Clinical Research Oriented Workshop (CROW) Meeting: Mar 12, 2010

Clinical Research Oriented Workshop (CROW) Meeting: Mar 12, 2010

Present: Matt Bovee, Kairn Kelley, Ben Littenberg, Mike MacCaskey, Charlie MacLean, Jeff Mogielnicki, Connie van Eeghen
Absent: Abby Crocker, Kim Dittus, Rodger Kessler

1. Start up: Book club – “The Checklist Manifesto”: The first half of the session was general discussion about Gawande’s Checklist Manifesto.
a. Master builders and their empirically based knowledge base (in a guild based organization)
b. “Against the Gods”: if you have no theory of probability, there is no reason to invest
c. Amanda: the inside truth about the construction industry re: Chapter 3; Gawande tells only half the story
i. We don’t have a history of using the simple tools we’ve got
ii. Sometimes the tools we’ve got are wrong (e.g. administering antibiotics for all presumed pneumonia patients admitted to the ED -> antibiotic induced diarrhea, some of which results in death)
d. Both building and health care have a reactive component – both have to adapt rapidly to the “situation on the ground” – which still supports the usefulness of the checklist
e. So… why is the use of checklists not blanketing the industry
i. Resistance to change
ii. Ability to change
iii. Buy in for change – from leadership – with the time needed to make it happen
f. Next week: chapters 5 and 6

2. Roundtable, with update, short term goals, long term goals

a. Ben: How to find the checklist for writing articles – see the Equator Network link on the Blogspot. Ben’s own checklist to reviewing articles:
i. Who did it – watch for corporate interests in what appears to be medical research
ii. When – how old? Is there rebuttal, discussion, and new information? Has it stood the test of time?
iii. Why – what’s the research question (the goal)? What’s the study question (the aim)? What’s the analytic question (the application of the aim in this case)?
iv. What – what was the design? (or, look at the conclusion next, and decide if the rest of the article is worth the time investment needed. In other words, is this study relevant?)
v. How – execution and analysis? (is it valid: internal and external validity)
vi. Discussion – what are the implications?
b. Charlie: Checklist for reviewing articles by Sackett, et al. (2000): “Evidence Based Medicine” which includes color coded index cards that provide checklists for review

3. Next Fellows Meeting(s): Mar 19, 2010 from 9:30 – 11:00 a.m., at Given Courtyard Level 4
a. Mar 19: Bookclub (chapters 5 & 6); Peter Callas on data entry of results
b. Mar 26: Bookclub (chapters 7 – 9); data follow up session
c. April 2: Bookclub (how does this apply to my work?) How to predict medical events effectively OR Mapping new NHANES data with mortality (Ben)
d. Future agenda to consider:
i. Skype demo: Connie & Matt? Wait until Amanda K is back. Or do twice?
ii. Future: Review of different types of journal articles (lit review, case study, original article, letter to editor…), when each is appropriate, tips on planning/writing (Abby)
iii. Future: Informed consent QI: Connie to follow up with Nancy Stalnaker, Alan Rubin will follow up with Alan Wortheimer or Rob McCauly

4. Fellows document – nothing new this time

Recorder: Connie van Eeghen