INTRODUCTION

Urinary stone disease remains a significant global and national health concern. This underscores the need for measures to improve disease outcomes. The development and implementation of clinical practice guidelines for urolithiasis was deemed essential due to variations in practice, the evolving urologic field with its emerging interventions, which may have significant cost implications.

METHODS

The CPG was developed following the GRADE Adolopment method, the CORE GRADE Approach and the GRADE Evidence to Decision framework, and utilized the Technical Manual for Clinical Practice Guideline Development of the Department of Health (2nd edition). The guideline development group was organized after review and management of the members' conflict of interest declarations. Clinical questions were prioritized and a systematic search and synthesis of the relevant literature to answer the questions was done. Considering the balance of benefits and harms, certainty of the evidence, cost and cost effectiveness, accessibility, acceptability and feasibility of the interventions, the guideline panel developed recommendations by consensus.

RESULTS

The CPG addresses eleven priority clinical questions involving diagnosis and treatment of acute flank pain due to suspected urolithiasis among adults, minimally invasive treatment of nephrolithiasis measuring 1-2 cm and the use of alpha blockers after ESWL through twelve recommendations and one good practice statement.

CONCLUSION

The Philippine CPG on the management of urolithiasis in adults provides actionable recommendations to address important clinical questions on the diagnosis and management of urinary stone disease. The full text of the clinical practice guideline may be viewed and downloaded from https://doh.gov.ph/dpcb/doh-approved-cpg/

Human ; Adult ; Urolithiasis

Human ; Diagnostic Tests, Routine ; Urolithiasis ; Urologists

Key Findings Current evidence does NOT support use of IgM/IgG rapid test kits for the definitive diagnosis of COVID-19 in currently symptomatic patients. • The present standard for diagnosis of COVID-19 is through qualitative detection of COVID-19 virus nucleic acid via reverse transcription polymerase chain reaction (RT-PCR). • Due to long turnaround times and complicated logistical operations, a rapid and simple field test alternative is needed to diagnose and screen patients. • An alternative to the direct detection and measurement of viral load (RT-PCR) is the qualitative detection of specific antibodies to COVID-19. ELISA (discussed in a separate rapid review) and lateral flow immunoassay (LFIA) IgM/IgG rapid test kits are two currently available, qualitative, antibody tests for COVID-19. • Two low quality clinical trials showed that there is insufficient evidence to support the use of IgM/IgG rapid test kits for the definitive diagnosis of COVID-19. Diagnostic accuracy varies greatly depending on the timing of the test. The test performed very poorly during the early phase of the disease (i.e., less than eight days from onset of symptoms). • Existing guidelines do not recommend serologic antibody tests for the diagnosis of COVID-19 in currently symptomatic patients.
Coronavirus ; Covid-19