Endocrine Abstracts

The growing complexity of medical practice has increased the demand for well conceived guidelines. Such guidance is also urgently needed in endocrinology, but difficult, as well-conducted trials are scarce. As a first step towards the systematic development of ’Best Practice in European Endocrinology’ a guideline for diagnosis and treatment of hyponatremia was initiated.

Hyponatremia is the most frequent electrolyte disorder and of prognostic significance. Furthermore, with the availability of V2-receptor antagonists a new treatment option has become available which poses a challenge to optimal diagnosis and targeted treatment.

The European Society of Endocrinology together with the Europeans Society of Intensive Care Medicine and the European Renal Best Practice Initiative of ERA-EDTA has, therefore, jointly initiated this guideline. A key technique is the PICOM methodology for selecting the relevant papers by defining the patient population (P), the intervention/exposure (I), the adequate comparator (C) and the relevant outcome (O) respectively. Furthermore the methodology of the respective studies needs to be carefully addressed (M). Careful development of the PICOM questions is key in the guideline development, as it is at the basis of the literature search. After defining the PICOM questions a comprehensive literature search was completed with a first screening based on titles and abstracts, followed by a second screening to eliminate editorials letters and comments without primary data. In the next screening phase the working group members of the guideline committee performed comprehensive data extraction of the relevant papers using a standardized data extraction form. This allows a summary of all findings in tables and a grading of the evidence applying GRADE methodology.

It is expected that at the time of presentation a first summary of the evidence can be presented. This effort represents an important first exercise to implement structures for the continuous development of ‘Best Practice in European Endocrinology’.

Declaration of interest: The author that there is a conflict of interest.

Funding: This work was supported, however funding details are unavailable.