This second edition of Finding the Evidence was published in October 2001: the first edition is already available online, at http://www.focusproject.org.uk, under completed work and available resources. As the editors comment in their introduction, this is ‘a living document’ and it is hoped that this version will be updated with new material every 6 months. The editors also hope to arrange for cited articles to be critically appraised and posted on the web. The ultimate aim is that fulltext articles will be available through internet links.
This ‘work in progress’ consists of a guide to current evidence-based medicine for clinical practice. Two methods were used in its compilation. First, electronic search strategies were applied to identify relevant systematic reviews, meta-analyses and practice parameters of clinical guidelines. Second, experts were asked to choose non-systematic reviews, cutting-edge and classic papers and books. The experts were asked to address two critical questions about their particular field of expertise: ‘What are the latest developments in understanding the management of the condition?’ and ‘What are the key messages from new research that are not being widely used?’
Part 1 of the book provides a description of terms for conducting an electronic search, as well as a guide to searching and a summary of a search strategy. In part 2 evidence is reviewed by clinical category. There are sections on emotional, physical and sexual abuse, attention-deficit hyperactivity disorder, bullying, conduct disorders and juvenile delinquency, and deliberate self-harm. The review continues with eating disorders, elimination and emotional disorders. Gender identity disorders, paediatric liaison, pervasive developmental disorders, post-traumatic stress disorder and psychoses are considered, as are substance misuse and tic disorders. A section is devoted to treatment approaches, which covers psychotherapeutic and psychopharmacological evidence reviews. Another section deals with emerging data-sets, where current evidence is not as well developed. The penultimate section includes assessment, attachment disorders, electroconvulsive therapy, mental health and deafness, and the mental health of children and adolescents from ethnic minorities. The final section is devoted to a review of service development and legal issues. Appendices contain further information on search strategies, randomised controlled trials for systematic reviews and meta-analyses, and critical appraisal tools. For the interested reader, FOCUS provides useful links to other evidence-based medicine resources that expand the information in the book.
The value of this publication lies in both its up-to-the-minute review of current data and the critical questions considered by the experts. The quality of evidence in child psychiatry is not as well developed as in other medical disciplines, and there is a relative lack of systematic reviews, meta-analyses and clinical guidelines. The role of the expert in developing an overall formulation and the raising of critical questions is often still primary in setting the gold standard. However, some of the topic areas covered here lack expert critical comments on the current literature. Treatment categories such as psychopharmacology and psychotherapy appear to be covered briefly and in an undifferentiated manner and might well have benefited from sub-categorisation. The 38 contributors to this work have done a good job in developing an initial database that will hopefully grow and may well become the first port of call for an up-to-date clinical review of ‘the evidence’. That this will be useful to carers and relatives, as the editors hope, seems to be less realistic, as their needs are likely to be quite different from those of clinicians. A book to be recommended for the academic library and the individual academic, this is of less immediate value for front-line clinicians.
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