Reaching consensus on the physiotherapeutic management of patients following upper abdominal surgery: a pragmatic approach to interpret equivocal evidence

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dc.contributor.authorHanekom, Susanen_ZA
dc.contributor.authorBrooks, Dinaen_ZA
dc.contributor.authorDenehy, Lindaen_ZA
dc.contributor.authorFagevik-Olsen, Monikaen_ZA
dc.contributor.authorHardcastle, Timothyen_ZA
dc.contributor.authorManie, Shamilaen_ZA
dc.contributor.authorLouw, Quinetteen_ZA
dc.date.accessioned2015-11-04T11:54:31Z
dc.date.available2015-11-04T11:54:31Z
dc.date.issued2012en_ZA
dc.description.abstractBACKGROUND:Postoperative pulmonary complications remain the most significant cause of morbidity following open upper abdominal surgery despite advances in perioperative care. However, due to the poor quality primary research uncertainty surrounding the value of prophylactic physiotherapy intervention in the management of patients following abdominal surgery persists. The Delphi process has been proposed as a pragmatic methodology to guide clinical practice when evidence is equivocal. METHODS: The objective was to develop a clinical management algorithm for the post operative management of abdominal surgery patients. Eleven draft algorithm statements extracted from the extant literature by the primary research team were verified and rated by scientist clinicians (n = 5) in an electronic three round Delphi process. Algorithm statements which reached a priori defined consensus-semi-interquartile range (SIQR) < 0.5-were collated into the algorithm. RESULTS: The five panelists allocated to the abdominal surgery Delphi panel were from Australia, Canada, Sweden, and South Africa. The 11 draft algorithm statements were edited and 5 additional statements were formulated. The panel reached consensus on the rating of all statements. Four statements were rated essential. CONCLUSION: An expert Delphi panel interpreted the equivocal evidence for the physiotherapeutic management of patients following upper abdominal surgery. Through a process of consensus a clinical management algorithm was formulated. This algorithm can now be used by clinicians to guide clinical practice in this population.en_ZA
dc.identifier.apacitationHanekom, S., Brooks, D., Denehy, L., Fagevik-Olsen, M., Hardcastle, T., Manie, S., & Louw, Q. (2012). Reaching consensus on the physiotherapeutic management of patients following upper abdominal surgery: a pragmatic approach to interpret equivocal evidence. <i>BMC Medical Informatics and Decision Making</i>, http://hdl.handle.net/11427/14673en_ZA
dc.identifier.chicagocitationHanekom, Susan, Dina Brooks, Linda Denehy, Monika Fagevik-Olsen, Timothy Hardcastle, Shamila Manie, and Quinette Louw "Reaching consensus on the physiotherapeutic management of patients following upper abdominal surgery: a pragmatic approach to interpret equivocal evidence." <i>BMC Medical Informatics and Decision Making</i> (2012) http://hdl.handle.net/11427/14673en_ZA
dc.identifier.citationHanekom, S. D., Brooks, D., Denehy, L., Fagevik-Olsén, M., Hardcastle, T. C., Manie, S., & Louw, Q. (2012). Reaching consensus on the physiotherapeutic management of patients following upper abdominal surgery: a pragmatic approach to interpret equivocal evidence. BMC medical informatics and decision making, 12(1), 5.en_ZA
dc.identifier.ris TY - Journal Article AU - Hanekom, Susan AU - Brooks, Dina AU - Denehy, Linda AU - Fagevik-Olsen, Monika AU - Hardcastle, Timothy AU - Manie, Shamila AU - Louw, Quinette AB - BACKGROUND:Postoperative pulmonary complications remain the most significant cause of morbidity following open upper abdominal surgery despite advances in perioperative care. However, due to the poor quality primary research uncertainty surrounding the value of prophylactic physiotherapy intervention in the management of patients following abdominal surgery persists. The Delphi process has been proposed as a pragmatic methodology to guide clinical practice when evidence is equivocal. METHODS: The objective was to develop a clinical management algorithm for the post operative management of abdominal surgery patients. Eleven draft algorithm statements extracted from the extant literature by the primary research team were verified and rated by scientist clinicians (n = 5) in an electronic three round Delphi process. Algorithm statements which reached a priori defined consensus-semi-interquartile range (SIQR) < 0.5-were collated into the algorithm. RESULTS: The five panelists allocated to the abdominal surgery Delphi panel were from Australia, Canada, Sweden, and South Africa. The 11 draft algorithm statements were edited and 5 additional statements were formulated. The panel reached consensus on the rating of all statements. Four statements were rated essential. CONCLUSION: An expert Delphi panel interpreted the equivocal evidence for the physiotherapeutic management of patients following upper abdominal surgery. Through a process of consensus a clinical management algorithm was formulated. This algorithm can now be used by clinicians to guide clinical practice in this population. DA - 2012 DB - OpenUCT DO - 10.1186/1472-6947-12-5 DP - University of Cape Town J1 - BMC Medical Informatics and Decision Making LK - https://open.uct.ac.za PB - University of Cape Town PY - 2012 T1 - Reaching consensus on the physiotherapeutic management of patients following upper abdominal surgery: a pragmatic approach to interpret equivocal evidence TI - Reaching consensus on the physiotherapeutic management of patients following upper abdominal surgery: a pragmatic approach to interpret equivocal evidence UR - http://hdl.handle.net/11427/14673 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14673
dc.identifier.urihttp://dx.doi.org/10.1186/1472-6947-12-5
dc.identifier.vancouvercitationHanekom S, Brooks D, Denehy L, Fagevik-Olsen M, Hardcastle T, Manie S, et al. Reaching consensus on the physiotherapeutic management of patients following upper abdominal surgery: a pragmatic approach to interpret equivocal evidence. BMC Medical Informatics and Decision Making. 2012; http://hdl.handle.net/11427/14673.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDivision of Physiotherapyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2012 Hanekom et al; licensee BioMed Central Ltden_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceBMC Medical Informatics and Decision Makingen_ZA
dc.source.urihttp://www.biomedcentral.com/bmcmedinformdecismak/en_ZA
dc.subject.otherPhysiotherapeutic managementen_ZA
dc.subject.otherClinical practiceen_ZA
dc.titleReaching consensus on the physiotherapeutic management of patients following upper abdominal surgery: a pragmatic approach to interpret equivocal evidenceen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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