Cowley Laura, Tempest Vanessa, Maguire Sabine, Mann Mala, Naughton Aideen, Wain Laura, Kemp Alison
BMJ Qual Improv Rep. 2013 Jul 24;2(1). doi: 10.1136/bmjquality.u201101.w703. eCollection 2013.
In contrast to other areas of medical practice, there was a lack of a clear, concise and accessible synthesis of scientific literature to aid the recognition and investigation of suspected child abuse, and no national training program or evidence based guidelines for clinicians. The project's aim was to identify the current scientific evidence for the recognition and investigation of suspected child abuse and neglect and to disseminate and introduce this into clinical practice. Since 2003 a comprehensive program of Systematic Reviews of all aspects of physical abuse, emotional abuse, and neglect of children, has been developed. Based on NHS Centre for Reviews and Dissemination standards, methodology was devised and reviewers trained. Dissemination was via peer reviewed publications, a series of leaflets highlighting key points in a Question and Answer format, and a website. To date, 21 systematic reviews have been completed, generating 28 peer reviewed publications, and six leaflets around each theme (eg fractures, bruising). More than 250,000 have been distributed to date. Our website generates more than 10,000 hits monthly. It hosts primary reviews that are updated annually, links to all included studies, publications, and detailed methodology. The reviews have directly informed five national clinical guidelines, and the first evidence based training in Child Maltreatment. Child abuse is every health practitioner's responsibility, and it is vital that the decisions made are evidence based, as it is expected in all other fields of medicine. Although challenging, this project demonstrates that it is possible to conduct high quality systematic reviews in this field. For the first time a clear concise synthesis of up to date scientific evidence is available to all practitioners in a range of accessible formats. This has underpinned high quality national guidance and training programs. It ensures all professionals have the appropriate knowledge base in this difficult and challenging field.
与医学实践的其他领域相比，在识别和调查疑似虐待儿童方面，缺乏清晰、简洁且易于获取的科学文献综述，也没有针对临床医生的全国性培训项目或循证指南。该项目的目标是确定识别和调查疑似虐待及忽视儿童的现有科学证据，并将其传播并引入临床实践。自2003年以来，已制定了一项全面计划，对儿童身体虐待、情感虐待和忽视的各个方面进行系统综述。根据英国国家医疗服务体系（NHS）综述与传播中心的标准设计了方法，并对综述人员进行了培训。传播途径包括同行评审出版物、一系列以问答形式突出要点的传单以及一个网站。迄今为止，已完成21项系统综述，产生了28篇同行评审出版物，以及围绕每个主题（如骨折、瘀伤）的6份传单。到目前为止，已分发超过25万份。我们的网站每月点击量超过1万次。它提供每年更新的初步综述、所有纳入研究的链接、出版物以及详细方法。这些综述直接为五项国家临床指南和首个关于儿童虐待的循证培训提供了依据。虐待儿童是每位医疗从业者的责任，做出基于证据的决策至关重要，正如在医学的所有其他领域所期望的那样。尽管具有挑战性，但该项目表明在这一领域进行高质量的系统综述是可行的。首次以一系列易于获取的形式为所有从业者提供了清晰简洁的最新科学证据综述。这为高质量的国家指南和培训项目奠定了基础。它确保所有专业人员在这个困难且具有挑战性的领域拥有适当的知识基础。
