing is considered a gold standard in diagnosing patients suspected of having OSA. However, when PSG is not available or impractical, using a home-based portable monitor is recommended. Conversely, testing patients for OSA in the absence of daytime sleepiness or treating those with a low apnea–hypopnea index (AHI) score is a low recommendation because evidence indicates that it does not improve clinical outcomes. The ACP guideline provides excellent clinical direction for OSA screening and testing in the primary care setting. A more current guideline has not been developed therefore this guide remains the best evidence-based guide available at this time. Although the recommendations are valuable and provide an important starting point for OSA screening and diagnosis, it remains important to stay aware of future recommendations.

Answer:

Student 1

It was good to see that the student has conducted an in-depth study of the CDC’s Sexually Transmitted Diseases Treatment Guidelines, 2015 using the rapid critical appraisal checklist method. I found the approach used by the student to describe conflicts of interest between workgroup participants quite effective. However, the student could have included a brief description of the recommendations provided by the two panels, for handling the challenges of conflicts of interests among the participants of the workgroup (Melynk & Fineout-Overholt, 2015). Apart from this, a few other questions could also be answered such as- Are all the STDs given equal weightage while formulating the guidelines? How the research done in the area of STDs can help in the development of a nation’s economy?

Student 2

I would like to congratulate the student on the commendable work he has performed. The analysis has been good and the main points of the guidelines have been well crafted and mentioned. The students was also able to provide a critical analysis of the tool used by him for conducting the study and explained the major challenges faced by them while using Agree II tool. However, the student could also mention the major recommendations in the abstract so that the reader could get a distinctive idea of what the solutions to the problem are.

Student 3

The student seems to have studied all the details regarding Obstructive Sleep Apnea in Adults and has done a detailed analysis of the guidelines related to this disorder, its treatment and such other aspects. All the evidences supported by the student seem to indicate that the guidelines are well crafted for this disease in the Clinical practice guidelines (A.Qaseem, et al., 2014). The few more questions, which the students could have   answered are - what are the future guidelines for managing this disorder? What research can be done further to improve the diagnosis and treatment of this disease?

References

A.Qaseem, Dallas, P., Owens, D., M.Starkey, Holty, J., & P. Shekelle. (2014). Diagnosis of obstructive sleep apnea in adults: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine. https://doi.org/10.7326/M12-3187 .

Melynk, B., & Fineout-Overholt, E. (2015). Evidence-Based Practice in Nursing and Healthcare. Philadelphia: Wolters Kluwer Health.

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