Five comments on the value of journal clubs (Director’s Blog: October 2018)

I am sure some of the SHARP core faculty and team members have been asking themselves why we bother to do journal clubs. I would put money on a bet that some of you have even rolled your eyes at the concept with the thought “I already have so much else to do for my research career to blossom. This is such a time suck.”  To be sure, reading the articles in advance and engaging for an hour in discussing the methods, content, and implications takes time. But, I would posit that it is a valuable use of time for several reasons:

  1. Read scientific literature. We have been forced into being skimmers and abstract readers. With the myriad constraints on our time we tend to live in the cliff notes version of scientific literature. Yet one of our key missions as health services researchers is to produce literature that will provide important knowledge to others and turn the dial in quality, costs, and outcomes for surgical care. Journal Clubs allow for us to read 2-3 full journal articles and contemplate their quality. This act in and of itself it edifying. It builds discipline and a number of key skills that are detailed in key points below.
  2. Build knowledge on HSR methods. These methods may be entirely new to us or a welcome review. Using this week’s journal club as an example, how many of you have ever done research using Medicare Prescription Drug Claims? Yet some of the most high impact work in medication use among the elderly in the past 4 years has come from this data source. The moment we think we are expert at something, whether as surgeons operating in the OR or as health services researchers, we have failed. There is always opportunity to grow one’s mind about HSR methods and we try to pick journal club articles that achieve that goal.
  3. Recognize and learn from bad research. No one wants to be known for their crappy research. Yet we all know people who have achieved that infamy. We don’t always pick the most perfectly executed HSR papers for journal clubs because it is worthwhile to dissect others’ research and make a judgment as to the quality be it pure methods critique, interpretation critique, or presentation critique. The ability to carefully assess the literature and determine whether the conclusions are meaningful based on a real evaluation of the methods is an essential skill for all researchers, practitioners, and policy-makers. We get an edge by practicing this at journal clubs, and we prevent ourselves from making the same mistakes.
  4. Consume literature outside of one’s specialty. The volume of journals that hit our real or virtual mailboxes is overwhelming. It’s hard to keep up and commonplace to simply focus on our clinical specialty. Journal clubs with articles curated by others provide the opportunity to examine HSR in other venues and find ways to replicate what impresses us (see #2) and avoid what seem poorly done (see #3). Also, given that all specialties’ patients might be touched by surgical disease, the content from other journals might provide us great targets for our own research. The impact factor of Annals of Internal Medicine is 19.4, why shouldn’t we try to publish there if we learn in today’s journal club that we have relevant work to share!
  5. Scientific kinship. You have all heard me talk about the SHARP family. You have also no doubt heard about cul de sac dwelling moms with book clubs. Our journal club is the SHARP friends and family version of the wine, cheese, and a good book to discuss with like minded people. It’s a way to get free of the other draining tasks of our work lives, a moment to reset together. We do it because “the book” will help us bloom in some way (see #1-4) and because it gives us a change gather without any real pressure. And yes, we aren’t naïve. Just like more than half the moms are there having not read the book, we hope that you will reap some the benefits of the face to face discussion even if you couldn’t put in the extra time in advance to read the “book.”

Thanks for continuing to show up and for giving these book clubs a chance. If you have suggestions sent them to Scott (Scott.Strassels@osumc.edu)

Director Office Hours Beginning July 2018

I hope many core faculty (like myself for only the second time in the last 10 years) are able to enjoy the July 4th holiday this Wednesday. As you know, we will not be having our usual SHARP meetings this week. On most Wednesdays moving forward from 8:30-10:30am I will be having office hours to meet with all of you. Please contact Lori Bardon (Lori.Bardon@osumc.edu) to sign up for 30 minute slots. I am always able to schedule at other times as well but I am hoping a recurring block will allow me to be maximally available to mentor, advise, and sponsor all of you in your HSR endeavors.

Heena

AcademyHealth Annual Research Meeting in Seattle Next Month

This is hands down the best HSR conference. The content is of the highest caliber with national experts on improving healthcare delivery. See their own description below.

“AcademyHealth’s Annual Research Meeting (ARM), the premier forum for health services research (HSR), convenes the foremost experts at the intersection of health, health care, and policy to share important findings and showcase the latest research on how the health system works, what it costs, and how to improve it.

The largest meeting of its kind, the ARM is packed with new research, cutting edge methods, and robust discussions of HSR’s impact on health policy and practice. The meeting features compelling sessions, panels on critical and emerging issues in health services research, and presentations of high quality peer-reviewed research.”

For more information or to register, click here.

 

Propensity Score Journal Club

On May 16, 2018 we will discuss the utility and application of propensity scores.

We will review 3 papers using propensity score to better understand surgical problems (cholecystectomy for biliary disease, “July effect” on emergency general surgery outcomes, and role of Do-Not-Resuscitate orders on mortality of elderly patients undergoing emergency general surgery).

A helpful methods paper by Austin can be found here. In addition, for those who want more in depth review on how to utilize propensity scores, we have included the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) three part series on the methodology (Part I, Part II, Part III).

Those wishing to leave comments before or after the in person journal club are welcome to do so on this page.