From systematic review to knowledge translation in emergency medicine: contribution of the Cochrane Pre-hospital and Emergency Care field

Article type
Authors
Lvovschi VE1, Meyran D2, Magee K3, Dumouchel J4, Auffret Y5, Nekhili N6, Beroud S7, Yordanov Y8, Miroux P9, Trinh-duc A10, Jabre P11
1Urgences CHU Rouen
2SMUR - Bataillon de Marins Pompiers de Marseille
3Dalhousie University, Halifax Infirmary
4Urgences CHU Tours
5Urgences CHU Brest
6SMUR Gonesse
7Urgences CHU Lyon
8Urgences CHU Saint-Antoine
9Urgences CHU Angers
10Urgences CHU Agen
11SAMU de Paris, CHU Necker Enfants Malades
Abstract
Background: Knowledge Translation is a challenge in Emergency Medicine. There is a need to improve the impact of evidence-based-medicine on physician practice. The Cochrane Pre-hospital and Emergency Care field (Cochrane PEC) is involved in the dissemination of relevant Cochrane systematic reviews (CSR). In January 2017, The Cochrane PEC embarked on a process to summarise relevant CSR for emergency physicians called “Practical Evidence About Real Life Situations” (PEARLS) and to ensure their dissemination.
Objectives: To assess the method, implementation processes and results of the production and dissemination of Cochrane PEC PEARLS.
Methods: Twelve international pre-hospital or in-hospital emergency physicians, using various communication channels, worked in partnership on a regular basis over a short timeframe. We report the methodologic steps used and model construction from Cochrane review selection to journal publication. We also detail a quantitative assessment of this activity.
Results: Methodology optimization and network development took twelve months. Five Cochrane PEC members identified CSR relevant to emergency medicine. Two Cochrane PEC members tagged these reviews in the Cochrane central server (“ARCHIE”). Through consensus, reviews demonstrating marked benefit or harm were identified and selected for PEARLS development.
The PEARLS, limited to 200 words, is written by two members before being presented to the working group. The title of the PEARLS is based on the conclusion provided by the CSR to underscore relevance. The background highlights the clinical and epidemiological conditions of the intervention evaluated. The clinical question is described in one sentence. Main results are presented in one or two informative sections and the limits are identified.
From June 2017 to January 2020, 49 PEARLS were written (one per month) and presented during the 29 working group meetings. Subsequent discussion and approval during the meeting took an average of 30 minutes. One hundred and thirty-five hours were devoted to the entire PEARLS production. The PEARLS were published in two scientific journals of Emergency Medicine: 20 in “Mediterranean Journal of Emergency medicine” in English and 29 in “Annales Françaises de Médecine d'Urgence” in French. Recently, two original Cochrane summaries were published in “Emergencias” in Spanish (impact factor=3.5). No specific financial resources were allocated to this activity.
Conclusions: The dissemination of Cochrane PEARLS is the result of an international collaboration of dedicated emergency physicians. This very successful standardized knowledge translation model is easily reproducible. Studying the impact of this knowledge translation activity is essential and constitutes the next step planned by the Cochrane PEC.