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| Title |
CRITICAL APPRAISALS OF CLINICAL RESEARCH ON THE
INTERNET: A PRELIMINARY ASSESSMENT |
| Author |
B Markovitz, R Snyder, R Sachdeva |
| Affiliation |
Washington University, Medical College of
Wisconsin |
| Introduction |
To leverage the Internet's reach and the tools
of evidence-based medicine, the Evidence-Based Journal Club (EBJC) on PedsCCM - The
Pediatric Critical Care Website (http://PedsCCM.wustl.edu) offers structured critical
appraisals of relevant clinical research in critical care medicine. This study represents
a preliminary attempt to assess the impact of this endeavor. |
| Method |
The directors of pediatric critical care
fellowship training programs were surveyed by email twice; prior to and then following
publication on the EBJC of a specific critical appraisal of Amato et al. (1), a clinical
trial evaluating a protective lung strategy (PLS) in mechanical ventilation (MV).
Directors were asked for their opinions of their fellows' knowledge and practice regarding
MV strategies in respiratory failure, and whether the Amato paper changed their practice.
The follow up survey queried the impact of the critical appraisal of this paper. |
| Result |
70% of directors surveyed replied to the first
survey; 45% to the second. Prior to the publication of this paper, 53% felt there was
sufficient evidence to practice a PLS with MV. 81% reported their fellows believed the
study to be valid, 65% believed it was applicable to their patients, and 58% reported that
their practice did not change with the publication of this paper. In the second survey,
67% either knew or believed that their fellows had seen the critical appraisal of this
paper on the EBJC. 86% now believed the study to be valid, 86% felt it was applicable to
their patients, and 69% reported their approach to MV did not change since the publication
of the appraisal. Of those programs where the fellows were believed to have read the
appraisal, 71% of directors reported it contributed either somewhat or substantially to
their fellows' appreciation of the original paper. |
| Conclusion |
From this preliminary and limited study, fellows
in pediatric critical care appear aware of the EBJC and find it useful. Further study of
the effect of such structured critical appraisals on trainee education and clinical
practice is indicated. 1. Amato MBP et al. N Engl J Med 1998; 338: 347-354. |
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