Are therapeutic decisions made on the medical admissions unit any more evidence-based than they used to be?
OBJECTIVE
To determine whether inpatients in a medical admissions unit in a UK district general hospital received evidence-based therapies in 2008.


METHODS
The diagnoses of and therapies received by inpatients at the George Eliot Hospital National Health Service Trust in Nuneaton were recorded. A clinical librarian searched the literature (Clinical Knowledge Summaries, Cochrane Library, Medline and Embase) for the best evidence for each diagnosis-therapy pair. Evidence was graded on the following scale: systematic review, randomized controlled trial, non-experimental evidence and no or contrary evidence.


RESULTS
One hundred and two patients generated 150 diagnosis-therapy pairs. Of these 61 (41%) had systematic review level evidence supporting them, 17 (11%) randomized controlled trial evidence, 48 (32%) non-experimental evidence and 24 (16%) no evidence.


CONCLUSIONS
Results were comparable with previous studies. Care in a medical admissions unit in 2008 is still evidence-based, but, despite the vast growth in medical literature, no more than it was. The process was a useful collaboration between medical and library staff to audit the quality of patient care.
Ayre
Stephen
S
Clinical Librarian, George Eliot Hospital NHS Trust, Nuneaton, Warwickshire, UK. stephen.ayre@geh.nhs.uk
Walters
Gareth
G
D003657:Decision Making; D019317:Evidence-Based Medicine; D006769:Hospitals, General; D006801:Humans; D016245:Librarians; D008485:Medical Audit; D010343:Patient Admission; D016032:Randomized Controlled Trials as Topic; D012196:Review Literature as Topic; D006113:United Kingdom