EVIDENCE-BASED EMERGENCY MEDICINE

WORKING GROUP

MINUTES 2/1/2000

Present: Jim Celentano, Peter Dayan, Barney Eskin, Peter Wyer and Ben Yeh

The meeting was called to order at 7:10 PM by Peter Wyer

OLD BUSINESS

Minutes of the January meeting were reviewed and approved.

WORKSHOP EVALUATION

Barney Eskin has written up an evaluation of last year's workshop, using the information from Rosanne Leipzig's pre and post workshop questionnaires as well as pre and post workshop quizzes and the survey of EBM resource use that Phil Hubel conducted. A summary will be published in the next NYAM EBM Newsletter and it was suggested that publication with Rosanne Leipzig be considered for a journal such as the Journal of Medical Education.

Y2K EDUCATIONAL PROSPECTIVE

SITE VISITS

At the focus group during last year's workshop, there was interest among participants in site visits at their institutions. Jim Celentano and Phil Hubel will poll sites to see specifically which are now interested in such a visit.

PEDIATRIC FELLOW WORKSHOP

Peter Dayan has 8 pediatric EM fellows in the NY area scheduled for a 2-day EBM workshop (Thursday and Friday, August 17-18) at Columbia University, where the library facilities will be available. He is currently trying to get funding for this from COPEM (Committee on Pediatric Emergency Medicine). There will be 4 hours each day in small group sessions and 2 hours each day in preparation time.

OCTOBER WORKSHOP

The next NYAM EBM workshop is planned for Monday October 2nd through Thursday October 5th. Discussion about possible participants included again limiting this to faculty from residencies (Dayan), as well as consideration of an advanced track for those who have taken the workshop before. Peter Dayan will be the director of the Emergency Medicine section. Ben Yeh suggested preparing a walk-through guide, ie., something that the participant could read before the workshop to prepare for the first small group session.

WEBSITE UPDATE

Ben Yeh reported that the previous NYAM administrator of the website left, but that after the transition the website is now running smoothly.




CENTRES FOR HEALTH EVIDENCE UPDATE

The website for the Centres for Health Evidence, at the URL, http://www.cche.net, is being run by Rob Hayward (formerly the informatics guru at McMaster) and Brian Rowe. Resources include online texts, the Cochrane collaboration, CAT banks, a medical record system and practice guidelines. Peter Wyer has access to parts of CCHE that are not available to the general user.

Peter Wyer suggested making the Journal Club Bank part of a research project through this site. We could monitor access to the bank, and find out if the people that submitted a specific entry actually accessed it and how often they did so. We could also contact those who accessed each entry and ask them whether they used the information for patient management and, if so, whether the patient benefited from it. This and other projects could require funding.

NEW BUSINESS

EXPANSION OF THE BIG CAT PROJECT

Peter Dayan has been in contact with Victor Montori an internist from Rochester, Minnesota, who knows Guyatt, and is interested in CATs. One of the questions that we would like to answer is, how do we decide if a particular CAT is valid?

Cochrane reviews are often published separately in journals because they are regarded as being of high quality. It is possible that if CATs were similarly regarded, they could be published in journals as well. Peter Wyer has submitted a paper on CATs for publication in the Annals of Emergency Medicine, entitled, "The Clinician and the Medical Literature. When Can We Take a Shortcut?" It addresses the issue of how we can integrate a short review such as a CAT into the literature and into our daily practice. It is part of the question that the clinician might address every day, namely, how do I use EBM to care for my patients?

The next monthly meeting will be held at the NY Academy of Medicine, 1215 Fifth Avenue (at 103rd St.) at

5:15 PM on Tuesday, March 7th. Food will be available. The meeting will be followed at 6:30 by an educational presentation entitled, "Undecided about Decision Analysis? A Beginner's Approach to Using Decision Analysis in Education."

There being no further business, the meeting was adjourned at 8:30 PM.

Respectfully submitted


Barney Eskin