Journal Club

RE: Journal Club

Arlo Guthrie — Wed, 21 Sep 2016 17:12:33 GMT

Meantime, I've started the discussion thread about the placebo study in the format I think they should be posted for now, here: https://www.vetsurgeon.org/uk/veterinary-journal-club/f/216/t/24851.aspx

Ready for the discussion to begin.

I'm also integrating navigation to the Journal Club, and finishing the setup now ...

RE: Journal Club

Virginia Campbell — Wed, 21 Sep 2016 12:38:38 GMT

Righto, sorted. Read over the weekend and discuss at start of next week then?

RE: Journal Club

Michael Woodhouse — Wed, 21 Sep 2016 11:17:15 GMT

go with placebo. 3 votes. Carried

RE: Journal Club

Beats — Wed, 21 Sep 2016 11:06:24 GMT

[quote user="David Mills"]the placebo one[/quote]

I'll second that then so that's 2 votes for this one then

Shall we say first to 3 votes and we have a decision?

One more taker? Virginia?

RE: Journal Club

David Mills — Wed, 21 Sep 2016 10:47:57 GMT

I think review articles should not be included, as they are a low form of evidence and the methodology cannot be critiqued - they are simply someone's opinion on the evidence, and often papers are misquoted or references so not support what they're supposed to.

I don't mind what we start with. Antibiotic resistance is a little dry for my taste, but whatever.

I linked up the placebo one because I think it fundamentally changes what we do and our justification for treatment. Pexion, for instance, was not trialled versus placebo for its licence, and - with the vagaries of subanalysis - it actually appears to perform only as good as placebo (though admittedly others' clinical experience may say different) if you extrapolate from other studies. That's an ethically murky place to find oneself in.

RE: Journal Club

Virginia Campbell — Wed, 21 Sep 2016 10:38:58 GMT

[quote user="Beats"] happy to do any first suggested paper to get going (even cattle theriogenology by this stage!) -[/quote]

Me too, I don't mind if we just pick one out of the hat and get going. Although I had to google theriogenology to check it means what I thought it meant, so that gives you an idea of the level at which I will be contributing to the scientific discourse ;-)

RE: Journal Club

Beats — Wed, 21 Sep 2016 07:46:01 GMT

[quote user="Michael Woodhouse"]You need something more interesting than that if you want to get maximum engagement.[/quote]

a review article maybe? Perhaps something like:

Veterinary Clinics of North America: Small Animal (Nov. 2016)

Controversies in Veterinary Nephrology: Renal Diets Are Indicated for Cats with International Renal Interest Society Chronic Kidney Disease Stages 2 to 4: The Con View
Review Article
Pages 1067-1094
Margie A. Scherk, Dottie P. Laflamme

don't get many open-access review articles though... indeed often a reason why articles are open-access and sadly not always a benevolent one

i'm happy to do any first suggested paper to get going (even cattle theriogenology by this stage!) - probably best to get one picked this week with view to giving folks a chance to read it and then discuss next week? Do you have any interesting paper suggestions, Michael? I find it hard to know what would appeal to anyone other than myself

Judging by engagement in this thread, I'm guessing there'll be maybe 5 or 6 folks that might join in - TBH more than that is maybe bit tricky for an online discussion anyway? (I have no direct experience of this to compare)

RE: Journal Club

Michael Woodhouse — Tue, 20 Sep 2016 23:56:21 GMT

You need something more interesting than that if you want to get maximum engagement.

RE: Journal Club

Beats — Tue, 20 Sep 2016 23:42:12 GMT

Is the poll in a different thread?

My vote's actually for the polymixin one if it's included in the poll. Given the widespread publicity to polymixin resistance arriving in UK such as: http://www.bbc.co.uk/news/health-35153795 and the widespread (ab)use of polymixins in both companion and farm animals, I'd like to look at the science ahead of the headlines. Topical with this vetsurgeon week's headline also: https://www.vetsurgeon.org/news/b/veterinary_news/archive/2016/09/19/140094.aspx though advertiser might not thank you...

It might be a bit heavy going for a first journal club though and perhaps too geeky... depends who you're trying to attract for the chat.

RE: Journal Club

Arlo Guthrie — Mon, 19 Sep 2016 11:56:55 GMT

[quote user="Francisco Gomez"]not sure if you thought about this Arlo, but it would be nice to have a 'Journal Club' tab under 'Write a new post'. That way, people could even select it and see, if wished, to see all JCs posts together.[/quote]

Hi Francisco Gomez - yes, that will all be coming soon (navigation to post in journal club etc) - just want to get final choice for first study agreed by all of you, and the email prepared.

RE: Journal Club

Francisco Gomez — Mon, 19 Sep 2016 09:17:02 GMT

not sure if you thought about this Arlo, but it would be nice to have a 'Journal Club' tab under 'Write a new post'. That way, people could even select it and see, if wished, to see all JCs posts together.

RE: Journal Club

Arlo Guthrie — Mon, 19 Sep 2016 08:25:03 GMT

[quote user="Michael Woodhouse"]The very last person you want to invite is the author. All that will do is to reduce the candid way in which one needs to approach a paper critically. [/quote]

Hmm, well, point taken.

[quote user="Michael Woodhouse"]I can be very brutal [/quote]

Ha - don't I know it!

I think let's see how it goes. Maybe it will be useful to invite an author to comment on some occasions and not others.

I'd like to get this off to a good start (ie try and encourage as much participation as possible), which will be partly down to selecting an interesting paper to kick off with, and partly with an email to announce the club to all members, inviting everyone to join in.

I will prepare the email and post a link here when it is ready for feedback. In the meantime, maybe a poll to pick the first study to look at from those suggested by the time the email is ready.

RE: Journal Club

Virginia Campbell — Sat, 17 Sep 2016 21:59:58 GMT

[quote user="Michael Woodhouse"]he placebo one is more practical, the ageing one would be fun to pick apart. [/quote]

I like both these plus Beats' chlorhexidine resistance one.

[quote user="Michael Woodhouse"] I'm not sure either would add very much to the vast majority of our clinical practice - which is kind of the reason for doing them.[/quote]

Yeah but they'll do to be going on with, all good practice for honing our critical skills.

[quote user="Michael Woodhouse"] It's also the reason I think doing them slowly is bad - there is a lot of material to pick over all the time. Spending ages picking over the minutia of a small animal paper won't really get me going [/quote]

Definitely. Maybe we should just lash a few up (subject to copyright so open access probably best to start) and have a go to begin with, it doesn't matter if we don't all do them to exam standard at first. Those of us with weaker critical analysis skills can learn as we go along and go off and find some of those "how to read a paper" articles (that I have previously pushed into the mental "should get around to doing" pile) to help ourselves.

RE: Journal Club

Beats — Fri, 16 Sep 2016 23:20:29 GMT

Here's some open-access (and less-accessible!) papers I've never read that looked superficially interesting to me to see if can find one with 3 or more votes

some more general suggestions on recent papers of potential relevance in informing opinion re avoiding antimicrobial-resistance selection:

Chlorhexidine-resistance in plaque bacteria (human): http://bmcmicrobiol.biomedcentral.com/articles/10.1186/s12866-016-0833-1

Environmental-antimicrobials selecting for systemic-antimicrobial-resistance also: http://jac.oxfordjournals.org/content/70/8/2241.full

Polymixin resistance: http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(15)00424-7/abstract

Sterile surgical technique re wedding ring (not open access I fear): http://www.ncbi.nlm.nih.gov/pubmed/19301805

Capsule endoscopy (this one in dogs with GI bleeding): http://onlinelibrary.wiley.com/doi/10.1111/jsap.12442/pdf

or this one in research dogs as alternative to culling during drug trials: http://www.ncbi.nlm.nih.gov/pubmed/22075243

Canine osteosarcoma - amputation with or without chemo: http://onlinelibrary.wiley.com/doi/10.1111/j.1939-1676.1988.tb00313.x/pdf

Does splinting work for distal antebrachial fractures in skeletally-immature toy breeds? (OK, that one's not on the net seemingly :-( Campbell JR. Healing of radial fractures in miniature dogs. Vet Annual 1980, 20:106-112.

I'm happy to take at least a quick look at any paper suggested as a starter (though I'll confess my interest level is likely to dip on heavy-going cattle theriogenology...)

RE: Journal Club

Michael Woodhouse — Fri, 16 Sep 2016 21:47:34 GMT

The very last person you want to invite is the author. All that will do is to reduce the candid way in which one needs to approach a paper critically. I can be very brutal and yet I'd rather not criticise the guy to his face. Chances are they are perfectly aware of the limitations of their work.

Arlo Guthrie needs to be careful he or the forum are not implicated in the illegal distribution of copyright material via email. The journal publishers are not the friendliest bunch when it comes to sharing their material.

The placebo one is more practical, the ageing one would be fun to pick apart. I'm not sure either would add very much to the vast majority of our clinical practice - which is kind of the reason for doing them. It's also the reason I think doing them slowly is bad - there is a lot of material to pick over all the time. Spending ages picking over the minutia of a small animal paper won't really get me going - I'll still likely read the thread and see if anything interesting there.

RE: Journal Club

Arlo Guthrie — Fri, 16 Sep 2016 14:16:09 GMT

So shall we do a test run with one of the two papers suggested so far:

Placebo Effect in Canine Epilepsy Trials

Exceptional longevity and potential determinants of successful ageing in a cohort of 39 Labrador retrievers: results of a prospective longitudinal study

Or would anyone else like to add any other suggestions?

When we have one to start with, other things I'll be thinking about:

a) Presentation of the study (ie integrated within the discussion, or just linked to).

b) Guest 'speakers' - whether we invite the authors of the study, and/or people with particular experience in EBVM to help with critical analysis.

c) a few other things I'll come back to later. But I've created this forum as part of a distinct 'group' on VS, which allows me to add a few extra features which could be helpful.

RE: Journal Club

Arlo Guthrie — Fri, 16 Sep 2016 08:40:16 GMT

[quote user="Beats"]but I think the open-access journal requirement a bit restrictive.[/quote]

Beats - it's not a requirement that studies are open access. Perhaps I should reword that to say something more like:

When selecting a paper for discussion, please bear in mind how accessible it is to other participants. Where many members of this community might be expected to have access to the Veterinary Record, an obscure subscription publication may be more problematic (you may want to contact support@vetsurgeon.org first to see if we can get permission to reproduce the study here).

[quote user="Beats"]Also, if formalised education (I'm not sure how one makes it that)[/quote]

Well, I think providing a specific format for the Journal Club, plus the 'Claim CPD' aspect moves it in that direction already. But I see this as just the first step, and already thinking about ways it could be developed.

[quote user="Beats"]if only a small number of participants then may be able just to email round a copy to them quite legitimately? (Obviously you'd need to check on the actual legalities of that...)[/quote]

I'm investigating that and other ways we can make even subscription studies more accessible for these discussions. Ideally, I'd like the papers somehow integrated within the forum (ie so you don't have to click to an external page).

[quote user="Beats"]PPS - perhaps having a few papers suggested and doing a quick poll week before to choose most popular one to do that week?[/quote]

Yes, I was thinking about that, but I think it depends on where this all takes us. Michael Woodhouse suggested a more free-range approach and anyone can start a thread with a paper, and I can see strengths in that way of doing things. Could be problematic if there are lots of suggestions, as risk of lack of focus.

I think we should probably start off by selecting the first one from suggestions posted in this thread, then see where it takes us.

RE: Journal Club

Michael Woodhouse — Thu, 15 Sep 2016 22:05:56 GMT

Plos one is all open access and has a building number of veterinary relevant papers.

RE: Journal Club

Beats — Thu, 15 Sep 2016 21:42:10 GMT

D'oh

Try 2: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4863359/

I like your suggestion for a first paper to look at.

RE: Journal Club

David Mills — Thu, 15 Sep 2016 21:08:35 GMT

[quote user="Beats"]

PS - here's an open-access suggestion to kick off with anyway:

http://www-ncbi-nlm-nih-gov.liverpool.idm.oclc.org/pmc/articles/PMC4863359/

Fat labradors - keep 'em lean, treat them mean?

[/quote]

It's behind a firewall

I'd suggest this interesting one I heard about yesterday...

http://onlinelibrary.wiley.com/doi/10.1111/j.1939-1676.2009.0407.x/abstract;jsessionid=815AD4ED715DE42261E1250E6750EE22.f04t02

RE: Journal Club

Beats — Thu, 15 Sep 2016 19:05:34 GMT

This looks good fun (and educational), but I think the open-access journal requirement a bit restrictive.

Some of the most fun papers (in my opinion) are ones that aren't even electronically-available but are given as references in textbooks to substantiate accepted wisdom in some instances where an objective look at the actual study in question leaves one rather more open-minded.

I would guess that a pretty high proportion of vets that are interested in discussing journal papers have journal access, so it might not be necessary to have such tight restriction on paper choice. Also, if formalised education (I'm not sure how one makes it that), then lecturers etc always gave the impression that it is OK to reproduce a specific paper and distribute to individuals taking part in the formalised learning class - if only a small number of participants then may be able just to email round a copy to them quite legitimately? (Obviously you'd need to check on the actual legalities of that...)

Dave

PS - here's an open-access suggestion to kick off with anyway:

http://www-ncbi-nlm-nih-gov.liverpool.idm.oclc.org/pmc/articles/PMC4863359/

Fat labradors - keep 'em lean, treat them mean?

PPS - perhaps having a few papers suggested and doing a quick poll week before to choose most popular one to do that week?

RE: Journal Club

Arlo Guthrie — Thu, 15 Sep 2016 16:22:04 GMT

Two stars? One, I understand. Five, I understand. But two? What on earth does that mean?!

RE: Journal Club

Arlo Guthrie — Thu, 15 Sep 2016 09:48:57 GMT

I've begun with the setup of the new Journal Club and created the tweaked 'Read Me' introduction here:

https://www.vetsurgeon.org/uk/veterinary-journal-club/f/216/t/24823.aspx

The list of journals at the foot is not necessarily correct - just one I have pilfered from elsewhere to kick off with. I'd like it to list just the ones that are reasonably well-respected (I'm not saying that any on there aren't - I don't know).

RE: Journal Club

Sarah Keir — Wed, 14 Sep 2016 11:34:12 GMT

I quite agree Martin. We don't need to name EBVM to be doing it. Recording and reflecting on CPD is on onerous, it is part of the learning and planning process.

RE: Journal Club

Martin Atkinson — Wed, 14 Sep 2016 11:01:49 GMT

[quote user="Sarah Keir"]There a a good proportion of vets that refuse to have anything to do with EBVM, for various reasons probably along the lines of a new fangled fashion thing, doesn't do anything for me, I already know what I am doing and doing it well. Another good proportion think they are practicing EBVM but only in name sake[/quote]While I agree with the first sentence I would put a caveat on the second. There are a good number of vets who practice EBVM but don't have to put a name to it, formalise it or compartmentalise it. There are only a limited number of journals anyone can read in a given time and no-one can accuse me of not embracing CPD wholeheartedly. Do I practice EBVM? Yes, but do I think to myself, 'ooh I must do a bit of EBVM today? No. I just learn, practice, gain experience accumulate evidence and change the way I work from it.

It surprises me that everyone seems to be so focused on everything having to be EBVM yet they object to recording their CPD in a formal way.

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