Bird migration is a synchronized event that has evolved over thousands of years. Changing temperatures due to climate change threaten the intricacies of migration timing for birds; however, the extent of these changes has only recently begun to be addressed. Utilizing data from the citizen-science website eBird and historical temperature data, we analyzed bird migration timing in two states warming quickly (Alaska and Maine) and one warming gradually (South Carolina). Using linear regressions, we looked at relationships between different temperature indices and year with bird migration timing from 2010 to 2016. Bird migration through all three states, regardless of warming rate, showed similar rates of alterations. Additionally, in every state over half of the birds that had altered migration timing were long-distance migrants. Furthermore, we performed feature selection to determine important factors for changing migration timing of birds. Changes to summer resident and transient bird migration were most influenced by state. In winter resident migration, departure date and length of stay were most influenced by maximum temperature, while arrival date was most associated with minimum temperature. Relationships between changing temperatures and migration timing suggest that global climate change may have consequential effects on all bird migration patterns throughout the United States.
Background
This analysis aims to evaluate the methodological quality of Evicore’s spinal imaging guidelines for lower extremity pain with neurological features with or without lower back pain by leveraging the AGREE II tool. The AGREE II tool provides a framework to assess guideline development. It is well validated and has been used to evaluate many other guidelines previously.
Methods
Five appraisers used the AGREE II appraisal tool to conduct a comprehensive review of Evicore’s spinal imaging guidelines for lower extremity pain with neurological features. Appraisers provided an overall assessment of the guidelines as well as specific scores pertaining to domains including scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, and editorial independence.
Results
Appraisers assigned numerical grades of 2, 2, 2, 3 and 4 (out of 7 total points, with 7 being the highest) for overall quality of the guidelines. Three appraisers recommended use of the guideline with modifications and two appraisers did not recommend the guideline. The AGREE II ratings had good reliability across the different raters [intraclass correlation coefficient (ICC) =0.881, 95% confidence interval (CI): 0.77, 0.94].
Conclusions
Evicore’s guidelines would greatly benefit from increased identification and diversification of guideline development parties and stakeholders, increased rigor of development including a more robust discussion of the body of evidence and its strengths and limitations, and incorporation of more explicit suggestions for implementation of guideline recommendations by healthcare providers.
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