The evidence required to say that the change is really "evidence based" would be a study comparing a series of shocks with a single shock. There has been no such study.
The change is in fact "consensus based" - it is the opinion of the group of experts who create the guidelines that the single shock group would be better. The change is based on a good theory - which may be either right or wrong. As there is no better evidence, a consensus of experts is as good a reason to change as you are going to get - so I would support the changes.
This is a good illustration of why it is good to add a level of evidence (rather than just using the term 'evidence based') - the new guidelines are mainly based on Level V evidence (which is the consensus of experts). See http://www.cebm.net/levels_of_evidence.asp#levels for a good table of levels of evidence.
I agree that it could be misleading to call the changes "evidence based". For those who do not have critical appraisal skills this terminology may give the impression that the changes are better supported than is actually the case.
Tim. Coats.
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]]On Behalf Of Craig Ellis
Sent: 10 December 2005 18:34
To: [log in to unmask]
Subject: Re: Resus Guidelines 2005
How can anyone say the change from stacked shocks to single shocks was
evidence based. There isnt any evidence. This change isnt evidence based. I
understand the logic of the change - but thats not the same as evidence. And
as far as I know the two studies looking directly at this havent even
reported preliminary data yet. Ive been disappointed that UKRC has made this
change - I think for many involved in resus it will be seen as a major
credability blow for UKRC - all just my opinion.
IF anyone with inside knowledge can address these concerns I would welcome
it
cheers
Craig
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