Retrieval research of evidence based clinical practice guidelines

BACKGROUND: The guidelines for the clinical and managerial work were usually prepared by selective collection of clinical trials and experts. This, however, cannot address the problems that confront the clinical and managerial work. The emergence of evidence-based medicine has been a new approach to these problems, in particular, the evidence-based clinical practice guidelines have provided the new hope for the treatments and relieve medical burden of patients. Good guidelines need evidence-based medicine to improve. However, clinicians are busy, and cannot be available to search and use the evidence-based clinical practice guidelines. Currently, there is no such literature. Thus this research was conducted to inform the readers of interest. OBJECTIVE: To make clinicians understand evidence-based clinical practice guidelines, and to overview the roles, the processing, availability and retrieving approach of clinical practice guidelines. RETRIEVE STRATEGY: The librarians from Books Information Center, West China Hospital, Sichuan University searched the literature from the Pubmed, NGC and the Cochrane Library between January 1990 and May 2007 with the of based medicine,clinical practice,guideline,search in English. Simultaneously, the Chinese CBM disc, CNKI, VIP databases were searched for relevant articles published from January 1999 to May 2007 with the key words of based medicine,clinical practice,guideline,search. A total of 109 papers were searched, and the literature was screened firstly. Inclusive criteria included ①clinical practice guideline research, ②the methods of evidence based medicine, and ③the articles with full content and reliable conclusion. Exclusive criterion included articles with repetitive studies. LITERATURE EVALUATION: Systematic review of relevant studies was conducted. Two reviewers screened and appraised the literature independently, and resolved the discrepancy through discussion and third-party consultation. Of the 35 studies included, nine were reviews, twelve were applied research (including clinical evidence based medicine) and the others were clinical or basic research. DATA SYNTHESIS: The guidelines for the clinical practice are complicated to make. To search present information of clinical practice guidelines can effectively elevate the quality and efficiency to make the guidelines. At present, no internal integrated web site on evidence based medicine appears, but some evidence based medicine guideline journal or web site can be retrieved. By computer, different databases and systems hold individual retrieve pathway and interface. Flexible retrieve skills and many retrieve methods can enhance full retrieve rate and exact retrieve rate. Evidence-based clinical practice is receiving more attention from the clinical, managerial and insurance staffs. This study is conducted for the following aims: ①clinicians improve clinical decision and reduce medical errors, ②patients receive safe, effective, and cost-effective treatments, ③managerial and insurance staffs make evidence-based decisions, and ④clinicians practice on the basis of evidence-based medicine. CONCLUSION: The study on evidence-based practice guidelines can help clinicians understand and use the information from clinical practice guidelines efficiently. These include rapid search and efficient use of clinical practice guideline. However, the studies on preparation of the guidelines need to be further strengthened.