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Objective: The objective of this paper is to propose an approach to visual unification of adapted guidelines and transformation of classifications of certainty of evidence (CoE) and strength of recommendations (SoR) into the approach suggested by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) working group., Study Design and Setting: We carried out a literature search in MEDLINE and Epistemonikos, an analysis of selected guidelines, and an iterative discussion to decide on a consistent visual presentation and CoE and SoR depictions., Results: The results of the literature search suggested this issue had not been addressed yet. The analysis of the chosen eight guidelines showed significant heterogeneity in the visual presentation of recommendations. Recommendations were often worded similarly to whether or not they were strong or conditional. Many guidelines contained "statements," almost all of which did not fulfill the good practice statement (GPS) criteria. We proposed an approach for transforming recommendations that are being adapted and which use various classification systems for CoE and SoR into GRADE and a consistent visual style., Conclusion: Guideline developers should aim for unification in the formulation of recommendations to improve transferability., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.) more...

Introduction: The incidence of colorectal cancer in young patients is increasing. The goal of this study was to investigate whether clinicopathological features and survival differed between young, middle-aged and elderly patients., Methods: The Czech National Cancer Registry was searched to identify all cases of colorectal cancer between 1982 and 2014. Three subgroups of patients were created: young patients, defined as being between 18 and 40 years of age, middle-aged patients, defined as being between 41 and 74 years of age, and elderly patients, defined as being over the age of 75 years., Results: A total of 192,241 patients diagnosed with colorectal cancer between the years 1982 and 2014 were included in the study. Out of these, 3,287 patients (1.7%) were between 18 and 40 years of age, 134,139 patients (69.8%) were between 41 and 74 years of age and 54,815 patients (28.5%) were 75 years of age or older. The young patients had a higher incidence of mucinous adenocarcinoma and signet ring cell carcinoma, more advanced disease and more rectal tumours than elderly patients. Nonetheless, young patients received treatment more frequently and had better cancer-specific survival than the older patients., Conclusion: The better prognosis in young patients is presumably due to their better physiological reserve and lower incidence of comorbidities. Efforts should be made in younger patients to diagnose early and treat aggressively., (Copyright © 2019 Elsevier Ltd. All rights reserved.) more...

Background: Various information systems for medical curriculum mapping and harmonization have been developed and successfully applied to date. However, the methods for exploiting the datasets captured inside the systems are rather lacking., Method: We reviewed the existing medical terminologies, nomenclatures, coding and classification systems in order to select the most suitable one and apply it in delivering visual analytic tools and reports for the benefit of medical curriculum designers and innovators., Results: A formal description of a particular curriculum of general medicine is based on 1347 learning units covering 7075 learning outcomes. Two data-analytical reports have been developed and discussed, showing how the curriculum is consistent with the MeSH thesaurus and how the MeSH thesaurus can be used to demonstrate interconnectivity of the curriculum through association analysis., Conclusion: Although the MeSH thesaurus is designed mainly to index medical literature and support searching through bibliographic databases, we have proved its use in medical curriculum mapping as being beneficial for curriculum designers and innovators. The presented approach can be followed wherever needed to identify all the mandatory components used for transparent and comprehensive overview of medical curriculum data., (Copyright © 2015 Elsevier Ltd. All rights reserved.) more...

Background: The objective of this study was to assess trends in overall and in stage-specific 5-year relative survival rates of the Czech cancer patients between periods 2000-2004 and 2005-2008., Methods: All Czech cancer patients diagnosed between 1995 and 2008 were included in the analysis. Period analysis was employed to calculate 5-year relative survival for 21 cancers., Results: Significant improvements in crude 5-year relative survival for 14 of 21 assessed types of cancer, including the most frequent diagnoses, such as, colorectal, prostate, breast, lung, kidney, pancreatic, and bladder cancer and melanoma, were identified. Moreover, in case of colorectal, lung, and prostate cancer, improvement in stage-specific 5-year relative survival was confirmed as statistically significant for all clinical stages. No diagnosis showed significant decrease in the 5-year relative survival. However, the 5-year relative survival remained poor in patients with metastatic cancers at diagnosis, particularly in case of liver, pancreatic, lung, and oesophageal cancer., Conclusions: The cancer-specific outcomes in the Czech Republic are improving. Nevertheless, despite the overall significant improvement in 5-year relative survival of most of the cancer diagnoses, the high proportion of patients primarily diagnosed with metastatic cancer still represents a substantial challenge for prevention and early detection., (Copyright © 2013 Elsevier Ltd. All rights reserved.) more...