Journal Club Summary
Methodology Score: 4.5/5
Usefulness Score: 4/5
Neumar RW, Shuster M, Callaway CW, et al.
Circulation. 2015 Nov 3;132(18 Suppl 2):S315-67
The Evolution and Future of ACC/AHA Clinical Practice Guidelines: A 30 Year Journey (optional reading)
Jacobs AK, Anderson JL, Halperin JL; ACC/AHA Task Force Members et al.
Circulation. 2014 Sep 30;130(14):1208-17
The 2015 update to the AHA guidelines on CPR and ECC, though not a complete revision of the 2010 edition, provides myriad new recommendations and changes relevant to Emergency Medicine practice. Overall, the combined ILCOR/AHA process through which the guidelines were drafted was impressively rigorous, systematic, open, and made laudable efforts to minimize bias. Journal Club attendees felt that that the document represents the most complete “state of the science” in resuscitation medicine and agreed that the recommendations put forward establish a new standard for resuscitative care going forward.
By: Dr. George Mastoras
Clinical Practice Guidelines
As defined by the Institute of Medicine, “Clinical practice guidelines are statements that include recommendations intended to optimize patient care that are informed by a systematic review of the evidence and an assessment of the benefits and harms of alternative care options.” The development of high quality CPGs is resource intensive and many guidelines may be of lesser quality. Practitioners must be aware of what to look in assessing quality:
1) Was there a rigorous and transparent process for evaluating the evidence?
2) Were conflicts of interest properly dealt with?
3) Are the levels of evidence and strength of the recommendations clearly presented?
4) Is there a process for regularly updating the guidelines?
By: Dr. Ian Stiell