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A search for the evidence supporting community paediatric practice
1Academic Unit of Paediatrics and Child Health, University of Leeds, UK.
Archives of Disease in Childhood
|May 18, 1999
Summary
This study assessed the evidence supporting community paediatric practices. Approximately 40% of clinical actions had strong evidence, with prescribing and health promotion showing the highest support.
Area of Science:
- Pediatrics
- Evidence-Based Medicine
Background:
- The evidence base for medical practice varies significantly across specialties.
- No prior studies have quantified the evidence supporting community paediatrics.
Purpose of the Study:
- To determine the extent of the evidence base for community paediatric practice.
Main Methods:
- Prospective review of 247 consultations and 1149 clinical actions by 12 community paediatricians.
- Systematic search of electronic databases for evidence supporting diagnostics, prescribing, referrals, counselling, and child health promotion.
- Critical appraisal of evidence quality and its support for clinical actions.
Main Results:
- Good evidence (RCT or equivalent) supported 39.9% of actions; convincing non-experimental evidence supported 7%.
- Inconclusive evidence was found for 25.4%, no evidence for 27.5%, and evidence of ineffectiveness for 0.2%.
- Prescribing and child health promotion had the highest quality evidence; counselling/advice had the lowest.
Conclusions:
- A substantial body of evidence supports community paediatric practice.
- This study uniquely included non-medication and non-surgical interventions, broadening the scope beyond previous research.