EVIDENCE-BASED EMERGENCY MEDICINE WORKING GROUP

MINUTES 7/6/99

Present: Jim Celentano, Peter Dayan, Barney Eskin, Phil Hubel and Peter Wyer.

The meeting was called to order at 1830 by the chair, Peter Wyer.

OLD BUSINESS

OCTOBER WORKSHOP

The recruitment of participants for the workshop is proceeding. The need to set up focus groups for workshop participants was discussed. The deadline for refund of checks is August 15. Mailings to the participants (course materials, etc.) should be sent shortly after this date.

SUMMARY OF EVALUATIONS RETREAT

Barney Eskin and Peter Wyer attended a retreat on June 6th on methods for evaluating how well we are teaching EBM. Presenters included Rosanne Leipzig (Mt. Sinai), Geoff Norman (McMaster), Ian Hart (University of Ottawa), Michael Green (Yale University) and Cheryl Walters (Columbia University). Four possible levels of evaluating courses were discussed: (1) satisfaction with the course (asking participants, how did you like the course?); (2) test of the skills learned by the participants (quizzes on knowledge learned; tests of ability to access electronic databases, etc.); (3) did the teaching session change the participants' behavior? (eg., did this lead to an increase in the use of EBM resources?); (4) did this result in improved patient outcome? The consensus was that (4) was too difficult to measure, particularly since other influences may affect the result. Although measuring (3) is probably best, (1) and (2) also need to be measured to demonstrate that changes in (3) result from a process that involves changes in (1) and (2) as well. Geoff Norman suggested a possible method for measuring (3), namely calling the participants sometime after they take the course and asking them, how often have you used EBM in the last week?

Additional discussion ensued. Brian Haynes (McMaster) has studied how well CME activities change physicians' behavior, which is also of interest to those who fund studies on teaching methods. Although we would like to develop evaluation tools that programs can use themselves, Geoff Norman pointed out that a study in which a complete evaluation of a teaching method is attempted can be very expensive.

BUDGET

A $5000 grant from Pfizer is being sought and there is a possibility of an additional $1000 from Ortho-McNeil. We agreed that any funds obtained cannot be tied to product promotion.

The budget was presented. Of the $700 thus far raised, $400 is left for the 1999-2000 academic year. The budget is as follows:

Our contribution towards dinners at monthly meetings: $100 x 12 = $1200
Workshop expenses:
Outside tutor (travel, hotel and honorarium) = $2000
Hotel for other tutors = $1000
Misc. (copying, workbooks) = $ 300

Total = $4500

Thus we need to raise an additional $4100 for the 1999-2000 academic year.

It was decided that the treasurer's report should be presented annually at the first meeting following the NYAM conference each year.

ONE DAY EBM WORKSHOP IN BROOKLYN

Jim Celentano volunteered to serve as liaison with Ted Gaeta (Methodist Hospital, Brooklyn) for the one day EBM workshop proposed this spring for 3 EM residencies in Brooklyn.

NEW BUSINESS

EDUCATIONAL PROGRAM

The agenda for teaching topics for the combined meetings with the general EBM group was discussed. Possibilities include: the journal club bank (Yeh); the pearls gleaned from McMaster (Eskin & Wyer); differential diagnosis (Hubel); why decision analysis, especially for pediatric topics such as bacteremia/UTI? (Dayan); and prediction rules (Dayan). It was decided that we ought to review the topics that had been discussed last year (Cochrane collaboration, Medline, CATs). Since the schedule for the coming year is now being prepared, we need to submit any topics we wish to be considered for presentation soon.

NYAM EBM NEWSLETTER

The Evidence-based Medicine Newsletter is published 2-3 times a year. In the last newsletter (July 1999), Ilene Wilets reviewed CATS. It was suggested that Ben Yeh write an article for the next newsletter on the CAT bank.

NEW USERS' GUIDE

A new users' guide was recently published: Barratt et al (1999) Users' guides to the medical literature: XVII. How to use guidelines and recommendations about screening. JAMA 281, 2029-34.

The next meeting of the Evidence-Based Emergency Medicine Working Group will be held at the NY Academy of Medicine at 1215 Fifth Avenue (at 103rd St.) at 6:30 PM on August 3rd.

Having no further business, the meeting was adjourned at 2000.


Respectfully submitted



Barney Eskin