Keeping up with Critical Care Research

Have you ever come across an intensivist who seems to reference a research study during every ward round? They may even spring some new evidence on you from an article that appeared to have been published only microseconds prior.
With the volume of medical research articles increasing exponentially, how do they keep up-to-date with the relevant critical care literature? And how do you, as a time-poor intensive care trainee, figure out what new research is going to potentially be helpful to your patients?

The Fundamentals

Firstly, all Australasian trainees should regularly check up on the Australian and New Zealand Intensive Care Society (ANZICS) website1 to check out what ANZICS Clinical Trials Group (CTG) endorsed research projects are currently underway.
The ANZICS CTG website is a great starting point for trainees for several reasons:
Trainees should also endeavour to look up literature that is relevant to a question that they are currently grappling with in their clinical practice. Using the P.I.C.O. search strategy in large biomedical literature databases (e.g. Pubmed), trainees should attempt to find evidence relevant to the patient in front of them.
This patient-centred, self-directed literature search is an important skill as:
Once found, there are multiple methods of compiling and storing relevant journal articles, including saving them on a personal computer, the cloud, referencing software programs or websites (e.g. Mendeley), or using specific Apps (e.g. Read by QxMD).

The Intensive Care Nerd

Critical Care Reviews2 is a website that compiles landmark trial in intensive care medicine. The team at Critical Care Reviews regularly livestreams meetings wherein the results of multi-centre, international intensive care trials are announced, so the most enthusiastic intensive care trainee can watch their favourite trial results live at four o’clock in the morning. Presentations (thankfully recorded) are often accompanied by panel discussion sessions with the study authors, and editorials provided by international leaders in critical care research. Regularly watching these editorials and discussions can assist trainees in developing an understanding of the mechanics of clinical research.

Signing up to the Critical Care Reviews Newsletter allows subscribers to additionally get regular updates directly to their inbox. These email updates, in addition to highlighting recently published landmark critical care trials, also contain references to recently published guidelines, narrative reviews, commentaries, and case reports. There is also the Critical Care Reviews Podcast available on iTunes for long car or train trips.

The particularly enthusiastic trainee may also wish to subscribe directly to journals. Many of the landmark papers relating to intensive care are published in the New England Journal of Medicine, the American Journal of Respiratory and Critical Care Medicine (a.k.a. The Blue Journal), Intensive Care Medicine, Critical Care Medicine, Critical Care, or JAMA. The section author uses the Read by QxMD app, linked to her institutional library access to get beyond paywalls, to help her peruse the contents of these journals. However, subscribing directly to journals is more time-consuming, as it requires self-directed curation of relevant articles. Further, some important landmark papers are published in other medical journals not listed above and thus may be missed.

When You Need A Little Help From Your Friends

The Bottom Line3 is a popular peer-reviewed website that provides summaries of landmark trials in intensive care medicine, emergency medicine, and peri-operative medicine in an easily digestible format. Whilst The Bottom Line is an excellent and high quality resource, trainees should be cautious of unquestioningly adopting the interpretations of others without critically reading the original manuscript themselves.

Trainees should also endeavour to attend their departmental journal club. Journal clubs have the benefit of not only exposing participants to new research they may not have yet stumbled across, but also provides a platform to learn more about the practical application of critical care research from your colleagues.

There are also numerous intensive care conferences that, in addition to being a platform for clinician-researchers to share the results of their current projects, will commonly hold research update sessions targeted at trainees and/or fellows.

Some Alternative Options

ACCESSSS4
A website wherein trainees can select their healthcare discipline (particularly useful for those dual training) and a desired frequency of email alerts (e.g. daily, second daily, weekly) together with a “relevance” and “newsworthiness” score. Selecting higher relevance and newsworthiness scores limits the influx of articles contained within each email. Scientific merit and clinical relevance are decided upon by selected research experts and frontline clinicians based on pre-defined criteria.

Journal Feed5 For the cognitively overwhelmed trainee. Journal Feed aims to summarise one key article relating to emergency medicine or critical care every day, and emails you a one sentence summary together with a link to the referenced article. The temptation is to just read the one-sentence summary and move on with your life, blissfully ignorant of the internal and external validity of the results. The purist intensive care trainee will find some of the more emergency medicine-based articles irrelevant to their practice.

Beyond Where The Light Touches

Finally, there is a glut of up-to-date information (and misinformation) on various social media platforms. One of the most active platforms for the intensive care clinician is Twitter. A foray into Twitter may result in the trainee finding some solid gold interpretations of the most up-to-date critical care literature, but it can be difficult to differentiate what is useful from the dogmatic, biased trash that sits disconcertingly alongside it.

Thankfully, there are some quality checklists and guides to help trainees critically appraise the information they find on various social media platforms (check out a checklist here)6.

If you have your own nifty way of keeping up-to-date with the intensive care literature not mentioned above, please let us know!

References and Resources

  1. ANZICS: Current Active Endorsed Research
  2. Critical Care Reviews - https://criticalcarereviews.com
  3. The Bottom Line - https://www.thebottomline.org.uk
  4. ACCESSSS https://www.accessss.org
  5. Journal Feed - https://journalfeed.org
  6. Colmers IN, Paterson QS, Lin M, et al (2015) The quality checklists for medical education blogs and podcasts. The Winnower doi:10.15200/winn.144720.08769

Other Relevant Resources

Kamtchum-Tatuene J, Zafack JG (2021) Keeping Up With the Medical Literature: Why, How, and When? Stroke 52(11):e746-e748 doi:10.1161/STROKEAHA.121.036141

Section Author

Dr Kerina Denny
Kerina is an intensive care advanced trainee with an interest in critical care research, research education, and peer support. She enjoys hanging out at the beach and exploring the Gold Coast hinterlands with her family and friends.

Trainee Reviewer

Dr India Zweng
India is an intensive care advanced trainee currently working at the Gold Coast University Hospital. She has a penchant for making delicious vegan chocolate cakes.

Section Editor

Dr James McCullough
©2022- Dr Kerina Denny