What's the use of Archimedes?

L ast year, Archives of Disease in Childhood introduced a new section entitled " Archimedes ". Its purpose is " to assist practising clinicians by providing 'evidence based' answers to common questions which are not at the forefront of research but are at the core of practice ". 1 Archimedes is actively looking for paediatricians to submit their efforts at finding answers to these questions. In October 2001, five SpRs and four community paediatricians on the MMedSc in Child Health at the University of Leeds decided to take up the challenge. Each undertook to tackle one question of either general or community paediatric interest that had arisen recently in the course of their clinical practice. In accordance with the principles of evidence based practise, 2 they pursued the evidence, critically appraised it, and presented it to their colleagues. Table 1 shows the results of their endeavours. DISCUSSION Nine paediatricians took an average of 5.4 hours each in their attempt to track down an answer to an important clinical question they had; this does not take into account the time taken to appraise the evidence. At the end of the day, only two of them came up with adequate evidence of sufficient quality to change their clinical practice. The question has to be asked whether all this effort was worthwhile. Is this the sort of investment that we need to make in order to promote evidence based medicine? On the surface, it is hard to justify so many hours of work searching databases, obtaining articles, critically appraising the evidence, and debating its quality and application. Can we expect professionals to exert this effort in what too often is a frustrating and fruitless search? Perhaps surprisingly, we all concluded that it was a worthwhile exercise. At the end of five weeks, after we had shared our experiences and results together, we anonymously and independently evaluated the process. Without exception all of us felt that our skills in searching electronic databases, asking structured clinical questions, and critically appraising the literature , had improved, and that these were all key skills which were essential to acquire. So, as a learning experience the exercise was worthwhile. But, we felt, there were other reasons for supporting Archimedes' columns. The process has highlighted the very real lack of evidence available to answer important everyday questions. Why is there an increasing number of research papers on the use …