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LIS-MEDICAL  June 2014

LIS-MEDICAL June 2014

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Subject:

Re: Do systematic reviews improve patient outcomes?

From:

"Gray Anne (NHS GREATER EAST MIDLANDS COMMISSIONING SUPPORT UNIT)" <[log in to unmask]>

Reply-To:

Gray Anne (NHS GREATER EAST MIDLANDS COMMISSIONING SUPPORT UNIT)" <[log in to unmask]>

Date:

Sat, 21 Jun 2014 15:46:16 +0100

Content-Type:

multipart/mixed

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text/plain (89 lines) , image003.png (89 lines)

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
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