This site is an attempt to share some of the experience that I have gained as a GP in Hertfordshire and a reviewer and editor with the Cochrane Airways Group. Evidence Based Health Care starts with the patient in the consulting room, and in my view there is no substitute for good listening to find out the reason for that particular visit, as I have written in an article for Doctor. However there are questions arising from almost every consultation that I cannot answer, and from time to time I attempt to turn these into a four-part question (as described in the EBM handbook by Sackett et al). For those who want to read more about the PICO framework for such questions, please see the article that I wrote for Pulse on asking a good question. There are further articles in this series on critical reading.
We have successfully introduced an evidence-based policy for the place of antibiotics in children with acute otitis media and details are now available on the Evidence to Change Practice page , including a link to the published report of our new approach and the resulting change in prescribing in the BMJ. We used a handout to explain the reason for our change and this is available in the version that we currently use; feel free to adapt it for your own use if you wish.
Visual Rx is free software to convert Odds Ratios into Numbers Needed to Treat. This was designed to help with the interpretation of results from Systematic Reviews and clinical trials by producing a graphical display demonstrating the impact of treatment if it were given to 100 people with the relevant condition.
Other pages on this site link to a series of articles that I have written for Update and Prescriber and Doctor on understanding statistics and critical appraisal and a variety of prescribing issues. I have added a Bibliography of some books that I have found helpful for those who want to read more.
The first Cochrane systematic review that I have authored compares the use of spacers and nebulisers to deliver Beta-agonists in acute asthma. This has now been updated four times over the past 10 years. The full version of the review is published in the Cochrane Library.
I hope this site may serve as a stimulus to others to find answers to day-to-day questions from practice, and will help those who want to understand some of the tricks to look for when reading articles in medical journals. Please feel free to email me
Dr Chris Cates