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EVIDENCE-BASED-HEALTH  November 2000

EVIDENCE-BASED-HEALTH November 2000

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Subject:

Practice guidelines in pediatrics - some info

From:

"padmanabhan badrinath" <[log in to unmask]>

Reply-To:

padmanabhan badrinath

Date:

Mon, 20 Nov 2000 04:33:20 GMT

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (134 lines)

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)

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