Sistema de Gestión de Salud para el Distrito (SGS-D) FaseII :

IP 1130-14-12803v.1. Arquitecturas del sistema integral de referencia y contrarreferenciapara el distrito capital -- v.2. Modo de operacion presente-procesos y manuales ESE y CRU:anexos: manualgeneral de ESE's-sistema integral de referencia y contrarreferencia-manual de procedimientos actividades electivas y urgentes ; sistema integral de referencia y contrarreferencia manual de procedimientos-centroregulador de urgencias CRU-actividades electivas y urgentes -- v.3. Modo de operacion futuro-procesosyprocedimientos del sistema integral de referencia y contrarreferencia SIRC DC (modelo basado en conectividad) --v.4. Manual de referencia del sistema integral de referencia y contrarreferencia (SIRC): anexos : descripcion de los modulos de aplicacion ; diagramas de casos de uso ; modelo estatico de la aplicacion;diagramasde actividades ; diagramas de secuencia ; arquitectura de datos -- v.5. Manual de usuario aplicacion SIRC -- v.6. Diagnostico de procesos y procedimientos SIRC en la Subred sur -- v.7. Diagnostico de procesos y procedimientos SIRC en la Subred centro oriente : anexos : seguimiento de herramientas y formatosSIRC;seguimiento de pacientes ; toma de tiempos ; sistemas de informacion -- v.8. Diagnostico de procesos yprocedimientos SIRC en la Subred norte : anexos : instructivo formato seguimiento : herramientas, formatos SIRCyelaboracion de informe por PA y ESE ; instructivo formato de seguimiento de pacientes ; instructivodediligenciamiento : formato de toma de tiempos para el SIRC ; instructivo de diligenciamiento formato : sistemas de informacion -- v.9. Diagnostico de procesos y procedimientos SIRC en la Subred sur occidente: anexos : instructivo formato seguimiento : herramientas, formatos SIRC y elaboracion de informe por PA yESE ; instructivo formato de seguimiento de pacientes ; instructivo de diligenciamiento : formato de tomadetiempos para el SIRC ; instructivo de diligen informacion

International eDelphi Study to Reach Consensus on the Methotrexate Dosing Regimen in Patients With Psoriasis

Abstract Importance: A clear dosing regimen for methotrexate in psoriasis is lacking, and this might lead to a suboptimal treatment. Because methotrexate is affordable and globally available, a uniform dosing regimen could potentially optimize the treatment of patients with psoriasis worldwide. Objective: To reach international consensus among psoriasis experts on a uniform dosing regimen for treatment with methotrexate in adult and pediatric patients with psoriasis and identify potential future research topics. Design, setting, and participants: Between September 2020 and March 2021, a survey study with a modified eDelphi procedure that was developed and distributed by the Amsterdam University Medical Center and completed by 180 participants worldwide (55 [30.6%] resided in non-Western countries) was conducted in 3 rounds. The proposals on which no consensus was reached were discussed in a conference meeting (June 2021). Participants voted on 21 proposals with a 9-point scale (1-3 disagree, 4-6 neither agree nor disagree, 7-9 agree) and were recruited through the Skin Inflammation and Psoriasis International Network and European Academy of Dermatology and Venereology in June 2020. Apart from being a dermatologist/dermatology resident, there were no specific criteria for participation in the survey. The participants worked mainly at a university hospital (97 [53.9%]) and were experienced in treating patients with psoriasis with methotrexate (163 [91.6%] had more than 10 years of experience). Main outcomes and measures: In a survey with eDelphi procedure, we tried to reach consensus on 21 proposals. Consensus was defined as less than 15% voting disagree (1-3). For the consensus meeting, consensus was defined as less than 30% voting disagree. Results: Of 251 participants, 180 (71.7%) completed all 3 survey rounds, and 58 participants (23.1%) joined the conference meeting. Consensus was achieved on 11 proposals in round 1, 3 proposals in round 2, and 2 proposals in round 3. In the consensus meeting, consensus was achieved on 4 proposals. More research is needed, especially for the proposals on folic acid and the dosing of methotrexate for treating subpopulations such as children and vulnerable patients. Conclusions and relevance: In this eDelphi consensus study, consensus was reached on 20 of 21 proposals involving methotrexate dosing in patients with psoriasis. This consensus may potentially be used to harmonize the treatment with methotrexate in patients with psoriasis

International eDelphi Study to Reach Consensus on the Methotrexate Dosing Regimen in Patients with Psoriasis

Importance: A clear dosing regimen for methotrexate in psoriasis is lacking, and this might lead to a suboptimal treatment. Because methotrexate is affordable and globally available, a uniform dosing regimen could potentially optimize the treatment of patients with psoriasis worldwide. Objective: To reach international consensus among psoriasis experts on a uniform dosing regimen for treatment with methotrexate in adult and pediatric patients with psoriasis and identify potential future research topics. Design, Setting, and Participants: Between September 2020 and March 2021, a survey study with a modified eDelphi procedure that was developed and distributed by the Amsterdam University Medical Center and completed by 180 participants worldwide (55 [30.6%] resided in non-Western countries) was conducted in 3 rounds. The proposals on which no consensus was reached were discussed in a conference meeting (June 2021). Participants voted on 21 proposals with a 9-point scale (1-3 disagree, 4-6 neither agree nor disagree, 7-9 agree) and were recruited through the Skin Inflammation and Psoriasis International Network and European Academy of Dermatology and Venereology in June 2020. Apart from being a dermatologist/dermatology resident, there were no specific criteria for participation in the survey. The participants worked mainly at a university hospital (97 [53.9%]) and were experienced in treating patients with psoriasis with methotrexate (163 [91.6%] had more than 10 years of experience). Main Outcomes and Measures: In a survey with eDelphi procedure, we tried to reach consensus on 21 proposals. Consensus was defined as less than 15% voting disagree (1-3). For the consensus meeting, consensus was defined as less than 30% voting disagree. Results: Of 251 participants, 180 (71.7%) completed all 3 survey rounds, and 58 participants (23.1%) joined the conference meeting. Consensus was achieved on 11 proposals in round 1, 3 proposals in round 2, and 2 proposals in round 3. In the consensus meeting, consensus was achieved on 4 proposals. More research is needed, especially for the proposals on folic acid and the dosing of methotrexate for treating subpopulations such as children and vulnerable patients. Conclusions and Relevance: In this eDelphi consensus study, consensus was reached on 20 of 21 proposals involving methotrexate dosing in patients with psoriasis. This consensus may potentially be used to harmonize the treatment with methotrexate in patients with psoriasis.