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`-1 Questions from NTH Consensus Development Conferences (October 1987-Seplember 1989) Magnetic Resonance Imaging (MRI) October 26, 1987 Are there contraindications to or risks of MRI? What are the technological advantages and limitations (disadvan- tages) of MRI? What are the clinical indications for MRI, and how does it com- pare to other diagnostic modalities? What are the directions for future research in MRI? Prevention and Treatment of Kidney Stones March 30, 1988 What are me methods of medical prevention, and how successful are they? What is the role of lithotripsy, and can it replace medical preven- tion? What are the clinical and laboratory approaches for the evaluation of patients with stones? What are the directions for future research? Cochiear Implants May 4, 1988 Who is a suitable candidate for a cochiear implant? What are the advantages and disadvantages of the different types of cochIear implants? How effective are cochIear implants? 71

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72 What are the risks and limitations of cochIear implantation? What are the special considerations for children? What are the important directions for future research? Dental Implants June 15, 1988 APPENDIX C What is the evidence that dental implants are effective for the long term? What are the indications and contraindications of various types of dental implants? What are the requirements for surgical, restorative, and per~odon- tal management of patients with dental implants? What are the health risks of dental implants? What are the future directions for research on materials and de- signs of dental implants and on clinical management? Perioperative Red Cell Transfusion June 27-29, 1988 What should the criteria be for perioperative red blood cell trans- fusion? What is the morbidity of anemia in the perioperative period? What are the risks of red cell transfusionboth immediate and long term? What are the alternatives to red cell transfusion? What are the directions for future research? Urinary Incontinence October 3-5, 1988 What is the prevalence and clinical, psychological, and social impact of urinary incontinence among persons living at home and in institutions? What are the pathophysiological and functional factors leading to urinary incontinence? What diagnostic information should be obtained in assessment of the incontinent patient? What criteria should be employed to determine which tests are indicated for a particular patient? What are the efficacies and limitations of behavioral, phannacol- ogical, surgical, and other treatments for urinary incontinence? What sequences and/or combination of these interventions are ap- propriate? What management techniques are appropriate when treatment is not effective or indicated? What strategies are effective in improving public and professional knowledge about urinary incontinence?

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APPENDIX C What are the needs for future research related to urinary incont~ nence? Therapeutic Endoscopy and Bleeding Ulcers March 6-X, 1989 73 Which patients with bleeding ulcers are at risk for rebleeding and thus emergency surgery? How effective is endoscopic hemostatic therapy? How safe is endoscopic hemostatic therapy? Which bleeding patients should be treated? What further research is required? . Oral Complications of Cancer Therapies: Diagnosis, Prevention, and Treatment April 17-19, 1989 Is there a role for pretherapy interventions affecting the oral cav- ity in reducing the incidence of oral complications in the can- cer patient? Which pretreatment strategies are optimal to prevent or minimize oral complications? What are the most effective strategies for management of acute oral complications occurring during cancer therapy? What are the indicated strategies for management of chronic oral complications following cancer therapy? What are the directions for future research? Sunlight, Ultraviolet Radiation, and the Skin May X-10, 1989 What are the sources of ultraviolet radiation, and is the extent of human exposure changing over time? What are the effects of sunlight on the skin? What factors influence susceptibility to ultraviolet radiation? Can ultraviolet-induced changes be prevented? If so, how? Are sunlight-induced adverse skin alterations treatable and/or re- versible? If so, how? What are the directions for future research? Treatment of Destructive Behaviors in Persons with Developmental Disabilities September I 1-13, 1989 What are the nature, extent, and consequences of destructive be- haviors in persons with developmental disabilities? What are the approaches to prevent, treat, and manage these be- haviors?

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74 APPENDIX C What is the evidence that these approaches alone or in combina- tion, eliminate or reduce destructive behaviors? What are the risks and benefits associated with the use of these approaches for the individual, family, and community? Based on the answers to the above questions and taking into ac- count (a) the behavior; (b) the diagnosis and functional level of the individual; (c) possible effects on the individual, family, and community; (~) the treatment setting; and (e) other factors, what recommendations can be made at present regarding the use of the different approaches? What research is needed on approaches for preventing, treating, and managing destructive behaviors in persons with develop- mental disabilities?