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It is easy to lose sight of the core of the practice of anaesthesia. As a profession we are easily seduced and distracted by the new and exciting; quickly forgetting that satisfyingly favourable outcomes for our patients occur not because of the advances in the technology and pharmacology of anaesthesia, but rather are owed to our training and performance as anaesthetists and anaesthesiologists managing that complex system.

Our ability to understand the complex model of patient, surgeon, drugs and scalpel; to resist distraction by the blinkenlights of whatever new device has been dragged in by the friendly equipment rep; the exciting kinetics of the latest drug; or the new ventilator modes on the anaesthetic machine - our ability to conceptually simplify these things and achieve good outcomes is at the core of what we do.

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Exciting news for metajournal this week — we're in open beta! This means that now anyone can sign up for a metajournal account and stay up to date with the latest, most personally relevant evidence in anesthesia, critical care and emergency medicine.

To thank all our early access users already using metajournal, we have both new pricing – and for a limited time a further $50 off the first year of your metajournal subscription.

Start your subscription today.

The quality of metajournal's article recommendations have continued to improve, and get spookily prescient once you are following a critical number of topics. To get (very!) good results follow at least 30 topics. For clairvoyant-quality evidence suggestions aim for 50-100 topics and be delightfully surprised!

Thank you!

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 50,000^th 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 1,706,641 articles!

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?

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.