How we produce Best Practice
In developing our expansive topic list, we consulted practising clinicians, clinical editors, contributors, peer reviewers, and subscribers, with the aim of covering all the most clinically important topics. Best Practice now contains over 1,000 articles (we call them ‘monographs’) - and we are still expanding its scope based on feedback from users, experts and customers.
Incorporating the evidence
At its core, Best Practice contains the internationally renowned Clinical Evidence. We incorporate the evidence from relevant Clinical Evidence systematic reviews into Best Practice articles, both as evidence scores throughout the text, and in a separate ‘Evidence’ section. As a recent enhancement, we have added direct links to each Clinical Evidence GRADE table in these sections, just below the list of clinical questions. These tables list quality assessment scores for each of the PICO (patient, intervention, comparison, outcome) combinations in each Clinical Evidence summary, based upon. the principles developed by the GRADE Working Group. Consistently evaluated criteria include study type, methodological quality, consistency across trials, directness (applicability and generalisability), and effect size.
And of course, our team of in-house medical information specialists searches Medline, Embase, The Cochrane Library, and other key global electronic databases covering over 5,000 journals for important systematic reviews. This research is used by our authors (all well-published experts in their specialist fields) to produce the most comprehensive and up-to-date information possible.
Best Practice articles provide links to the relevant major clinical management guidelines for diagnosis and therapy. All guidelines to which we link are updated regularly and have been produced by national or international government sources, professional medical organisations, or medical specialty societies.
The editorial process
Our in-house team of clinical editors is made up of experienced doctors scientists. This team is responsible for thoroughly assessing all submitted text and ensuring quality, consistency, and clinical accuracy across Best Practice. Our robust editorial process includes detailed peer review of each monograph, pharmacist drug dosage verification, and technical quality assurance steps, in addition to a multi-stage sign-off process.
Peer review process
Newly submitted articles are peer reviewed by at least two external expert clinicians. In order to create content applicable to an international audience, we aim to involve a mix of authors and peer reviewers from different global regions for each monograph.
Feedback, error corrections and user responses
We consider feedback a crucial tool for evaluating the information we publish, and for improving the way our articles are presented and distributed. All feedback is managed by our clinical lead. Urgent problems are dealt with immediately, and other suggestions are considered for incorporation during our regular updating cycle.
Our editorial process for new Best Practice monographs
1. Expert author commissioned
2. In-house guideline and evidence search presented to author
3. Clinical editor works with author during the writing stage
4. Author submits first draft of monograph
5. Draft is peer reviewed by at least two international experts
6. Clinical Evidence article combined with the monograph and evidence scores added where the evidence exists
7. Edited in-house by a clinical editor who is a qualified clinician
8. All drug recommendations clinically checked by a qualified pharmacist
9. In-house review by a senior clinical editor
10. Further quality assessment by another senior clinical editor
11. Epocrates clinical staff invited to comment
12. Monograph updated to incorporate all expert input
13. Copy edited by an in-house medical editor
14. Proofread by an independent proofreader
15. Published on a test website
16. Final version checked by the author before going live
17. Web and functionality checks performed by the Editor in Chief
18. Sign off for publication by the Editor in Chief
19. Published online
20. Feedback gathered and acted upon immediately
21. Monograph updated regularly
Our editorial process for updating Best Practice monographs
All updates undergo an equally robust editorial process in order to ensure that Best Practice monographs continue to be informed by the best available evidence, and to maintain and enhance their clinical relevance and high quality. In order to achieve this, the following steps occur for every Best Practice monograph:
1 All monographs are updated at least once a year, and may be altered more often if important new information is identified.
2. At each update, an in-house systematic search is performed for relevant SRs and RCTs.
3 At each update, an in-house systematic search is performed for new or updated guidelines.
4 Correspondence is undertaken with the expert author.
5 Any changes to existing content are overseen by the in-house editorial team.
6 Any changes to drug recommendations are clinically checked by a qualified pharmacist.
7 All updated monographs have digital checks, preview site checks, and post publication checks, whether content is altered or not.