紧急医疗服务（EMS）护理的证据状况：院前循证实践（PEP）项目的演变与当前方法
State of the Evidence for Emergency Medical Services (EMS) Care: The Evolution and Current Methodology of the Prehospital Evidence-Based Practice (PEP) Program.
作者信息
Carter Alix J E, Jensen Jan L, Petrie David A, Greene Jennifer, Travers Andrew, Goldstein Judah P, Cook Jolene, Fidgen Dana, Swain Janel, Richardson Luke, Cain Ed
机构信息
Medical Director, Research, Emergency Health Services, Emergency Medicine, Division of EMS, Dalhousie University, Halifax, NS.
Performance Manager, Emergency Health Services, Emergency Medicine, Division of EMS, Dalhousie University, Halifax, NS.
出版信息
Healthc Policy. 2018 Aug;14(1):57-70. doi: 10.12927/hcpol.2018.25548.
BACKGROUND
Emergency medical services (EMS) leaders and clinicians need to incorporate evidence into safe and effective clinical practice. Access to high-quality evidence, and the time to synthesize it, can be barriers to evidence-based practice. The Prehospital Evidence-Based Practice (PEP) program is an online, freely accessible, repository of critically appraised evidence specific to EMS. This paper describes the evolution and current methodology of the PEP program.
METHODS|DESIGN: The purpose of PEP is to identify, catalog and critically appraise relevant studies. Following regular systematic searches, two trained appraisers critically appraise included studies and assign a score on three-point level of evidence (LOE) and direction of evidence (DOE) scales. Each clinical intervention is plotted on a 3 × 3 (LOE × DOE) evidence matrix, which provides a summary recommendation.
DISCUSSION
The PEP program is a unique knowledge translation tool, specific to EMS. End-users can easily identify which clinical interventions are, or are not, supported by evidence.
背景
紧急医疗服务（EMS）领导者和临床医生需要将证据纳入安全有效的临床实践。获取高质量证据以及综合分析证据的时间可能成为循证实践的障碍。院前循证实践（PEP）项目是一个在线的、可免费访问的、针对EMS的经过严格评估的证据库。本文描述了PEP项目的发展历程和当前方法。
方法|设计：PEP的目的是识别、编目和严格评估相关研究。在定期进行系统检索之后，两名经过培训的评估人员对纳入的研究进行严格评估，并在三分制证据水平（LOE）和证据方向（DOE）量表上给出评分。每种临床干预措施都绘制在一个3×3（LOE×DOE）证据矩阵上，该矩阵提供了一个总结性建议。
讨论
PEP项目是一种专门针对EMS的独特知识转化工具。最终用户可以轻松确定哪些临床干预措施有证据支持，哪些没有。
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