Guías de práctica clínica y otros productos basados en la evidencia, en la consulta / Clinical Practice guides and other evidence based products in the clinic

GuíaSalud es un organismo del Sistema Nacional de Salud (SNS) en el que participa el conjunto de comunidades autónomas (CC. AA.), que cuenta con el refrendo del Consejo Interterritorial (CI) y el apoyo del Ministerio de Sanidad y Política Social a través de la Agencia de Calidad del SNS. Desde que da su primeros pasos, a mediados del año 2002, hasta la actualidad, se ha visto inmerso en cambios enmarcados en el Plan de Calidad del SNS, siendo el último, descrito en el Plan de Calidad del año 2007 el que implica un giro importante en objetivos, introduciéndose en la cartera de trabajo el desarrollo de productos basados en la evidencia científica que ayuden a los profesionales sanitarios en la toma de decisiones. Esto implica un cambio en la estructura organizativa de dirección y gestión de GuíaSalud, dedicación de recursos dirigidos a fortalecer el desarrollo de guías de práctica clínica (GPC) en nuestro país, y a abrir nuevas líneas de trabajo encaminadas a enriquecer la oferta de productos a los profesionales sanitarios, como es el caso para las preguntas clínicas. En esta estrategia se cuenta con las personas que integran el Comité Científico de GuíaSalud, su Consejo Ejecutivo (CE), y aquellos profesionales sanitarios interesados en una metodología de trabajo sistemática y explícita y que constituyen la red de colaboración de GuíaSalud. Desde la Secretaría de GuíaSalud se cuenta con un equipo de profesionales conocedores de la metodología de trabajo adecuada y una web 2.0 dirigida a interaccionar con los profesionales sanitarios (AU)

GuíaSalud is a National Health System (NHS) agency, which includes all the Autonomous Communities (CCAA), and has the endorsement of the inter-territorial council (IC) which is supported by the Ministry of Health and Social Policy through the NHS Quality Agency. Since its first steps, in mid-2002 until now, it has been immersed in framework changes within the quality of the NHS Plan. The latter being described in the quality plan of 2007, which involves important changes in the objectives, introducing into the work portfo lio the development of products, based on scientific evidence to assist health professionals in decision-making. This involves changes in the organizational structure of leadership and management of GuíaSalud, dedication of resources aimed at strengthening the development of clinical practice guidelines (CPG) in our country, and open new lines of work aimed at enrichment the offer of products to the health professionals, as is the case for clinical questions. This strategy includes professionals who are part of GuíaSalud’ s Scientific Committee, Executive Council (EC), and other health professionals interested in working with a systematic and explicit methodology; and are part of the GuíaSalud collaborative network. The GuíaSalud department has a team of professionals who know about the appropriate methodology and a web 2.0 designed to interact with health professionals (AU)

[Neuropaediatrics and primary care. Our experience in the 21st century]. / Neuropediatría y atención primaria.Nuestra experiencia en el siglo XXI.

INTRODUCTION: The quality of the health care in a major part of neuropaediatrics benefits from appropriate communication and strategies that have been agreed with primary care (PC) paediatricians. PATIENTS AND METHODS: We analyse the children who were assessed in the Neuropaediatric service at the Hospital Universitario Miguel Servet in Saragossa over a period of eight years and we also discuss the most important courses of action followed in the most prevalent problems. RESULTS: Eight reasons for visiting accounted for 86% of the total number: paroxysmal disorders (33%), headache (27%), psychomotor retardation (11.5%), alterations affecting the shape or size of the head (5.6%), problems at school and/or attention deficit (4.5%), behavioural disorders (4.25%), gait disorders (3.5%) and perinatal distress (3.4%). The most frequent diagnoses are headaches/migraines (26%), non-epileptic paroxysmal disorders (16.5%), prenatal encephalopathy (10.5%), epilepsy (8%), mental retardation (7.5%), infantile cerebral palsy (4.6%), cryptogenic attention deficit hyperactivity disorder (ADHD) (3.8%) and cryptogenic autism (3.6%). CONCLUSIONS: The PC paediatrician working in close relation with the children and their families in all cases is the person mainly responsible for conducting a follow-up on some of the most prevalent problems, such as headaches, many non-epileptic paroxysmal disorders and ADHD. The processes must be established, clearly specified, based on the best evidence, with the participation and within reach of all the professionals involved, in order to favour homogeneity and keep variability in the interventions to a minimum. Channels of communication, including the information and communications technologies, need to be set up to allow health professionals to be permanently up-to-date and capable of controlling their patients in the best possible way.