Article type
Year
Abstract
Background: US hospitals are preparing to evaluate and treat returning travelers at risk for Ebola Virus Disease (EVD). Our hospital is one of 35 designated by the Centers for Disease Control and Prevention (CDC) as an Ebola treatment center.
Objectives: Acquire, appraise, and apply best available evidence to develop protocols rapidly for the treatment of patients with possible EVD.
Methods: The focus and scope of our reports were determined in an iterative process between the research analyst, the clinicians, and the center director. Rapid review products from the center include evidence inventory reports that describe the type and quantity of evidence available in a specified area, evidence advisories based on secondary sources, and evidence reviews analyzing primary studies.
Results: The initial clinical query sought evidence on the effectiveness of rehydration, anti-emetic, and anti-diarrheal treatments in patients with EVD. An advisory was completed in 14 days, finding one guideline for caregivers in rural Gabon, but no studies in EVD patients. Given the limited direct evidence, the clinicians then requested a rapid review of oral rehydration for the broader population of patients with any acute infectious gastrointestinal diseases. That review identified a strong consensus of guidelines favoring reduced-osmolarity oral rehydration solutions. Based on those guidelines, the scope of review of primary literature was narrowed to studies of adults, which helped us complete the evidence tables and provide preliminary findings 14 days after the report request, and finalize the review and incorporate into a clinical protocol six business days later. The quality of the evidence base was low.
Conclusions: Close consultation between local evidence-based practice centers and clinical decision-makers can expedite evidence reviews to respond to urgent needs.
Objectives: Acquire, appraise, and apply best available evidence to develop protocols rapidly for the treatment of patients with possible EVD.
Methods: The focus and scope of our reports were determined in an iterative process between the research analyst, the clinicians, and the center director. Rapid review products from the center include evidence inventory reports that describe the type and quantity of evidence available in a specified area, evidence advisories based on secondary sources, and evidence reviews analyzing primary studies.
Results: The initial clinical query sought evidence on the effectiveness of rehydration, anti-emetic, and anti-diarrheal treatments in patients with EVD. An advisory was completed in 14 days, finding one guideline for caregivers in rural Gabon, but no studies in EVD patients. Given the limited direct evidence, the clinicians then requested a rapid review of oral rehydration for the broader population of patients with any acute infectious gastrointestinal diseases. That review identified a strong consensus of guidelines favoring reduced-osmolarity oral rehydration solutions. Based on those guidelines, the scope of review of primary literature was narrowed to studies of adults, which helped us complete the evidence tables and provide preliminary findings 14 days after the report request, and finalize the review and incorporate into a clinical protocol six business days later. The quality of the evidence base was low.
Conclusions: Close consultation between local evidence-based practice centers and clinical decision-makers can expedite evidence reviews to respond to urgent needs.