A systematic review of the accuracy of first-trimester ultrasound examination for detecting major congenital heart disease.

Objective: To evaluate the accuracy of first-trimester ultrasound examination in detecting major congenital heart disease (CHD) using a systematic review of the literature.

Methods: General bibliographic and specialist computerized databases along with manual searching of reference lists of primary and review articles were used to search for relevant citations. Studies were included if a first-trimester ultrasound scan was carried out to detect CHD that was subsequently verified by a reference standard.

Incorporating the views of obstetric clinicians in implementing evidence-supported labour and delivery suite ward rounds: a case study.

Objectives: To implement evidence-supported delivery suite ward rounds using strategies to overcome barriers.

Design: Qualitative case study to identify barriers and a quantitative assessment of outcomes on ward rounds.

Method: After an introduction to the proposed evidence-supported delivery suite ward round reactions were elicited from 15 clinicians.

Medical journals and effective dissemination of health research.

Clinical medical journals have not been effective in meeting the information needs of practitioners and bridging the gap between clinical research and practice. The slow adoption of results of clinical research is at least partly due to the failure of clinical journals to disseminate information in a way that would motivate practitioners to change practice. Although implementation is primarily a local process, medical journals are in a unique position to advance implementation by modifying their focus and adjusting their contents.

Critical appraisal in clinical practice: sometimes irrelevant, occasionally invalid.

A core activity of evidence-based practice is the search for and appraisal of evidence on specific clinical issues. Clinicians vary in their competence in this process; we therefore developed a 16-item checklist for quality of content (relevance and validity) and presentation (useability, attribution, currency and contact details). This was applied to a set of 55 consecutive appraisals conducted by clinicians and posted at a web-based medical journal club site.