مجله دانشکده پزشکی اصفهان
پیاپی 665 (هفته اول خرداد 1401)

The main purpose of guidelines is to improve patient care, and if properly developed, will lead to improving the quality and quantity of health services. Most clinical guidelines don`t meet the necessary standards, so this study was commissioned by the relevant ministry with the aim of preparing an application package for designing medical guidelines.

This development research plan was conducted in 2020 in four stages; Searching and collecting scientific resources, collecting experts opinions in the field of guideline standards by qualitative method, analyzing texts and classifying information, final design package compilation. The content validity of the proposal forms and their instructions were obtained by calculating the CVI and CVR.

In this study, 13 knowledge products including design request process flowchart, checklist for necessity and type of guideline, pre-proposal, proposal of developing, updating and adapting of clinical practice guidelines and instructions for completing them, conflict of interest form, Guideline design progress report submission forms were prepared. The initial proposal form was also designed in 13 sections using scientific sources. The necessity CVR = (99%), clarity and applicability of the prepared forms and instructions were confirmed. The overall CVI index was 0.97.

The prepared package, is simple, practical, contains the necessary standards for developing/ updating/ adapting the guidelines, as well as in accordance with the requirements and structure of health status in the country. Therefore, it is suggested that a strategy be designed to institutionalize the process and informative products provided by the education system and the executive department of services.

Glioma is the most common primary brain tumor in adults. Various machine learning tools via magnetic resonance imaging can make it a practical instrument in accurate and early diagnosis of tumors thereby assisting physicians in diverse diagnostic and therapeutic fields. The aim of this study is to automate the process of defining and determing the grade of glioma tumor with the use of a variety of learning algorithms.

This is a fundamental-applied study performed on multimodal MRI images of 285 patients with glioma tumors from the BraTS 2018 Challenge Database. In order to classify glioma tumors as high and low grade, first a was performed with U Net network for the definition purposes, then the results were incorporated for classification in VGG16 network to determine the exact grade of tumor.

The mean value of Dice Similarity Coefficient (DSC) for the classification designed for regions of the complete tumor, core of the tumor and the enhanced areas were 0.76, 0.70 and 0.71 respectively. The accuracy of the proposed classification based on VGG 16 network to determine the grade of tumor in both HGG and LGG groups was 99.01%.

Machine learning methods can he useful to determine the glioma tumor grade instead of using invasive proceedures like biopsy which in turn improves overall survival rate of these patients and their quality of life.

Female sexual dysfunction is one of the major health problems of women after childbirth. So, the present study was conducted with the aim of localizing the postpartum sexual function and dyspareunia (The Carol Scale).

This methodological study conducted in 2019-2020 on 200 woman during three months after vaginal delivery. The original version of the Carol scale is in Spanish, which after obtaining permission from the tool developer, was translated into Persian using protocol of forward-backward translation. First, the face and content validity and then the construct validity were determined by confirmatory factor analysis. The reliability was determined by the test-retest method as well as the Intra class correlation coefficient (ICC).

Structural factor analysis was performed using confirmatory factor analysis and four factors of original tool were confirmed. The fit of the four-factor model was confirmed ideal fit based on goodness of fit indices. All reliability indices reported good internal consistency and the overall ICC was 0.793 which indicates the stability or repeatability of the scale over time.

The Persian version of the Carol scale has evidence supporting reliability, validity, and responsiveness and can be used for assessment of postpartum sexual function and dyspareunia among Iranian women after vaginal delivery.