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Review: commonly recommended well-child care interventions are not supported by evidence

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 Q What is the evidence base for commonly recommended clinical preventive services for children?

Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Paediatrics ★★★★★★☆

METHODS

Embedded ImageData sources:

Medline, CINAHL, Cochrane Library, ACP Journal Club, PsycINFO, reference lists, proceedings of the Pediatric Academic Societies (1997–2003), internet, and contact with experts.

Embedded ImageStudy selection and assessment:

high quality systematic reviews were sought. Randomized and controlled clinical trials published after a review’s search dates were then sought. If no reviews existed, clinical trials were sought for all dates. Studies and reviews had to evaluate a well-child care intervention in healthy children between birth and 18–21 years of age. Exclusion criteria: studies assessing only change in health knowledge and attitudes, studies in non-clinical settings (eg, schools), and studies using tests for diagnosis or management rather than screening.

Embedded ImageOutcomes:

prevention of disease/disability, improvements in health/wellbeing, developmental and behavioural outcomes, and healthy behaviours.

MAIN RESULTS

A table on the website summarises the evidence (www.evidence-basedmedicine.com). Behavioural counselling. Several high quality systematic reviews and trials evaluated injury prevention. A modest benefit was seen …

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Footnotes

  • For correspondence: Dr V A Moyer, University of Texas-Houston Health Science Center, Houston, TX, USA. virginia.a.moyeruth.tmc.edu

  • Source of funding: Agency for Healthcare Research and Quality.