Medical Literature

Aka: Medical Literature, Patient Oriented Evidence that Matters, Disease Oriented Evidence, POEMS, DOE, Preprint Report, Early Release Article, Online First Article

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II. Precautions: Preprint Reports (Early Release Articles)

  1. Exercise caution in interpreting journal articles before full peer review
  2. During Covid Pandemic 2020-2021, Early Release Articles became common
    1. Early Release Articles allow for faster dissemination of possible practice changing evidence
    2. However, preliminary data before peer review risks dissemination of misinformation
    3. Exercise caution and critical analysis if acting on preliminary data
    4. Less than a fifth of submitted articles are published, and those published often require significant revision

III. Approach: Patients

  1. Discuss evidence with patients regarding absolute risk (not Relative Risk) or as Number Needed to Treat
  2. Example
    1. Statin related Relative Risk of Diabetes Mellitus 9%
    2. However the absolute risk is increased only 0.4% from 4.5 to 4.9%
    3. Number needed to harm: 100/0.4 or one in 250
  3. References
    1. (2017) Presc Lett 24(10): 59

IV. Approach: General

  1. Always assess validity
  2. Focus reading on Peer Reviewed Journals (examples follow)
    1. Annals of Internal Medicine
    2. ACP Journal Review
    3. Journal Watch
    4. Pediatrics
    5. Green Journal (ACOG)
    6. Postgraduate Medicine
    7. American Family Physician
    8. New England Journal
    9. JAMA
  3. Approach literature in hierarchical pattern
    1. Scan Table of Contents
    2. Read Appropriate Abstracts (Small list)
    3. Read Appropriate articles (Smaller list)

V. Types: Articles

  1. POEMS (Patient Oriented Evidence that Matters)
    1. Concentrate on these articles!
    2. Studies that look at illnesses
      1. Direct bearing on patient outcomes
      2. Problems common to your practice
      3. Information that will change the way you practice
  2. DOE (Disease Oriented Evidence)
    1. Understanding of pathophysiology, and Pharmacology

VI. Resources: General Evidence-Based Guidelines and Databases

  1. Cochrane Collaboration
    1. http://www.cochrane.org
  2. Institute for Clinical Systems Improvement
    1. http://www.icsi.org
  3. National Guideline Clearing House
    1. http://www.guidelines.gov

VII. Resources: Literature Reviews and Summaries

  1. American College of Physicians Journal Club
    1. http://www.acpjc.org
    2. Subscription: 30 article reviews per issue published twice monthly
  2. Bandolier
    1. http://www.medicine.ox.ac.uk/bandolier
    2. Free: British Online newsletter reviews evidence-based answers to clinical questions
  3. BMJ Evidence Centre Updates
    1. http://plus.mcmaster.ca/evidenceupdates
    2. Free: Weekly email summarizing several articles
  4. Daily POEMs Alerts
    1. http://www.essentialevidenceplus.com/product/features_dailyip.cfm
    2. Subscription: One article review emailed daily
  5. Evidence-Based Practice
    1. http://www.ebponline.net
    2. Subscription
  6. Journal Watch
    1. http://www.jwatch.org
    2. Subscription: Article reviews published in two issues monthly

VIII. Resources: Medication Reviews

  1. Medical Letter
    1. http://www.medicalletter.org/
    2. Subcription: Thorough individual medication and Drug Class reviews
  2. Prescriber's Letter
    1. http://www.prescribersletter.com/
    2. Subscription: Paragraphs summarizing new findings with links to online in-depth reports

IX. Resources: Other

  1. MLA Brandon/HIll Online Journal Links
    1. http://nnlm.gov/libinfo/ejournals/branhill.html
  2. Turning Research Into Practice
    1. http://www.tripdatabase.com
    2. Evidence-based answers to clinical questions via multi-site search

X. Reference

  1. (2021) Presc Lett 28(5):26-7
  2. Shaugnessy (1997) Am Fam Physician 55(6): 2155-60 [PubMed]
  3. Shaugnessy (2009) Am Fam Physician 79(1): 25-6 [PubMed]

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