NeuroICU Journal Club

Responsible Consultant: Dr Ankit Jain

Venue

Seminar room

Neuro Intensive Care Unit (NICU)
2nd Floor, Atkinson Morley Wing
St George’s Hospital
Blackshaw Road, London SW17 0QT

Day

Every alternate Friday

Time

  • 2PMto3PM
  • 40-45 minutes to discuss the paper.
  • 15-20 minutes to discuss a topic on concepts in clinical epidemiology relevant to the paper.

Aims of this Journal Club

  • Continuing professional development for doctors and nurses rotating in NICU.
  • Keeping up-to-date with the literature in practise of NICU and post neurosurgical patients.
  • Disseminating information on and build up debate about good (evidence based) practice inmanagement of critically ill patient in neuro intensive care unit.
  • Ensuring that professional practice is evidence-based
  • Learning and practicing critical appraisal skills.
  • Providing an enjoyable educational and social occasion and develop an environment of shared learning.

Content of the meetings

  • This will most often include discussing (and critically appraising) a particular paper of interest.
  • Occasionally discussion can be topic based e.g. hypothermia in TBI and discussion of relatedevidence (EUROTHERM, POLAR). This type of journal club usually starts with a clinical question and then analyses the literature to try and answer that question. E.g. What are the transfusion triggers for a brain injured patient?
  • One person to present and discuss a paper or topic. This can be a senior or junior doctor or nurse. All members of the clinical team are invited to attend the journal club.
  • Use the template provided to present the journal club to maintain quality and consistency in the appraisal process. Us the checklist provided. Some level of deviation is acceptable if necessary for the presentation. Please discuss with the moderator.
  • We will spend 10-20 minutes towards the end of the journal club to understand and discuss topics relevant and important to research methodology e.g. types of error, investigation bias, internal and external validity etc. The idea is to improve the quality of discussions in journal club by using this knowledge to challenge the methodology in subsequent sessions.
  • Please use this as an opportunity to practice and give feedback on presentation skills.

Choosing a Paper

The list of scientific papers provided are thought to be relevant to the practise of Neuro Intensive Care at the time of distributing the list. This is not an exhaustive list. Please feel free to discuss a paper that is not on the list after discussing it with the moderator for your presentation. We will endeavour to keep the list as up to date as possible.

Core Concepts in Critical Appraisal of a Paper

  • Type 1 Errors
    • Deciphering the P-Value conundrum. (Statistical vs Clinical Significance) 
    • Fragility Index – The Fluke!
  • Type 2 Errors 
    • “Power” struggle
  • Unmasking Sensitivity and Specificity to the clinician. What it should mean to you? (With paper discussing a diagnostic test)
  • Time to Intervention Study design – The Demerits (With Stroke Thrombosis Paper)
  • We are all “Biased” – Types of Bias (2 Sessions)
  • Outcomes
    • Mortality End Point: Is it always the right outcome? (With paper discussing no mortality benefit)
    • Secondary Endpoints (With paper stressing positive secondary endpoint) 
    • Subgroup Analysis and Intention to treat analysis.
  • Meta-Analysis and Systematic Review – Not a summary of the best evidence (With a Meta Analysis Paper)

Journal Club Preparation Checklist

  • Confirm the presentation schedule with the next presenter at least two weeks in advance
  • Ask presenter to submit their choice of journal club paper at least one week in advance
  • Provide the presentation guidelines and template to the presenter
  • Forward the journal club paper to all participants one week in advance
  • Ensure that pre-readers understand their responsibilities
  • Confirm room booking
  • Send a reminder email to all members at least two days in advance
  • Appoint a facilitator for the meeting
  • Make arrangements for food and drinks
  • Print the attendance sheet
  • Print presenter evaluation sheets
  • Print feedback forms when appropriate

Please access PDF for papers & feedback form

nitu-jc-v2.1Download