Thank you for taking time to review these components of the next edition of the CARPA Standard Treatment Manual. As you will see there are two components to the 4^th edition, firstly the protocols, which are a revision of what you would be used to in the 3^rd edition. Secondly there are the longer "background documents" that are to explain the rationale for the protocols.

The protocols should describe what you need to know to deal with the person with the condition of interest, and it should tell you what to do. Sometimes it should tell you how to do particular procedures or parts of the examination/assessment. The protocols do assume a basic level of training for Drs, AHWs and RANs.

The protocols need to be easy to read, easy to understand and easy to follow. They need to be "doable", realistic. They need to be of assistance particularly to the practitioner who is not used to remote Indigenous health work.

The protocols also need to be up to date and consistent with the available evidence of what works, thought this may be modified to make it appropriate to the setting in which the CARPA-STM is used.

The background document will usually be lengthier, more technical, far more detailed. It should however be understandable and it should lead you through a discussion of the new, contentious, evolving, debatable issues of the topic. It should be fairly comprehensive and up to date in covering the relevant literature and evidence around the points of interest.

Unfortunately I will not always be able to send the two out for review together if the authors are late with the background documents.

You have been asked to review these components because of your technical expertise in the area (able to comment on the "academic" completeness of the discussions of the evidence underlying the protocols and its relevance to the CARPA regions), and or for your experience as a remote practitioner. It is crucial that the CARPA-STM provides what the remote practitioner needs in a manual like this. We need to know if the advice in the protocol and the discussion in the background are useable, are they likely to be followed, can they be understood.

If possible, try using the protocols in real life settings in your remote practice. Also try to get opinions/ feedback from other clinic staff, RANs, AHWs, Drs, others.

These headings may help your reviewing, but you do not need to use them.

Are the protocols:

Clear, easy to read, easy to follow, practical issues, confusing, conflicting with other guidelines?

Are the background document notes:

Helpful, understandable, accurate, up to date? Do they explain why the protocol is the way it is?

Please let me know about your comments, positive and negative. This can be by annotating the drafts I have sent you, phoning me, emailing me, making separate notes.

Thank you

Dan Ewald
(Dan Ewald was the editor of the 4th edition of the CARPA STM)