EVIDENCE-BASED EMERGENCY MEDICINE

WORKING GROUP

MINUTES 3/7/00

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

The meeting was called to order at 5:25 PM by Peter Wyer

OLD BUSINESS

Minutes of the February meeting were reviewed and approved.

TREASURER'S REPORT

Phil Hubel will be preparing a final financial report for this academic year which will include expenses for the 1999 NYAM Workshop. This will be submitted to NYAM for final reckoning. Preliminary calculations suggest that we will have a small surplus at the end of the academic year.

NYAM WORKSHOP 2000

Tom McGinn will be the overall director of the workshop. Peter Wyer has agreed to coordinate fundraising for the overall workshop.

Several questions about Emergency Medicine participation in the workshop were discussed: (1) How many tutorial sessions do we want? We will likely set 2 or 3 groups as a goal. (2) Should we again limit the participants to those from residency programs? We might preferentially accept those participants, but probably would open the workshop to other physicians as well. (3) How should we organize the groups if we have more than one? Two possibilities were discussed. One was to separate participants from teaching programs from the other participants. Alternatively, the small group sessions may work better if the participants were grouped according to their prior knowledge of EBM, which was the way the groups were organized for the 1999 workshop. (4) Can we fill more than 1 group? We thought that to fill 2 or 3 groups we would need to advertising nationally. This could be done via the internet or notices in the Annals of Emergency Medicine. (Since we are registered with ACEP to receive CME credit, the Annals will include a posting of the workshop in their monthly posting of meetings.) We probably have enough tutors for 3 tutorial groups in the NY metropolitan area. However, if we are going to advertise nationally, we would probably invite at least one nationally known EBM teacher, such as Steve Hayden or Brian Rowe, to the workshop. The cost (including expenses) of each such outside tutor is about $2500 apiece. (3) Should we participate in the renewal of the grant that is currently being used to underwrite the workshops? We thought that it would be advantageous to get involved in this process.

These questions will be reconsidered over the next month and final decisions will be made at the next meeting in April.

Further discussion ensued about our goals in continuing holding workshops. These workshops require considerable investment of time to organize and raise funds to meet expenses. Reasons for continuing the workshops include: (1) We like teaching EBM; (2) This furthers our academic careers; (3) Teaching EBM to our colleagues in the NY metropolitan area facilitates intelligent discussions about clinical questions and policies; (4) We could become the national center for teaching EBM to emergency physicians (none other exists).

WEBSITE UPDATE

Ben Yeh reported that the website is working satisfactorily. Links to our site have been posted on two other sites on the Internet.

BIG CAT PROJECT

Peter Wyer reported that the protocol for reviewing CATs has been distributed and will be posted on the website. At this point the best strategy for proceeding is to begin posting a few CATs on the site as a sort of testing phase for visitors to try out. Before posting, CATs would first be reviewed by physician and librarian reviewers. Tracy Allen has volunteered to help with the latter. Issues of evaluating the quality of the posted CATs were discussed. Having two reviewers grade the CAT independently and then generate a kappa value of their reviews was suggested as a possible way of validating this method of estimating the quality of each CAT.

SITE VISITS

At the focus group during last year's workshop, there was interest among participants in site visits at their institutions. Plans for site visits this year are still preliminary. However, as a start, Peter Wyer has been invited to LIJ to give EBM Grand Rounds on practice guidelines and will meet informally with NYAM workshop graduates there afterwards.

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

6:30 PM on Tuesday, April 4th. Food will be available.



There being no further business, the meeting was adjourned at 6:40 PM.

Respectfully submitted

Barney Eskin