1. Evidence Based Medicine Worth Spreading
Christopher R. Carpenter, MD, FACEP, FAAEM
Great Plains SAEM Regional Meeting
September 28, 2013

2. It takes 17 years to turn 14 per cent of original research
18%
variable
Negative results
Dickersin, 1987
Submission
46%
0.5 year
Kumar, 1992
Koren, 1989
Acceptance
Negative results
0.6 year
Kumar, 1992
Publication
It takes 17 years to turn 14 per cent of original research
to the benefit of patient care
35%
0.3 year
Poyer, 1982
Balas, 1995
Lack of numbers
Bibliographic databases
50%
years
Antman, 1992
Poynard, 1985
Reviews, guidelines, textbook
9.3 years
Inconsistent
indexing
Implementation
E.A. Balas, 2000

4. CORD survey of 157 conference attendees with 98 faculty respondents (62% response rate)
75% reported no formal EBM curriculum or Journal Club
71% do not use structured critical appraisal forms to analyze manuscripts

5. EM faculty EBM expertise expectations differ
A “successful” EBM curriculum during EM residency will ensure that learners can
Identify flawed research (45%)
Apply research findings to patient care (43%)
Comprehend research methods (33%)
EM faculty EBM expertise expectations differ
Critical appraisal proficiency (63% high or very high)
Access/use secondary peer review sources (88% agree or strongly agree)

6. Characteristics of Suboptimal Journal Club/EBM Curricula
Lack of a single faculty leader
Suboptimal manuscript selection
Failure to use critical appraisal forms
No archiving of results
Research nihilism
Statistical uncertainty
Insufficient individualized feedback
Failure to translate findings to bedside
From “Teaching Lifelong Learning Skills” in Practical Teaching in Emergency Medicine, 2nd Edition, 2012

7. Easy to find website via Google search for “emergency medicine journal club”. Can also join monthly stream or on Twitter. Rated the #1 FOAMed website by the Skeptics Guide to Emergency Medicine.

10. The website also includes a “toolbox” of useful links to other EBM resources to assist learners and EBM practitioners.

14. BEEM Best Evidence in Emergency Medicine
YOU!
the EM articles are sent to over 100 BEEM raters. These are front line emergency doctors just like you.
Raters are asked to assume that the results of this article are valid.
They are then asked to rate clinically how important the paper is to their own practice.
Again, many articles to not make it past this stage. Only those highly rated papers are appraised by BEEM faculty
Standardized EBM tools are used to create a critical appraisal and BEEM bottom line.
These critical reviews are then provided to you so you can provide your patients with the BEST care.

15. Acad Emerg Med 2011; 18:
Acad Emerg Med 2013 (in press)

16. BEEM is Global BEEM is Global.
It has presented its high quality, clinically relevant information around the world including:
- Australia, Europe, Middle East, Caribbean, Mexico and USA.

17. Skeptics Guide to Emergency Medicine: www.TheSGEM.com
KT/Dissemination Project
44 podcasts on iTunes
1,200 registered to blog
700 twitter followers
Turning MedEd on its Head
FOAMed
Car is the Classroom
The SGEM: Meet ‘em, greet ‘em, treat ‘em and street ‘em.
First rule of emergency medicine...Don’t panic, All bleeding stops, eventually
Turning medEd on its head and trying to shorten the KT window form 10 years down to 1
Part of the FOAMed movement (Free Open Access to Medical Education)
Uses social media (weekly podcast, twitter/Facebook, blog and youtube videos)
Turn your car into a classroom
The Medium is the Message
Be skeptical of anything you learn, even if you heard it on The Skeptics Guide to Emergency Medicine
"The medium is the message." Marshal McLuhan

18. Meet at 12PM on May 15 in Tower Room 1403

19. Resources Twitter http://tinyurl.com/WashU-EMJournalClub
Twitter
Wash U JC: @emjclub
SAEM
SGEM: @TheSGEM