Protocol for the development of a multidisciplinary clinical practice guideline for the care of patients with chronic subdural haematoma

Introduction: A common neurosurgical condition, chronic subdural haematoma (cSDH) typically affects older people with other underlying health conditions. The care of this potentially vulnerable cohort is often, however, fragmented and suboptimal. In other complex conditions, multidisciplinary guidelines have transformed patient experience and outcomes, but no such framework exists for cSDH. This paper outlines a protocol to develop the first comprehensive multidisciplinary guideline from diagnosis to long-term recovery with cSDH. Methods: The project will be guided by a steering group of key stakeholders and professional organisations and will feature patient and public involvement. Multidisciplinary thematic working groups will examine key aspects of care to formulate appropriate, patient-centered research questions, targeted with evidence review using the GRADE framework. The working groups will then formulate draft clinical recommendations to be used in a modified Delphi process to build consensus on guideline contents. Conclusions: We present a protocol for the development of a multidisciplinary guideline to inform the care of patients with a cSDH, developed by cross-disciplinary working groups and arrived at through a consensus-building process, including a modified online Delphi.</p

London/Saskatoon Exchange

Moppett examines eight artists' work and their approach to their subjects and materials. Biographical notes

Bill Laing

Moppett examines Laing's work in relation to light, movement and the influence of photography. Biographical notes

Les Graff : Paintings and Drawings, 1966-1984

Moppett surveys Graff's painting career, noting how he developed a pictorial language of significant form, based on his experience of nature. Biographical notes. 3 bibl. ref

Don Foulds : Interiors

Moppett refers to the monumental and the totemic qualities of Foulds' sculptures which, he asserts, express the inherent qualities of steel. Biographical notes

Graham Fowler : The Water Paintings

Moppett presents Fowler’s paintings in light of the artist’s biography, his development and influences. Because he painted Monet’s garden at Giverny, Fowler and his paintings are compared and contrasted with those of the Impressionists. Moppett comments at length on the significance of photography in terms of painting in general and Fowler’s work in particular. List of works. Biobibliography 2 p. 4 bibl. ref

Lorna Russell : Drawings, 1980-1983

Moppett discusses Russell's drawings of the prairie landscape and approach to materials, surface and light. Biographical notes

John Hall : Paintings and Auxiliary Works, 1979-1980

George Moppett briefly discusses the use of brightly coloured souvenirs, photographs and postcards as central themes in Hall's realist paintings. In interview with Carroll Moppett, Hall discusses his use of photographic sources as a means of describing truth. Biographical notes. 30 bibl. ref