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Thursday, November 5, 2009

"Where are the answers?"

From time to time I get feedback on the Journal Club.  People who use it have been pleased with the tips for organizing a local journal club sketched by Dr. Jeff Peipert and have been challenged by the questions Dr. Cathy Spong and I constructed.  However, I’ve been asked, “Where are the answers?”  When told that there are no answers supplied with the Journal Club questions, reactions vary from bewilderment to indifference to disappointment.  I have even gotten arguments that journal club questions should not be asked without providing answers.

We’re accustomed to getting answers.  When we order a lab test or an imaging study we expect results.  When we do the ABOG ABC questions we expect to find the answers hidden in the articles—kind of like an elaborate word-search puzzle.  And when we ask our 17-year-old son where he was until 11:30 PM last night, we expect to hear a detailed log of specific times and places.  But are the best answers always supplied by someone else, and is there always one correct answer?  (I’m not even sure that there is only one or even any correct answer to some of the ABC questions, but that’s a topic for another blO+G.)

The editors and Editorial Board of the Green Journal have discussed whether answers to the Journal Club questions should be provided to the readers, as is the case with other published journal clubs.  The purpose of the questions is to guide the local journal club to examine the quality of the evidence presented in the paper.  Questions relate to articulation of hypotheses, study design, statistical analyses, and clinical applicability.  Tools that we provide to assist the local club include links to UpToDate, Committee Opinions, Practice Bulletins, and other previously or simultaneously published articles. We concluded that the local club will be able to use these tools for penetrating and memorable discussions that will result in better understanding of the paper and its subject than any scripted summary would provide.  And there will be less time wasted discerning whether the club got the “correct” answer.

So, where are the answers?  You won’t find them on this web site.  The best answers are in the creative ideas, thoughts, and impressions of your own journal club.  Listen carefully; otherwise you might not get them.

If you have an opinion, let me know by posting a comment.