AMERICAN SOCIETY OF EXTRACORPOREAL TECHNOLOGY

The National Society of Perfusionists

About the Society
ICEBP Newsletter #9 - December 2011
ICEBP Newsletter # 9 December 2011
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www.icebp.org
IN THIS NEWSLETTER
  • Best Practices and Safety in Perfusion Meeting – “It’s A Wrap”
  • AmSECT-ICEBP webinar - "Bringing it Home Challenge"
  • Revised Mission and Vision Statement
  • EJA Editorial – an interesting read (and it’s for free…)
SOON...
Next Newsletter, our tenth, will focus on some interesting publications that have been issued in 2011 on guidelines and evidence-based medicine.
Best Practices and Safety in Perfusion Meeting 2011 – “It’s a Wrap”
AmSECT and the ICEBP are most appreciative of the delegates at the Safety & Best Practices meeting. Delegates were present from eight countries, and their participation and input were instrumental to the success of the meeting; from the conference floor to the workshops, simulation sessions and town hall chats and also on to the electronic evaluation forms.
Based on the feedback provided through the electronic evaluation forms, we can state that the meeting was well received, especially the interaction during the different break-out sessions. For those not in attendance, didactic sessions featuring testimonials on how people had introduced change into their practice, were alternated with workshops, low-fi simulation sessions and town hall chats, providing some variation to the flow of the meeting.
San Diego 2012
While we have your attention, we would like to focus on next years’ meeting, which will take place in San Diego, California, from October 10 to 13, at the Sheraton San Diego Hotel and Marina. We hope to meet you there for equally interesting encounters!
Invitation to AmSECT-ICEBP Webinar:
"Bringing it Home Challenge"
During the final session of the San Antonio meeting, which was superbly moderated by Jeff Riley, the “ICEBP – Bringing it Home Challenge” was introduced. This is a small ‘tool’ to help you bring change to your clinical practice through some manageable action items, which then are to be evaluated after some months.
To introduce and later evaluate this tool, we organize an introductory webinar on Wednesday, January 18 at 5 pm EST.
Another webinar will follow a few months later for follow-up.
If you like to participate in this webinar, please RSVP to communications@icebp.org and the call-in details will be sent to you in a timely fashion.
We have added a PDF-file from the presentation by Jeff Riley.
Revised Mission and Vision Statement
At the Steering Committee Meeting, that was held during the San Antonio meeting in October, and which was open to all interested, the Mission and Vision Statement of the ICEBP was revised.
No changes were made to the mission statement, but the group found that we would do well to change our vision statement to reflect the following:
1. We wish to develop and support the use of clinical registries, rather than to assume that we could manage how and the pace in which others develop clinical registries. The previous statement sounded too much like micro-managing this activity.
2. Key words in each of the bullet points were underlined to reinforce the activity coming out of the ICEBP.
The modified Mission and Vision Statement is as follows:
Mission:
The International Consortium for Evidence-Based Perfusion (ICEBP) is a partnership and collaboration between perfusion societies, medical societies, clinicians and industry to improve continuously the delivery of care and outcomes for our patients.
Vision:
To achieve this mission, we will:
1. Develop and support perfusion registries to evaluate clinical practices.
2. Develop and publish evidence based guidelines, and support their integration into clinical practice.

3. Identify gaps in the medical literature and empower investigation into areas where evidence is lacking.

4. Identify gaps between current and evidence-based clinical practice to promote the improvement in patient care.
European Journal of Anesthesiology Editorial –
an interesting read
This editorial1 from the European Journal of Anesthesiology highlights the difficulties that are encountered when trying to implement guidelines and recommendations from evidence-based medicine.

The authors identify problems that all come down to the bold statement that “The trouble with evidence-based medicine is that most of it is wrong”. They put forward two major problems that prevent guidelines from being taken seriously:
  • the actual evaluation of guidelines to determine their effects is rare
  • just because a guideline claims to be evidence-based does not necessarily mean that it gives the correct advice
They also identify some major sources of bias in the existing evidence from which we try to produce guidelines:
  • lack of randomisation and open instead of double-blind studies can result in major bias
  • statistical analyses are often performed on small datasets, in which the random play of chance is potentially huge
  • non-Gaussian distributions reported as averages represent another major problem; their use is known to be incorrect. The use of incorrect averages in trials is compounded as meaningless means in meta-analyses, and runs the risk of informing guidelines that are just plain wrong
  • short duration trials overestimate efficacy compared with those of longer duration, and different methods of imputation to deal with patients who withdraw from studies can completely change the result of a trial
The authors conclude that, next to the fact that the evidence that is produced is often wrong, the road from evidence-based medicine to guidelines and recommendations is long and winding.
Solutions for the latter problem are that relatively simple but important managerial efforts by teams deliver the best results. For instance, one solution may be to identify barriers to guideline compliance.
Finally, it is recommended that we embrace both success as well as failure, and measure the incidence of both..
It’s a free download from The European Journal of Anesthesiology
Reference
1. Moore RA, Derry S, Aldington D From evidence-based medicine to guidelines and recommendations: a long and winding road EJA 2011, 28: 753–755
We hope you have enjoyed this edition and look forward to providing you with the next issue!