The Cochrane Child Health Field is a small knowledge intensive organisation [1
] that functions within The Cochrane Collaboration
to advocate for high-quality scientific evidence that reflects the particular needs of infants, children and youth. Furthermore, the Child Health Field works within the child health community to advocate for decision-making based on finding, understanding, and using the best available evidence. Out of these mandates came the Clinical Answers (CAs) project, which aims to develop short, one-page summaries of evidence to quickly answer questions posed by pediatricians.
Studies suggest that clinicians are increasingly turning to electronic evidence to find information to support clinical decision-making [2
]. In a study conducted among pediatricians in Ireland, many believed that the quality of patient care depended on the ability of clinicians to use online resources [5
]. Among the many online resources available to clinicians are summaries of research evidence to support clinical decision-making, such as Best Bets or UptoDate. Best Bets was originally developed for topics in emergency medicine, and is written by volunteers who register to develop a Best Bet. Evidence is presented in a table, and includes primary studies that are evaluated by authors. UptoDate covers a wide range of topics and is written by physicians; information included spans textbooks to primary studies and is several pages in length. Ketchum et al
] reviewed several of these resources, and found that point-of-care products varied greatly in content, type of evidence, and currency of the evidence. There is a need for consistent and current high-quality evidence delivered in a systematic format; we aim to meet this need by creating and publishing CAs.
Developing short summaries of up-to-date, high-quality evidence is important because clinicians are often unable to keep abreast of current relevant literature [2
]. Alper et al
] estimate (from 2005 database figures) that clinicians would require 627.5 hours per month to evaluate all relevant articles - over 20 hours per day, an impossible task. For example, worldwide productivity in asthma research (measured by number of articles published) has doubled from 1994 to 2004 and is continually growing [9
]. Riordan et al
] found that pediatricians did not have time to track down information and critically appraise evidence while on call; they conclude that pediatricians need easy access to evidence-based answers to common clinical questions.
We chose to develop CAs in the area of respiratory child health, because almost 20% of all reviews published in the Cochrane Database of Systematic Reviews are related to respiratory medicine in children [12
]. CAs present evidence from Cochrane systematic reviews, and potentially non-Cochrane systematic reviews, in short one-page electronic summaries with links in text to addendums, that will also be readable in hardcopy. The CA format that we tested consisted of eight separate sections: Question, Answer, Background, Search strategy, Included reviews, Results, Limitations, and References. The addendums included the full search strategy, tables and figures (including forest plots), and references (Additional file 1
). Topics for our initial CAs were suggested by pediatricians in the child health field listserv, and also those associated with the Airways and Acute Respiratory Infections Cochrane Review Groups. As CAs are concise, two pediatricians on our team selected the most important outcomes to present for each CA, and decision rules for data extraction and analysis were agreed by our team.
CAs have the potential to be useful for child health clinicians in point-of-care decision-making by providing current high quality evidence in a consistent way to answer common clinical questions. A survey was prepared to test the CA among its intended users. The purpose of the survey was to test the format of the CA, not the particular clinical content of the example used (for example, the survey included questions on the amount and type of information presented, but not whether the clinician agreed with the recommendations for treating bronchiolitis or methodology in producing the CA content). In this paper, we report the survey results and discuss the changes we will implement in the CA format. Conducting this survey assisted us in refining and producing a better product for our future users.