EMPOWERING PHYSICIANS WITH EVIDENCE-BASED CONTENT
 

Home > Browse Topics

<< Evidence-Based Management Of Sickle Cell Disease In The Emergency Department

Critical Appraisal Of The Literature

A literature search was performed using PubMed, using the search terms pain, vaso-occlusion, acute chest syndrome, stroke, avascular necrosis, priapism, sepsis, osteomyelitis, transient red cell aplasia, pulmonary hypertension, hyphema, fat embolism, splenic sequestration, hepatic sequestration, hemolysis, and iron overload. A total of 596 articles from 1964 to the present were reviewed. The Cochrane Database was searched for systematic reviews using the key term sickle cell, which identified 35 reviews. Guidelines released by the National Institutes of Health (National Heart, Lung, and Blood Institute) in 2002 and the American Pain Society (APS) in 1999 were also reviewed. Both of these guidelines represent consensus statements and are not systematic, evidence-based guidelines. Using standard evidence-level scales, the majority of clinical evidence in SCD falls into the weaker and moderately-strong categories. There are several reasons for this. First, SCD is a rare disorder, and properly designed clinical trials are often too resource-intensive to perform. Second, SCD research is severely underfunded (cystic fibrosis, a disease that is one-third as common as SCD, receives millions of dollars more in funding each year). A third and final issue is the effect of medical advances on our knowledge of the disease. For example, many observational studies of SCD were performed before the development of the pneumococcal vaccine. This and other advances in preventive medicine may call into question results of earlier observational and interventional trials. When available, recommendations

Other Articles Similar To This One:

Related Links:

EMplify, the new Emergency Medicine Practice podcast, is now available

 

About EB Medicine:

Products:

Accredited By:

ACCME ACCME
AMA AMA
ACEP ACEP
AAFP AAFP
AOA AOA
AAP AAP

Endorsed By:

AEMAA AEMAA
HONcode HONcode
STM STM

 

Last Modified: 07/23/2017
© EB Medicine