Whether you're a seasoned pharmacist or a student, presenting a journal club can be a daunting task.
Whether you’re a seasoned pharmacist or a student, presenting a journal club can be a daunting task.
Nevertheless, literature evaluation is a crucial tool that will enhance your knowledge base and help to educate your colleagues. Primary literature is the basis for clinical practice and FDA drug approval. With these 5 tips, you’ll be a rock star for your journal club presentation!
It may be tempting to just read the abstract; however, that’s only a summary of the article. Think of the abstract as the menu of the study; it provides an overview. Additionally, the abstract could contain errors. Therefore, it’s important to take the time to critique the study. Focus on the methods and results, which are really the meat of the study.
Examine the inclusion and exclusion criteria and determine whether they’re appropriate. Evaluate the treatment protocol to determine whether the dosing, monitoring, and follow-up are appropriate. For example, if the primary objective is to evaluate the effect of a diabetes medication on hemoglobin A1c, then the study duration should be at least 3 months.
Evaluate whether your study used the gold standard of the intention to treat (ITT) analysis. The ITT includes all patients in the results that were randomized—even if they dropped out or failed to comply. It’s considered the gold standard analysis because it tries to reflect what’s actually observed in clinical practice. This is an important discussion point for your journal club.
Conduct a quick PubMed search from the references in the introduction section to check the results of previous studies. These studies will ultimately be the basis for why this clinical trial is being conducted. You should also research background information on the disease state being studied and present a brief overview in your presentation.
Take the time to calculate the NNT, which is the number of patients you need to treat in order to to prevent one additional bad outcome (eg, death, stroke, myocardial infarction). The following equations can help you calculate the NNT:
NNT = 1/Absolute Risk Reduction (ARR)
ARR = Control event rate-experimental event rate
The ARR is the amount by which the therapy reduces the risk of a bad outcome.
The NNT is a great value to discuss during your journal club presentation.
The results may be statistically significant, which by convention is p < 0.05. However, it’s extremely important to determine the clinical significance and how it relates to your patients. Let’s look at the following example:
Researchers conducted a study comparing the efficacy of a new antihypertensive drug compared to placebo. After 180 days of treatment, the new drug reduced blood pressure by 1 mm Hg versus placebo (p < 0.05).
This study would be statistically significant, but with such a small drop in blood pressure would not be clinically significant.
Check with your preceptor or colleagues about the time frame, but generally 10 to 20 minutes is a good presentation length. Also, it’s a good idea to make copies of your handout for everyone. Use the following as an outline tool to assist you with your journal club presentation:
These tips can serve as a journal club toolbox for your practice setting or clinical rotations. Good luck on your journal club journey!