Evidence Based Review Guide
We are asking for a high level of consistency and quality in the content. When you begin your review of each card or Topic assigned to you, we ask that you look at several specific references and search several databases to assess the existing content for timeliness and completeness, and to build in the highest level of evidence for recommendations. In general, the best evidence exists in treatment recommendations, with less evidence for assessment and disposition recommendations. We are not asking for a determination of “level of evidence” for recommendations in this version, although we may move to that in the future.
General info on searching for evidence
A series of excellent articles in Annals describe the process of database searching for evidence. The last article (#4 below) from July 2003 has a really good summary.
How to find evidence when you need it, part 1: Databases, search programs, and strategies. C. James Corrall, MD, Peter C. Wyer, MD, Laura S. Zick, MIS, Christine R. Bockrath, MLS March 2002 • Volume 39 • Number 3 • p302 to p306
How to find evidence when you need it, part 2: A clinician's guide to MEDLINE: The basics. Patricia E. Gallagher, MLS, AHIP, Tracy Y. Allen, MLS, Peter C. Wyer, MD April 2002 • Volume 39 • Number 4 • p436 to p440
How to find evidence when you need it, Part 3: A clinician's guide to MEDLINE: Tricks and special skills. Patricia E. Gallagher, MLS, AHIP, Tracy Y. Allen, MLS, Peter C. Wyer, MD May 2002 • Volume 39 • Number 5 • p547 to p551
How to find evidence when you need it, part 4: Matching clinical questions to appropriate databases (Skills for Evidence-Based Emergency Care) .P C Wyer, T Y Allen, C J Corrall July 2003 • Volume 42 • Number 1 • p136 to p149
Suggestions and guidelines for the content review
Search the last ten years literature, then extend or reduce your search from there.
Include a MEDLINE or PubMed search, although these non-filtered databases may be too general for many of the clinical questions. Also, because of indexing issues, MEDLINE searches have been found to identify as few as 50% of all available randomized control trials in a topic area.
The most efficient approach to searching for systematic reviews on topics of therapy is to search the Cochrane Library’s Database of Systematic Reviews (CDSR). The Cochrane collaboration is an international, collaborative, multidisciplinary organization whose mandate is to produce, update, and disseminate reviews on the effectiveness of medical therapy. These reviews use standardized, validated review methods and Cochrane members take advantage of many resources not normally available to the authors of systematic reviews. The Cochrane Library contains the products of the Collaboration and is available by subscription in a CD-ROM version and on-line from Update Software (http://www.updateusa.com/cochrane.htm). A limited version of the Cochrane Library can also be obtained from Ovid (http://www.ovid.com).
Other databases include Best Evidence Topics (http://www.bestbets.org/), a free access online database of shortcut reviews maintained by the ED at Manchester Royal Infirmary in the UK; Clinical Evidence (http://clinicalevidence.com/), a database useful for issues of therapy, available online by subscription; and Emergency Medicine Abstracts (http://ccme.org/EMA/EMA_about_set.htlm), a subscription product available on CD-ROM and online.
Review the pertinent parts of Gausche-Hill M, Fuchs S, Yamamoto L Advanced Pediatric Life Support 2004 textbook to assure consistency.
Search the ACEP, ACEM and AAP databases (and others where appropriate) for current organizational clinical guidelines on your subject.
Please cite 5 to 10 references for each PEMSoft Topic.
Resuscitation advice is based upon consensus approaches to pediatric advanced life support, outlined in the following references:
ECC Committee, Subcommittees and Task Forces of the American Heart Association. 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2005;112:IV-156-IV-166.
Dieckmann RA (ed). American Academy of Pediatrics. Pediatric Education for Prehospital Professionals. Jones and Bartlett, Boston, 2006.
Emergency Nurses Association. Emergency Nursing Pediatric Course Provider Manual. Third Edition. Des Plaines, 2004.
Gausche-Hill M, Fuchs S, Yamamoto L (eds). American Academy of Pediatrics, American College of Emergency Physicians
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