Our panel attempted to develop guidelines that would meet the needs of a person
with recent onset spinal cord injury who is in respiratory distress. This
document represents the best recommendations that we could provide given
the availability of scientific evidence. As chairman of the panel writing these
guidelines, my goal was to gather and disseminate the best available knowledge
and information about managing the respiratory needs of patients with ventilation
This review was conducted by a team from Johns Hopkins University with expertise in the
management of sickle cell disease, clinical trial methodology (including clinical trials of
hematological agents), systematic literature review, epidemiological studies, and ethics and
adherence research. External technical experts, including academic and clinical experts and
representatives of patients and public interest groups, provided input regarding the selection and
refinement of the questions to be examined and the relevant literature to be considered.
The Guidelines Review Group of the Yale Center for
Medical Informatics used GEM-COGS,
implementability appraisal and extractor software, to ap-
praise adherence of the draft guideline to methodologic
standards, to improve clarity of recommendations, and to
predict potential obstacles to implementation. Panel mem-
bers received summary appraisals in March 2007 and mod-
iﬁed an advanced draft of the guideline.
The ﬁnal draft practice guideline underwent extensive
external peer review. Comments were compiled and re-
viewed by the group chairperson.
There is now widespread consensus that the Earth is warming at a rate unprece-
dented during post hunter-gatherer human existence. The last decade was the
warmest since instrumental records began in the nineteenth century, and con-
tained 9 of the 10 warmest years ever recorded. The causes of this change are
increasingly well understood.
To reinforce these recommendations and to provide guidance, the New York State Department of Health convened an expert panel of health care professionals who are involved in promoting the health of pregnant women and children. The panel reviewed literature, identified existing interventions,
practices and guidelines, assessed issues of concern, and developed recommendations.