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Putting evidence into practice: part 2
  1. Bob Phillips
  1. Evidence-based On Call, Centre for Evidence-based Medicine, University Dept of Psychiatry, Warneford Hospital, Headington OX3 7JX, UK;

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    How do your remember what you read in a paper? How do you call to mind that reference about petechiae and vomiting that means you don’t have to stick this perfectly well 8 year old needle-phobic? Capturing the outputs of your critical appraisals so you can retrieve them is easier if you formally record them in some way. These records have been described by lots of different people in lots of different ways. They are called a number of things, mostly with punishingly painful acronyms attached. Hence you get “critically appraised topics” (CATs—probably the most generic phrase), “best evidence topics” (BETs), or “patient orientated evidence that really matters” (POEMs) depending on where you live or work. The topics you read here in Archimedes are printed as BETs, with fuller individual CATs on the ADC website. A template you can fill in with your own questions is also available on the website, along with Instructions to Authors.

    The underlying principles of all these different records are fairly similar. They have a headline which describes either the question under consideration or a compact form of the answer. They have the question that triggered the CAT to be created. They detail the study methodology and comment on strengths and weaknesses, and relay the relevant results. They may have further comments, but nearly all will have a summary of the clinical bottom lines.

    Once you’ve created your summaries, you still need to keep them accessible. Placing them all (with copies of Archimedes) in a big red folder might seem a bit cheesy, but it’s been shown to be an effective way of getting clinical questions answered quickly.1 It also doesn’t rely on your hospital computer working, and can be safely accessed while drinking coffee. It has the benefit of having instant feedback too—with the aid of a pencil or pen, comments can be added to the margins without difficulty. The more technologically minded might want to put your own on a website. Many widely used word processing programmes will allow you to save your version of an evidence summary as web (html) pages. (From there, getting them onto a website is then a case of finding someone with a bit of IT knowledge.) Developing the technological idea further, a PDA (handheld computer) version could be made by those with adequate skills.

    Of course, the next logical step when you’ve worked with your colleagues to produce a high quality summary of the evidence related to a clinically important question is to submit it to Archimedes. You too could be the next proud provider of information which makes clinical paediatrics more evidence based.



    • Bob Phillips

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