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Centre for Evidence-
Based Medicine

Systematic Reviews: Clinical Scenario

You are the practice manager in an inner city practice. The practice health visitor is about to retire, and you are considering whether to reallocate the resources to other services within the practice. The health visitor claims that she plays an important role in accident prevention and shows you the attached systematic review as evidence. You are aware that 5% of your childhood population (<5yrs) suffer from accidental injuries.

What recommendations do you make to the practice management committee report about whether to continue to employ a health visitor in the practice? In children can home visits decrease the risk of injury?

Search strategy for Health Visitors
Type in:

  1. explode CHILD/ all subheadings
  2. VISIT*
  4. REVIEW*
  7. #2 and (#3 and #6)

You find the article: Roberts, I., Kramer, M.S., and Suissa, S. Does home visiting prevent childhood injury? BMJ 312:29-33, 1996.

Read the article and decide:

  1. Is the evidence from this systematic review valid?
  2. Is this valid evidence from this systematic review important?
  3. Can you apply this valid and important evidence from this systematic review in caring for your patient?

Continue to completed worksheet