Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary

Abstract

Best evidence topic reports (BETs) summarise the evidence pertaining to particular clinical questions. They are not systematic reviews, but rather contain the best (highest level) evidence that can be practically obtained by busy practising clinicians. The search strategies used to find the best evidence are reported in detail to allow clinicians to update searches whenever necessary. Each BET is based on a clinical scenario and ends with a clinical bottom line that indicates, in light of the evidence found, what the reporting clinician would do if faced with the same scenario again. The BETs published below were first reported at the Critical Appraisal Journal Club at the Manchester Royal Infirmary1 or placed on the BestBETs website. Each BET has been constructed in the four stages that have been described elsewhere.2 The BETs shown here, those published previously and those currently under construction, can be seen at http://www.bestbets.org.3 Three BETs are included in this issue of the journal. Accuracy of emergency department ultrasound in detecting abdominal aortic aneurysms Use of aspirin in acute stroke Myringotomy in traumatic haemotympanum 1 Carley SD, Mackway‐Jones K, Jones A, et al. Moving towards evidence based emergency medicine: use of a structured critical appraisal journal club. J Accid Emerg Med 1998;15:220–2. 2 Mackway‐Jones K, Carley SD, Morton RJ, et al. The best evidence topic report: a modified CAT for summarising the available evidence in emergency medicine. J Accid Emerg Med 1998;15:222–6. 3 Mackway‐Jones K, Carley SD. bestbets.org: odds on favourite for evidence in emergency medicine reaches the worldwide web. J Accid Emerg Med 2000;17:235–6.