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Fun with Journal clubs

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Brijesh Desai

on 27 May 2015

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Transcript of Fun with Journal clubs

Scientific papers

What is expected in a Journal Club

Obtaining feedback

Literature search & Referencing systems

Resources for statistics

Critical appraisal checklists

Further reading

Referencing systems
What is expected in a JCP
1. Identify a paper

2. Circulate to everyone in advance {CRUCIALLY IMPORTANT}

3. Prepare presentation (rather than just taking the paper to presentation).

4. Think together
Literature Search
Fun with Journal Clubs
Brijesh Desai

Consultant Psychiatrist

11th September 2014
Think together
Bouncing ideas
Take home
Title, journal, author
Context - its place in the literature

The Research Question/s

The Paper
Sample, Method, Stats, Conclusions, Limitations, Recommendations
Critical appraisal
Take Home
Why this research? It's value

Does it add to our knowledge?
Why this method?
Other research that supports or refutes this?
Step-by-step appraisal
Results helpful in clinical practice?

Gist of authours' conclusions

Your conclusion about the paper

Further Reading
Discuss with ES before presenting
Give WPBA form to assessor (ST4-6, Consultant)
BEFORE presenting
Good idea to get feedback from audience too


Appraisal Checklists
Systemic Reviews
Qualitative Studies
Diagnostic Studies
SIGN checklists
Consolidated Standards of Reporting Trials


Quality of Reporting of Meta-analyses
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
Consolidated criteria for reporting qualitative research

Scottish Intercollegiate Guidelines Network
Papers App
Not optional !

Major chunk of exams

Very very useful skill to have

Fear is your enemy
Ajetunmobi, O. 2002. Making sense of critical appraisal. Arnold Publishers. London.

Bowers, D., House, A., Owens, D. 2001. Understanding clinical papers. Wiley. West Sussex.

Freeman , C., Tyrer, P. (Eds.) 2006. Research methods in psychiatry. Gaskell. The Royal College of Psychiatrist, London.

Greenhalge, T. 2001. How to read a paper-the basics of evidence based medicine. 2nd Ed. BMJ Books. London.

BMJ Statistical Notes - fantastic short articles series at:


Statistics at Square One - online book at:


Davis, J.M., Chen, N., Glick, I.D. 2003. A meta-analysis of the efficacy of second-generation antipsychotics. Arch Gen Psychiatry, 60(6), p. 553-564.
Year of publication
Article Title
Issue, vol, pages
Taylor, D., Paton, C., Kapur, S. 2009. The Maudsley Prescribing guidelines. 10th Ed. Informa Healthcare. London.
Publication year
Place of publication
Book title
Lithium is effective in the treatment of moderate to severe mania with a NNT of 6 (Taylor et al., 2009).
Referencing within the body of article
Armtage JO, Weisenburger DD. New approach to classifying non-Hodgkin's lymphomas:clinical features of the major histologic subtypes. Non-Hodgkin's lymphoma classification project. J Clin Oncol 1998; 16:2780-95.
Article title
Journal & year of publication
Vol, pages
...little evidence that couselling is effective for mental helath problems in the long-term.
Referencing within the body of article
Thank You
Which journal ?
Impact Factor -
measure of
article citations in a journal over time

Top journals in psychiatry (2008) [Psychiatrynet.eu]

1. Archives of general Psychiatry - 14.3
2. Molecular Psychiatry - 12.5
3. American Journal of Psychiatry - 10.6
4. Biological Psychiatry - 8.7
5. Neuropsychopharmacology - 6.8
6. Schizophrenia Bulletin - 6.6
7. The British Journal of Psychiatry - 5.1
8. Journal of clinical Psychiatry - 5.1
9. Journal of Child Psychology
and Psychiatry - 4.9
10. Journal of American Academy
of Child & Adolescent
Psychiatry - 4.8

Peer reviewing
Conflict of interest
Worth reading :
Kendall, T. 2011. The rise and fall of atypical antipsychotics. BJPsych, 199, p.266-268.

Questions ?
Thank You
An RCT reports remission rates for depression of 70 % for drug X and 60 % for drug Y. The number of patients that must receive drug X for one patient to achieve a demonstrable beneficial effect is:

A. 15
B. 10
C. 20
D. 1.16
E. 130

Which of the following measures is used in correlation analysis for non-parametric data?

A. Kappa statistics
B. Pearson's correlation
C. Spearman's correlation
D. Cohen's d
E. Cronbach's alpha
Which of the following is a suitable match for study question and study design?

A. Diagnostic test: case-control study
B. Prognosis : prospective cohort study
C. Drug treatment: cross-sectional survey
D. Aetiology: case series study
E. Epidemiology:Randomized Controlled Trial
Which of the following methods is NOT used to assess heterogeneity in a meta-analysis?

A. Paired t test
B. Q statistic
C. I squared statistic
D. L'Abbe plot
E. Galbraith plot

Sensitivity of a test is defined as:

A. The proportion of subjects with the disorder (by gold std) who have a positive result (by new test)

B. The proportion of subjects who do not have the disorder and who have a negative result

C. The proportion of subjects who have a positive test result who do have the disorder

D. The proportion of subjects with a negative test result who do not have the disorder

NNT- Number Needed to Treat

NNT = 1/ ABI (Absolute Benefit Increase)
ABI= difference betn benefit due to experimental intervention and compared intervention

ABI= 70%-60%= 10% --> NNT=100/10=10
Answer: Spearman's correlation

Kappa statistics- a measure of agreement not correlation

Pearson's correlation - is for parametric correlation

Cohen's d - to calculate effect size

Cronbach's alpha - for measure of internal consistency of an instrument

Answer B

Diagnostic test: survey

Prognosis : prospective cohort study

Drug treatment: Randomized Controlled Trial

Aetiology: cohort or case-control studies

Epidemiology: cross-sectional survey
Answer: Paired t statistic

All other methods can be used to assess heterogeneity in a meta-analysis
QALY (Quality Adjusted Life Year) is a utility measure used in which of the following study designs?

A. Qualitative study
B. Cost-utility study
C. Cost-benefit analysis
D. Cost-effectiveness analysis
E. Cost-minimization analysis
Answer- cost-utility analysis

QALY = (no. of extra yrs of life obtained) x (the value of the qualityof life during those extra yrs)

Cost-utility analysis is used to make choices between interventions for different conditions in which the units of outcome differ
Answer : A (true-positive rate)

B= Specificity (true negative rate)
C= Positive predictive value
D= Negative predictive value
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