the metablog

Posts written by Daniel Jolley.
Daniel Jolley

About the author

Daniel Jolley is an anesthesiologist, founder and CEO of metajournal, providing personalized medical research recommendations to fellow doctors.

Read more from Daniel or follow on twitter.

We just indexed our 50,000th article

The number of new articles published keeps increasing everyday. In fact PubMed adds roughly one new article to its 23-million-strong database every minute!

Metajournal indexes, qualifies and assesses each new article from (currently) more than 70 critical care specialty journals – each and everyday. Today we just indexed our 50,000th article from which metajournal can recommend to you the highest quality, most significant and personally relevant evidence for you and your unique practice.

Each day we add another 20 to 100 new articles to that repository – to keep us all up to date.

And if you are reading this in the future (queue Dr Who theme music...) the metajournal article library right now stands at an impressive 878,701 articles!

Better is continuous, incremental improvement

The Japanese have a word 'Kaizen' (改善) that captures the concept of continuous improvement, or at a greater level, the philosophy of continuous improvement made in small incremental steps. Kaizen empowers the individual to improve their work in small, but significant ways. Each small improvement compounds upon the last, driving personal and institutional excellence. But this starts with the individual, humanized. Can metajournal lead you to kaizen?

Metajournal: Assessing and applying the evidence

It’s not that Dr. John Ioannidis envisions doctors making all their decisions based solely on solid evidence — there’s simply too much complexity in patient treatment to pin down every situation with a great study. “Doctors need to rely on instinct and judgment to make choices,” he says. “But these choices should be as informed as possible by the evidence. And if the evidence isn’t good, doctors should know that, too. And so should patients.”

— David Freedman on Dr. John Ioannidis, medical meta-researcher.

   Lies, Damned Lies, and Medical Science, The Atlantic, 2010.

Getting better at what you do

Four steps along the journey to getting better at what you do:

  1. You need to be willing to be wrong — and willing to be corrected.
  2. Always be questioning and learning. Be open to learn from others no matter their experience.
  3. You must care about patient outcomes. Empathically.
  4. Finally, you need to contextualize your care for each patient — to their needs and your resources.

"There is only one corner of the universe you can be certain of improving, and that's your own self." — Aldous Huxley

Critically appraising the evidence

It’s hard to keep up with the latest evidence. Not only is the sheer volume of newly published papers overwhelming and the variety of topics broad and wide, but then after finding a paper that piques your interest you are still faced with the tricky task of critically assessing the paper's quality and relevance. Metajournal aims to solve many of these problems, but sometimes you need to just sit down and drag that paper over the keel yourself.

One of the most useful tools I have found are checklists provided by the Critical Appraisal Skills Programme, a UK non-profit based in Oxford. CASP runs workshops that educate healthcare workers and others on how to appraised medical evidence — and they share online the great checklists they use during the workshop under a Creative Commons license.

Find → Appraise → Act

They provide a set of eight critical appraisal tools designed to be used when reading research, covering:

  1. Systematic Reviews
  2. Randomised Controlled Trials
  3. Cohort Studies
  4. Case Control Studies
  5. Economic Evaluations
  6. Diagnostic Studies
  7. Qualitative studies
  8. Clinical Prediction Rule

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