BEST PRACTICE

Variation in practice and quality of care are startling both across the UK and abroad. This has led to emphasis on best practice — using the best and most current information for diagnostic and therapeutic decisions and for discussing prognosis with families. One Education and Practice section will focus on current treatment for specific diseases. The section editors, Ian Maconochie and Monica Lakhanpaul, will ensure quality and consistency in the articles. Each article will include a review of recent guidelines and literature relevant to the topic. Because many statements are published and labelled as guidelines, but do not meet accepted standards, we will focus on guidelines that are systematic reviews of the literature and include an appraisal of the quality of research and an accepted rating of evidence. Other well known databases, such at Cochrane and Clinical Evidence, will also be queried and areas of clinical uncertainty and controversy will be discussed. The topics to be covered will be those where data about variation and quality of practice suggest problems. Please let us know which areas you would like reviewed.

PROBLEM SOLVING

We recognise that despite the importance of evidence in decision making, much of medicine remains an art, particularly the process from presenting signs and symptoms to diagnosis. Patrick Cartlidge edits our case-based section. Beginning with a patient complaint, or a set of symptoms, these cases will emphasise the importance of history and physical examination, as well as integrating experience with evidence for arriving at a diagnosis. We will include cases that highlight not only common problems, but also those that address more contemporary issues, including end of life decisions and culture in health care. The cases will be drawn from our own practices, but again, we urge you to suggest specific cases, as well as areas of interest.

PHARMACY UPDATE

Many new drugs have been introduced for children—for example, the new treatments for hyperactivity. Understanding indications, dosing, and interactions of new drugs is important if we are going to ensure best practice. Imti Choonara and Sharon Conroy edit our pharmacy update section. Not only will they present new specific drugs, the section will also include other areas of importance, such as medical errors, drug overdose, and adherence. Relevant tables from Medicines in Children will be reproduced to ensure consistency of recommendations.

GUIDELINES

Finally, the popular guideline review column edited, by Harry Baumer, will move from the monthly general ADC edition to Education and Practice. The ubiquitous presence of guidelines in medicine necessitates our understanding of them.

CONTINUING PROFESSIONAL DEVELOPMENT

After the recent publication of the General Medical Council’s guidance A licence to practise and revalidation (www.appraisaluk.info), there will be an increasing emphasis on continuing professional development certification. Reading journals is viewed as part of paediatricians’ day to day activities, therefore no credit can be claimed; however, UK paediatricians can gain up to 20 CPD points per year by reflective notes on articles in ADC. This new supplement might stimulate such notes better than original research reports. Paediatricians may claim points by submitting copies of worked reflective notes—for example, brief descriptions of problems posed by clinical cases, to prove that the journal has not only been read but understood and lessons learnt.

Our hope is that ADC Education and Practice will evolve over the coming years to meet the needs of paediatricians. The sections may change with time, and new ones may be added. From time to time we will include illustrations from our regular contributors (Jack Maypole and Terry McElroy); a couple from Terry decorate this page. We want to ensure that the material is presented in a lively fashion and that the content is relevant to your practice. We welcome your suggestions.