Librarians’ role in developing international pediatric clinical guidelines

Background: Due to a library’s liaison program, a pediatrician had an established working relationship with two librarians already and utilized our evidence synthesis expertise. In fall of 2019, the liaison librarians joined an international team of physicians, respiratory therapists, and nurses to establish the first international clinical practice guidelines for pediatric ventilator liberation. One of the aims of this project included establishing consensus-based recommendations for methods to assess when a pediatric patient is ready to be liberated from mechanical ventilation. When consensus was not reached, a systematic review needed to be conducted. This project demonstrated the importance of librarians in the development of practice guidelines and furthers the practical impact librarian expertise brings to clinical care.

Description: Upon joining the team, the librarians helped develop workflows and data management for the different research questions. Eight of the PICO questions failed to reach consensus and each required a systematic review. The librarians created two reusable filters that repeated across all PICO questions (pediatrics and ventilation). The searches for the unique PICO concepts were created by working closely with smaller groups of specialists. The librarians divided the searches amongst them, while also working closely with one another to build and review the searches. Typical evidence synthesis services were provided as well such as retrieving full text and citation management. As an integral part of the team, the librarians attended recurring administrative meetings, international conferences, and worked directly with the principal investigators when challenges arose.

Conclusion: Including librarians on the team showed many medical professionals the skills required for a truly exhaustive search. A portion of salary savings for the library was a benefit of this grant-funded project. Three papers and counting have been published (executive summary, definitions, and a meta-analysis) with the librarians as coauthors. The executive summary received laudatory comments from the journal editor, praising its importance to the field and unique methodology. Due to the successful working relationship, the librarians have been asked to participate in another clinical guidelines project. The librarians are in the process of archiving the searches in SearchRxiv to ensure digital preservation of their searches, disseminate their work, normalize sharing of searches, and highlight the importance of high-quality searches.