LEADING ARTICLE
Quality of practice
The Quality of Practice Committee of the RCPCH
1 University of Edinburgh, UK
2 Derriford Hospital, Plymouth, UK
Correspondence to:
Correspondence to:
Prof. N McIntosh
Department of Child Life and Health, University of Edinburgh, 20 Sylvan Place, Edinburgh EH9 1UW, UK; neil.mcintosh@ed.ac.uk
Update on the clinical effectiveness programme
Keywords: clinical practice guidelines; consensus statements; evidence based practice; guideline appraisal; Royal College of Paediatrics and Child Health
| The first 150 words of the full text of this article appear below. |
Failure by doctors to incorporate strong research evidence into their clinical practice delays improvement in mortality and morbidity. The logo of the Cochrane collaboration1 (fig 1
) shows the clear evidence of benefit from the randomised controlled trials of antenatal steroids in preterm labour available in 1982 if studies had been subject to meta-analysis.2 Antenatal steroids took over a decade after this point to be widely incorporated into obstetric practice despite the clear evidence that neonatal mortality and subsequent neurodevelopmental morbidity were reduced.3 Similarly suboptimal management was shown in a proportion of children with Kawasaki disease in the UK in 1990.4,5 Only 60% received intravenous gammaglobulin, some in an inadequate dose, despite clear evidence of benefit from randomised controlled trials. A further example might be professional advice on the sleeping position for babies and the risk of cot death.6
[in a new window] Figure 1 Logo of the Cochrane collaboration.
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