Beginners Guide: Appraising Medical Articles & Evidence-Based Medicine

Many find reading medical journal articles overwhelming. There was a point where I was like this as well, I wasn’t born knowing how to read this nerdy stuff. Here’s a quick tip to get you started and to share with your friends. This is by no means an all encompassing review. There are many ways to do this. This methodology is my opinion to get your feet wet. Your strategy may change as you become more advanced. I personally no longer do not read papers like this myself. The first draft of this was published online on 10/17/21 and will be a work-in-progress.

The Abstract: Do Not Read This and Pretend You Read the Paper.

The first thing you are going to see in medical articles on the first page is the abstract. The abstract is what most people read and then put the disappointingly put the article down feeling satisfied that they did something. I’ve had very intelligent individuals regurgitate to me what is in the abstract and stating we need to practice based on the abstract but this is a flawed way of thinking. We are all better than this. More will be discussed later.

Introduction: Establishing what we know up to this point

The introduction is one of my favorite parts of any paper. In the introduction, they break down the problem and what they are looking for in as basic as they can nerdily state (with citations for deeper dives which I love digging into). Here you’ll learn a bit about pathophysiology and other basics. This isn’t a book chapter as it is typically short, but authors typically provide you with the path for you to take a deeper dive.

Take the cited article. “Lung response to a higher positive end-expiratory pressure in mechanically ventilated patients with…” You read that title and immediately say, “I don’t understand a thing”. The authors describe what ARDS is, what CT scans typically show, how PEEP works, how we typically ventilate patients, etc. all in 2 paragraphs.

Skip to the Discussion of medical articles (Remember, this is for beginners)

Skip everything else and hit the “Discussion” section. Remember, we are learning to read articles so we need to get used to the patterns of how these articles are written. If I start talking about Cox regression you’re going to immediately tune out. We can get to that later. We are trying to fill in the BASICS. Walk before we run, right?

In the discussion section of medical articles, the authors discuss what they found and put a nice little bow on it. Please don’t stop reading until you get to the limitations. Here the authors will (should) be transparent on why their study might potentially suck and why you may have to take their conclusions with a grain of salt).

Wrapping medical articles up-ish.

Reading medical articles can be frustrating but again, it’s all patter recognition and learning what you are looking for. I can read an article in minutes simply because I have read so many that I can predict what the methodology should be. That took time and practice. It did not happen overnight. So don’t be so hard on yourself. Reading evidence-based medicine studies can be fun (at least for me).

Citations

Protti A, Santini A, Pennati F, Chiurazzi C, Cressoni M, Ferrari M, Iapichino GE, Carenzo L, Lanza E, Picardo G, Caironi P, Aliverti A, Cecconi M, Lung response to a higher positive end-expiratory pressure in mechanically ventilated patients with COVID-19, CHEST (2021), doi: https:// doi.org/10.1016/j.chest.2021.10.012.
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