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Evaluation of a Scientific Study - Evidence Based Medicine September 19, 2007

Posted by Dr. Birdi in : Journal Club, Resources , add a comment

Wander over to the Evidence Based Medicine section of the website which has recently been opened!

Here you will have an opportunity to review an excellent series from the BMJ by senior lecturer Trisha Greenhalgh entitled “How to read a paper.” This series goes through the basics of a systematic approach on reading, analyzing and critiquing a scientific paper. The BMJ has consistently been a reliable resource for evidence based medical practice sticking to their motto “Helping doctors make better decisions.” Enjoy!

This should at least provide a starting point for our young medical colleagues as well as a good review for the more experienced ones in the art of scientific investigation and evidence based medical decision making. As always please feel free to leave comments and suggestions. Remember, this is an open forum, become part of it!

Therapy Misalignment: How does this happen? September 5, 2007

Posted by Dr. Birdi in : Journal Club, CCF, Resources , 1 comment so far

Dr. Tim Sable’s review of a common and recurrent issue in critical care practice: therapy misalignment. Review the presentation to see how current practitioners use randomized controlled trials to manage ICU patients and whether or not these therapies are in line with the results of the studies. Dr. Sable reviews the TRICC and ARMA trials as examples. This presentation is archived in the section of Journal Club Presentations.

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Early Goal-Directed Therapy in Septic Shock August 22, 2007

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Dr. Dana Darwish presents an excellent review of one of the classic papers in critical care literature by Rivers et al. This landmark study looks at Early Goal-Directed Therapy in the treatment of Septic Shock. Do we finally have an answer to the near 40% mortality rate from this morbidity? The review of the stud below may help you figure that out. This presentation is archived in the section of Journal Club Presentations.

 

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SICU Journal Club Minutes (Part 3) - July 25th July 28, 2007

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Dr. Christofer Utz did an excellent review of the Critical Care Safety Study published in 2005 Critical Care Medicine. The primary objective of this study was to identify the incidence and rates of adverse events in critical care units per 1000 patient days. Dr. Utz reports the study design, methods as well as resuts and finished the presentation with a nice critique on several limitations of this study. The discussion was very engaging and raised several important questions regarding how should we truly define a medical error. The audience also questioned whether we should be reporting some of these errors at all vs. should we be reporting more than we already do today. This presentation is archived in the section of Journal Club Presentations.

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SICU Journal Club on July 25th (articles available) July 23, 2007

Posted by Dr. Birdi in : Journal Club, CCF, Resources , 1 comment so far

The articles for the next journal club are linked for download below:

  1. Boyle et al. Disclosing errors and adverse events in the intensive care unit. CCM 2006
  2. Rothschild et al. The Critical Care Safety Study: The incidence and nature of adverse events and serious medical errors in intensive care. CCM 2005

SICU Journal Club Minutes (Part 1) July 19, 2007

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Dr. Michael Fernando (CA-2) did an excellent presentation of Acute Renal Failure and Sepsis featured in the July 2004 New England Journal of Medicine. With the significant morbidity and mortality associated with sepsis, septic shock and acute renal failure it is prudent to understand the mechanisms of this disease process as well as evaluate which interventions make therapeutic sense! This review in NEJM gives us some insight and may help intensivists answer some of these questions. This is archived in the collection of Journal Club Presentations.

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It was identified that early sepsis maybe a state in which physiologically the body is depleted of (more…)

SICU Journal Club Minutes (Part 2) July 18, 2007

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Dr. Ricardo Riveros (CA-2) presents a thorough review of Mechanisms of Sepsis-Induced Cardiac Dysfuntion featured in the May 2007 Critical Care Medicine. This was a very difficult review of basic science as well as the mechanistic molecular biology of the cardiac dysfunction that occurs in septic patients with myocardial dysfunction. This article focuses on the intracellular pathways that are disrupted by sepsis hence leading to cell death, apoptosis. Dr. Riveros points out the animal models and patient studies used to study these mechanisms as well as their downfalls. A great resource for basic review of what goes wrong within the cell during sepsis. This is archived in the collection of Journal Club Presentations.

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