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Best paediatric evidence; is it accessible and used on-call?
F A I Riordan1, E M Boyle, B Phillips
1Dept of Child Health, Birmingham Heartlands Hospital, UK. Andrew.Riordan@heartsol.wmids.nhs.uk
Insights
Paediatric trainees have access to evidence-based medicine resources but rarely use them on-call. Local guidelines are frequently used instead of databases like Medline for clinical decisions.
Area of Science:
- Medical Informatics
- Evidence-Based Medicine
- Pediatrics
Background:
- Effective evidence-based medicine (EBM) requires access to quality filtered resources, bibliographic databases, and journals.
- Paediatricians need these tools to critically appraise evidence for clinical practice.
Purpose of the Study:
- To assess paediatrician access to EBM resources while on-call.
- To determine if these resources are utilized for answering clinical questions.
Main Methods:
- A telephone survey was conducted with paediatric and neonatal units in November 2001.
- On-call paediatricians were queried about their access to Medline, Cochrane, and paediatric journals, and their usage patterns.
Main Results:
- High access to Medline (99%) and Cochrane (92%) was reported, but on-site access varied.
- While most departments had numerous local guidelines, only 16% of trainees used Medline on-call, compared to 70% using guidelines.
Conclusions:
- Paediatric trainees generally possess the necessary resources for evidence appraisal.
- Despite resource availability, on-call usage for clinical decisions is low, with a preference for local guidelines.
Background:
Paediatricians wanting to use evidence based medicine (EBM) strategies, need to be able to track down and critically appraise evidence. This requires access to quality filtered resources (for example, Cochrane Library), bibliographic databases (for example, Medline), and paediatric journals.
Aims:
To determine whether paediatricians have access to these resources when on-call and if they use them to answer clinical questions.
Method:
A telephone survey of paediatric and neonatal units was performed during November 2001. The "paediatrician-on-call" was asked whether they could access Medline, Cochrane, and paediatric journals, and if they used these when on-call.
Results:
Paediatric trainees were available in 87 of the 97 units contacted. All except one had access to Medline; although only 56 (64%) could do this near their ward. Eighty had access to Cochrane. Thirteen (15%) could not gain access to their library out-of-hours. All except one department had local guidelines, with 71% having >15 guidelines. Access to any of the top seven "best evidence" paediatric journals varied from 64% to 100%. Only 26% of trainees had read the evidence based section of Archives of Disease of Childhood, Archimedes. Many trainees claimed to use guidelines when on-call (61; 70%), but few used Medline (14; 16%).
Conclusions:
Paediatric trainees mostly have access to facilities to help them to track down and critically appraise evidence. However, few of them have used it to help make clinical decisions when on-call. Many of the doctors contacted said they used local guidelines as their source of information on-call.
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