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Dear Oliver, Greetings from Al-Ain, the oasis city of the Middle East. Regarding your request on practice guidelines in Paediatrics I did a quick search through WWW and came out with the following. As some otheres in the list may also be interested in the search methodology (and might suggest better ways of searching) I am copying it to the list as well. I searched secondary and primary sources. Secondary: Cochrane library. http://www.obgyn.net (free access to full text with a user friendly search engine). I used the key words clinical guidelines, patient care and found these two reviews. Effect of Clinical Guidelines on Medical Practice: a Systematic Review of Rigorous Evaluations Grimshaw J M, Russell I T,. Effect of Clinical Guidelines on Medical Practice: a Systematic Review of Rigorous Evaluations. Lancet 1993, 342, pp. 1317-1322. This is what the Cochrane review says about this review: This review has been assessed by the UK Cochrane Centre as meeting all of the following criteria. Firstly it is a systematic review (rather than a practice guideline, economic analysis or decision analysis). Secondly it must be relevant to health care. Thirdly it must have explicit criteria for including studies in the review. Fourthly, at least one of the included studies must be an RCT and finally there must be a summary of included studies. The NHS Centre for Reviews and Dissemination has not evaluated the quality of this review any further. CRD database number: DARE-942302 Implementing clinical practice guidelines: can guidelines be used to improve clinical practice? CRD database number: DARE-978122 (DARE Assessed reviews) These are the authors' conclusions: Guidelines can change clinical practice and affect patient outcome. The methods of development, implementation and monitoring of guidelines influence the likelihood of adherence to clinical guidelines. All guidelines should be based on the systematic identification and synthesis of evidence of clinical and cost-effectiveness. Further research is needed to ensure that resources made available for the development of guidelines are used cost effectively. Primary: I searched Medline using Internet gratefulmed @ http://igm.nlm.nih.gov As you had asked specifically for Paediatric topics I created a temporary journal group of 12 pediatric journals and searched them using the key word clinical guidelines for the last 10 years. There were 283 articles and I scanned the first 200. None of them answered your questions directly but I thought you might find the following useful as a starting point. TITLE: Effectiveness of a clinical pathway for inpatient asthma management. AUTHORS: Johnson KB, Blaisdell CJ, Walker A, Eggleston P SOURCE: Pediatrics. 2000 Nov;106(5):1006-12. TITLE: Pediatricians' attitudes, beliefs, and practices regarding clinical practice guidelines: a national survey. AUTHORS: Flores G, Lee M, Bauchner H, Kastner B SOURCE: Pediatrics. 2000 Mar;105(3 Pt 1):496-501. TITLE: Evaluation of an evidence-based guideline for bronchiolitis. AUTHORS: Perlstein PH, Kotagal UR, Bolling C, Steele R, Schoettker PJ, Atherton HD, Farrell MK SOURCE: Pediatrics. 1999 Dec;104(6):1334-41. TITLE: Clerkship curricular revision based on the Ambulatory Pediatric Association and the Council on Medical Student Education in Pediatrics guidelines: does it make a difference? AUTHORS: Kuo AA, Slavin SJ SOURCE: Pediatrics. 1999 Apr;103(4 Pt 2):898-901. TITLE: The neonatal "sepsis work-up": personal reflections on the development of an evidence-based approach toward newborn infections in a managed care organization. AUTHORS: Escobar GJ SOURCE: Pediatrics. 1999 Jan;103(1 Suppl E):360-73. TITLE: Parent's participation and perspectives regarding clinical judgment and clinical guideline development. AUTHORS: Pachter LM SOURCE: Curr Opin Pediatr. 1998 Oct;10(5):476-9. Review. TITLE: Pediatricians' awareness of and attitudes about four clinical practice guidelines. AUTHORS: Christakis DA, Rivara FP SOURCE: Pediatrics. 1998 May;101(5):825-30. TITLE: Guidelines for antithrombotic therapy in pediatric patients. AUTHORS: Andrew M, Michelson AD, Bovill E, Leaker M, Massicotte MP SOURCE: J Pediatr. 1998 Apr;132(4):575-88. Review. TITLE: Clinical practice guidelines in pediatric and newborn medicine: implications for their use in practice. AUTHORS: Merritt TA, Palmer D, Bergman DA, Shiono PH SOURCE: Pediatrics. 1997 Jan;99(1):100-14. I hope you find al least some of this useful. Cheers & warm regards, Badri Dr.P.Badrinath M.D.,M.Phil.,(Epid) PhD(Cantab) Clinical Assistant Professor and Epidemiologist, Department of Community Medicine, UAE University, PO Box 17666, Al Ain, United Arab Emirates. Tel: 00 971 3 7039 652 Fax: 00 971 3 7672022. [log in to unmask] "For an excellent review of the current medical literature, go to Journals Scan www.uaeu.ac.ae/jscan/index.htm" - BMJ 3rd June 2000,Reviews(Netlines) _________________________________________________________________________ Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com. Share information about yourself, create your own public profile at http://profiles.msn.com. %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%