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Triaging Journals

In the ever-expanding landscape of medical literature, it’s crucial for healthcare professionals to not only know how to read research but also understand what to focus on. This guide discusses the distinction between knowledge creation and translation journals, emphasizing the importance of patient-oriented evidence that matters (POEM). Discover how to stay informed with high-yield journals, analyze relevance to patient care, and enhance your medical knowledge while managing memory limitations and time constraints. Optimize your reading strategy for impactful clinical practice.

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Triaging Journals

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  1. Triaging Journals Tony Myers MD 9/26/00

  2. Bottom Line We need to learn not only howto read the medical literature, but what to read.

  3. Medical Journals • “Knowledge creation” vs. “translation” journals • Knowledge creation journals • Good for keeping up: temptation to bypass • Fountain from which all knowledge flows • Academic translation journals vs Throw-aways

  4. Academic Translation Journals • Evidence-based Practice • jfp.msu.edu/ebp.htm • JFP POEMS • jfp.msu.edu

  5. Why Am I Reading? • Goal of reading • Keeping up • Disease specific knowledge • Patient specific knowledge

  6. Goal of Reading • Disease and Patient specific knowledge. • Memory limitations • Review articles and textbooks • Point of care searching

  7. Keeping Up • Concentrate on “high yield” journals with favorable POEM:DOE ratio • Scan table of contents for titles of interest • Consider three questions to determine relevance

  8. Determining Relevance • Will this information have a direct bearing on the health of my patients (is it something they care about)?

  9. Determining Relevance • POEM=Patient Oriented Evidence that Matters • Study looked at outcomes that matter to patients. • Live longer? • Feel better? • Less need for dialysis?

  10. Determining Relevance • POEMs? • Intensive insulin tx lowers Hgb A1C • CHF patients live longer on ACE inhibitors • Calcium channel blockers lower BP • HCTZ decreases the incidence of stroke in hypertensive patients

  11. Determining Relevance • Will this information have a direct bearing on the health of my patients (is it something they care about)? • Is the problem common to my practice? • If true, will it require me to change my current practice?

  12. High Yield Journals • Four editors reviewing 85 journals each month • Original research articles, including meta-analyses and brief reports • Gold standard: Group consensus

  13. Finding POEMs • Six month review: identified 8085 articles (1350 per month) • Only 211 (2.6%) POEMs

  14. Finding POEMs • Positive Predictive Value: 49% • Negative Predictive Value: 99% • Reason for disagreement: “Change” factor

  15. Finding POEMs • > 10% POEMs: JAMA, Ann Int Med, NEJM, JABFP, JFP, Arch Int Med, Am J Em Med • 10 or more POEMs: JAMA, Ann Int Med, NEJM, Arch Int Med, BMJ, Ob/Gyn

  16. Feeling Good About Not Knowing Everything:Information Mastery • Responsibility: less to read, but more important to find and evaluate

  17. Conclusions • Read few, only if forced by screen for relevance • Get rid of “bedside” stack • Use time for other things (e.g.., letters to the editor, JFP POEMs/ACP Journal clubs, EBM, monthly searches “POEM bulletin boards”- Evidence-Based Practice

  18. Exercises • Will this information have a direct bearing on the health of my patients (is it something they care about)? • Is the problem common to my practice? • If true, will it require me to change my current practice?

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