Evidence map›Paper›PMID 26621675›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2016

Compliance with Evidence-Based Guidelines in Acute Pancreatitis: an Audit of Practices in University of Toronto Hospitals.

J A Greenberg, J Hsu, M Bawazeer, J Marshall, J O Friedrich, A Nathens, N Coburn, H Huang, R S McLeod

Registry-linked trialAbstract read
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In one paragraph

Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04747990 (coMpliAnce With evideNce-based cliniCal Guidelines in the managemenT of Acute biliaRy pancreAtitis), which is not on this map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04747990 completednot on this mapstarted 2021, after this paper: background citation

coMpliAnce With evideNce-based cliniCal Guidelines in the managemenT of Acute biliaRy pancreAtitis

TypeobservationalSponsorUniversity of CagliariRan2021 to 2021Enrolled600ConditionsAcute Pancreatitis, Acute Pancreatic Necrosis, Acute Pancreatitis Due to Gallstones, Acute Pancreatic Fluid CollectionArmsEarly Definitive Treatment
3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Inappropriate use of clinical practices in Canada: a systematic review.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2022
    Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

J A GreenbergDepartment of Surgery, University of Toronto, Toronto, ON, Canada.
J HsuDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
M BawazeerDepartment of Surgery, University of Toronto, Toronto, ON, Canada.
J MarshallDepartment of General Surgery, St. Michael's Hospital, Toronto, ON, Canada.
J O FriedrichDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
A NathensDepartment of Surgery, University of Toronto, Toronto, ON, Canada.
N CoburnDepartment of Surgery, University of Toronto, Toronto, ON, Canada.
H HuangZane Cohen Centre for Digestive Diseases, Mount Sinai Hospital, Toronto, ON, Canada.
R S McLeodDepartment of Surgery, University of Toronto, Toronto, ON, Canada. robin.mcleod@cancercare.on.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Despite existing evidence-based practice guidelines for the management of acute pancreatitis, clinical compliance with recommendations is poor. We conducted a retrospective review of 248 patients admitted between 2010 and 2012 with acute pancreatitis at eight University of Toronto affiliated hospitals. We included all patients admitted to ICU (52) and 25 ward patients from each site (196). Management was compared with the most current evidence used in the Best Practice in General Surgery Management of Acute Pancreatitis Guideline. Fifty-six patients (22.6 %) had only serum lipase tested for biochemical diagnosis. Admission ultrasound was performed in 174 (70.2 %) patients, with 69 (27.8 %) undergoing ultrasound and CT. Of non-ICU patients, 158 (80.6 %) were maintained nil per os, and only 18 (34.6 %) ICU patients received enteral nutrition, commencing an average 7.5 days post-admission. Fifty (25.5 %) non-ICU patients and 25 (48.1 %) ICU patients received prophylactic antibiotics. Only 24 patients (22.6 %) with gallstone pancreatitis underwent index admission cholecystectomy. ERCP with sphincterotomy was under-utilized among patients with biliary obstruction (16 [31 %]) and candidates for prophylactic sphincterotomy (18 [22 %]). Discrepancies exist between the most current evidence and clinical practice within the University of Toronto hospitals. A guideline, knowledge translation strategy, and assessment of barriers to clinical uptake are required to change current clinical practice.

Indexed as

Guideline AdherenceAdultAgedCanadaCholecystectomyCholestasisEnteral NutritionFemaleHospitalizationHospitals, UniversityHumansMaleMedical AuditMiddle AgedPancreatitisPractice Guidelines as TopicEvidence-based practiceGuideline adherencePancreatitisPractice guidelines as topicProfessional practice

Identifiers

PMID26621675

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.