Brandon O
Puzzled by facies
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Hi folks!
There's been talk about starting a forum journal club. If you're not familiar, journal clubs are a longstanding practice in clinical and academic settings; odds are your local hospital or med school has a few. Basically, it's nothing more than a group that meets periodically to discuss recent research, usually focusing on a particular study that's relevant to their practice. You sit down and really dig into it, hashing out the good, the bad, and the ugly. It's a great way to stay current on the literature as well as practicing the skills needed to critically appraise all the nonsense that gets published.
So let's give it a try! We'll figure out the nuts and bolts as we go, but right now, I'm thinking that we can basically just post an article and go nuts on it. I have a list of questions to give some structure to the discussion; if you respond, it'd be great if you tried to answer at least one of the questions -- or try anyway! (Don't just say "I like it!" or "I hate it!" Let's get into why...)
So here's one to get us started...
Goto Y, Maeda T, Goto YN. Effects of prehospital epinephrine during out-of-hospital cardiac arrest with initial non-shockable rhythm: An observational cohort study. Critical Care. 2013 Sep 3;17(5):R188.
Questions:
There's been talk about starting a forum journal club. If you're not familiar, journal clubs are a longstanding practice in clinical and academic settings; odds are your local hospital or med school has a few. Basically, it's nothing more than a group that meets periodically to discuss recent research, usually focusing on a particular study that's relevant to their practice. You sit down and really dig into it, hashing out the good, the bad, and the ugly. It's a great way to stay current on the literature as well as practicing the skills needed to critically appraise all the nonsense that gets published.
So let's give it a try! We'll figure out the nuts and bolts as we go, but right now, I'm thinking that we can basically just post an article and go nuts on it. I have a list of questions to give some structure to the discussion; if you respond, it'd be great if you tried to answer at least one of the questions -- or try anyway! (Don't just say "I like it!" or "I hate it!" Let's get into why...)
So here's one to get us started...
Goto Y, Maeda T, Goto YN. Effects of prehospital epinephrine during out-of-hospital cardiac arrest with initial non-shockable rhythm: An observational cohort study. Critical Care. 2013 Sep 3;17(5):R188.
Questions:
- What's the question we're looking at? Why do we care in EMS?
- What type of study was this? If observational, was it retrospective or prospective?
- What is the PRIMARY outcome? (Was there more than one?) What were the SECONDARY outcomes? (Were there more than three?) Do we care about these outcomes?
- Any reason to suspect bias? Conflicts of interest among the authors? Who sponsored the study?
- Who was the study population (what were the inclusion/exclusion criteria)? 1. Is it suitable to answer the question? 2. Is this population relevant for us?
- What was the comparison/control? Was it appropriate? If randomized, what was the allocation method, was it concealed, and were the groups initially similar? If observational, are there potential variables that were not controlled, and what effect might they have?
- Is there any reason why control patients might have been treated differently after enrollment, and was this controlled? If not, what effect might it have?
- Were there any losses/failures after enrollment, and if so, were they analyzed using intention-to-treat?
- Were patients blinded? Providers? Evaluators of the gold standard? Statistical analysts?
- How reliable was the gold standard? How long was study follow-up, and was this adequate? Was the study stopped early?
- What are the results? Are they statistically significant? Clinically meaningful? Are they the same primary/secondary outcomes initially described? Are they plausible?
- What are the results in terms of NNT (for therapy) or LR (for diagnostics/risk)? What were the harms? Were benefits greater than harms?
- What were the authors' conclusions, and are they supported by the results?