Toward this end, a latent content analysis of a variety of public and private documents is performed where we find that the transformation of the jurisdiction of internal auditing to be rife with conflict, characterized by a heated dramaturgy of exchange relations among the Big Five, the AICPA, the IIA, the SEC, and also the US Congress. Check attesting to your personal character & professional ethics.pdf you have access through your login credentials or your institution. Prior versions of this paper were presented at the Conference of the Global Business and Technology Association and the American Sociological Association.
AHA Guidelines for Implantation of Pacemakers and Antiarrhythmia Devices. This executive summary appears in the April 7, 1998 issue of Circulation. AHA Class I, II, and III recommendations, is published in the April 1998 issue of the Journal of the American College of Cardiology. Reprints of both the executive summary and the full text are available from both organizations. Following extensive review of the medical literature and related documents previously published by the American College of Cardiology, the American Heart Association, and the North American Society for Pacing and Electrophysiology, the writing committee developed recommendations that are evidence based whenever possible. Evidence supporting current recommendations is ranked as level A if the data were derived from multiple randomized clinical trials involving a large number of individuals. Evidence was ranked as level B when data were derived from a limited number of trials involving comparatively small numbers of patients or from well-designed data analysis of nonrandomized studies or observational data registries.
Evidence was ranked as level C when consensus of expert opinion was the primary source of recommendation. The committee emphasizes that for certain conditions for which no other therapies are available, the indications for device therapies are based on years of clinical experience as well as expert consensus and are thus well supported, even though the evidence was ranked as level C. These guidelines include expanded sections on selection of pacemakers and ICDs, optimization of technology, cost, and follow-up of implanted devices. Journal of the American College of Cardiology. The follow-up sections are relatively brief because in many instances the type and frequency of follow-up examinations are device specific.
The importance of adequate follow-up, however, cannot be overemphasized because optimal results from an implantable device can be obtained only if the device is adjusted to changing clinical conditions. The text accompanying the list of indications should be read carefully because it includes the rationale and supporting evidence for many indications and in several instances includes a discussion of alternative acceptable therapies. These terms are not specifically defined because the time element varies in different clinical settings. The treating physician must use appropriate clinical judgment and available data in deciding whether a condition is persistent or when it can be expected to be transient.