 |
 |
Hi all I don't know the subject of the systematic review in question, but to broaden the discussion the following article is of interest. Have we drawn the wrong conclusions about the value of care pathways? Is a Cochrane Review appropriate? Vanhaecht K1, Ovretveit J, Elliott MJ, Sermeus W, Ellershaw J, Panella M. Evaluation and the health processions 2012 v35(1) p 28-42 Care pathways are used increasingly worldwide to organize patient care. However, different views exist about their effectiveness. One of the reasons for this is that pathways are complex interventions. A recent Cochrane review was published which reported positive results, but although the Cochrane team performed excellent work with an enormous commitment, the conclusions may be inappropriate. To fully understand the potential and problems of care pathways, it is important to define (a) exactly what we are talking about (b) whether the study methods are appropriate, and (c) whether we can properly define the outcomes. http://www.ncbi.nlm.nih.gov/pubmed/21708891 Comments from the authors: "The critical commentary offered by Vanhaecht et al. is a misrepresentation of the process and content of the review and suggests they have not taken the time and effort to thoroughly read and understand this comprehensive review." Even if the conclusion is wrong (see Comments) the discussion about how research evidence does not support pathway design is, in my opinion, still valid. Current research is designed to minimise the variation resulting from context, while pathways are all about context and location. "An effective pathway in one place may be ineffective in another." This is why using research evidence to support commissioning is so problematic. As the professional whose job it is to support evidence based healthcare, we have to work to develop an understanding of the research so it can support not just patient care, but population care. Thus ends the sermon for today!! Anne Anne Gray Knowledge Officer Greater East Midlands Commissioning Support Unit T: 01604 651608 Francis Crick House, Summerhouse Road, Moulton Park Industrial Estate, Northampton NN3 6BF http://www.gemcsu.nhs.uk http://www.twitter.com/NHS_GEM From: UK medical/ health care library community / information workers [[log in to unmask]] On Behalf Of Hickman Marie (RXM) Derbyshire Healthcare Foundation Trust [[log in to unmask]] Sent: 20 June 2014 13:54 To: [log in to unmask] Subject: Do systematic reviews improve patient outcomes? Hi This is the search question I was asked yesterday by a doctor who has completed a Cochrane review and who has been asked to write a short piece to “prove” that undertaking systematic reviews actually does improve patient outcomes. I have searched all the usual sources for him, but it is proving more difficult than first thought and I was hoping that someone out there has a piece of research or paper that they can point me to in order to answer his question. Many thanks in advance Marie Marie Hickman Library and Knowledge Manager [log in to unmask] Follow us on Twitter@DHCFTLibrary Derbyshire Healthcare NHS Foundation Trust Library Ashbourne Centre Kingsway Site Derby DE22 3LZ Tel: 01332 623700 ext 33449 www.derbyshcft.nhs.uk The information transmitted by or with this email is intended only for the named addressee and may contain confidential material which is subject to law. If you have received this email in error, please contact the sender and delete it from your system. ******************************************************************************************************************** This message may contain confidential information. If you are not the intended recipient please inform the sender that you have received the message in error before deleting it. Please do not disclose, copy or distribute information in this e-mail or take any action in reliance on its contents: to do so is strictly prohibited and may be unlawful. Thank you for your co-operation. NHSmail is the secure email and directory service available for all NHS staff in England and Scotland NHSmail is approved for exchanging patient data and other sensitive information with NHSmail and GSi recipients NHSmail provides an email address for your career in the NHS and can be accessed anywhere ********************************************************************************************************************