Summary of the original article in French https://www.cfp.ca/content/cfp/68/10/729.full.pdf
Written by Louis Melançon, Research Assistant at Research Impact Canada
The Rourke Baby Record (RBR) is a document intended to help family physicians and other healthcare professionals guide their preventive care for young children, from birth to 5 years of age. Created in 1979 by doctors James and Leslie Rourke in Ontario as a memory aid to facilitate care in their clinic, this tool quickly became the de facto Canadian standard in early childhood care.
After an extensive bibliographic review to confirm that the recommendations respected the most recent scientific knowledge, an unprecedented process that predates the widespread use of evidence-based medicine by several years, the first version of the RBR was published in Le Médecin de famille canadien in 1985. After the journal received many requests for reprints, a telephone service was set up to allow all Canadian family physicians to obtain a free copy.
The RBR has evolved a lot over the years, both to keep up with the latest scientific advances and to improve its presentation and accessibility. The guide was updated in 1994, and then reworked again in 1998 to include a very interesting innovation: indicating the quality of the evidence behind each of the recommendations by a print font code. Items supported by “sufficient” evidence are printed in bold; those supported by “acceptable” evidence are printed in italics; and those supported by “consensual or insufficient” evidence are printed in normal characters. This innovative code remains in place to this day. Since 2010, the RBR website has included a summary of the evidence for each recommendation. The current version of the website, updated in 2020, contains an interactive guide in French and English, with information tailored to both health professionals and parents. A simple click on each recommendation links to its scientific source.
Despite considerable changes in medical care over the past 40 years, the RBR has evolved to remain an effective, relevant, and increasingly accessible tool. For example, the RBR has been modified and adapted for specific populations such as in Nunavut and the Northwest Territories. In 2019, new physicians and a clinical group of users joined the RBR team. This team plan to involve more health professionals and families to participate in the drafting of the Record in the coming years, especially from diverse social and cultural backgrounds.
The authors of the RBR, drawing on 40 years of experience in reviewing evidence and mobilizing knowledge, reach several conclusions. Despite the large number of published systematic reviews and clinical practice guidelines, they also often have limited application in primary care due to several factors. First, these publications do not pay enough attention to the implementation of the knowledge presented and to the involvement of end users in their research. Second, many studies do not lend themselves well to the generalization to primary care patients, as they are based on populations with very different demographic characteristics and life experiences. Finally, too many clinical practice guidelines are not updated to reflect new evidence.
RBR’s website: https://www.rourkebabyrecord.ca/