Focused, systematic, current awareness: ACP Journal Club
As time becomes more precious, reading and staying current may suffer. For GPs and family physicians reduced to reading a single journal and specialists struggling to stay current on developments outside their specialty, I recommend the ACP Journal Club. This journal scans 150 major journals, both general and specialist, in internal medicine, family practice, obstetrics, gynecology, pediatrics, psychiatry, and general surgery, as well as systematic reviews from organizations such as the Cochrane Collaboration and the Agency for Healthcare Research and Quality. Published bimonthly by the American College of Physicians– American Society of Internal Medicine (ACP–ASIM) and with editorial offices at McMaster University in Hamilton, this journal provides a single-page synopsis—a structured abstract plus expert commentary for perspective—for each article. Selections are made based on relevance to clinical practice and on criteria to ensure high-quality statistical methodology—if you are going to change clinical practice, you want to do so based on reliable evidence. These criteria vary depending on the clinical aspect, whether, for example, diagnosis, treatment, or etiology.
Titles are more informative about the clinical significance of the articles than the title of the research paper they review. Titles from the July/August 2001 issue include “Rate and rhythm control showed similar symptom improvement in atrial fibrillation” and “Evidence is sparse and inconclusive for treating and monitoring mild-to-moderate hypertension in pregnancy.”
Moving beyond internal medicine
ACP Journal Club began in 1991 as a supplement to the Annals of Internal Medicine, and coverage was limited to internal medicine. However, the more general value of the ACP Journal Club and its selection process became evident. In 1995, ACP–ASIM joined with the BMJ Publishing Group to publish Evidence-Based Medicine, expanding the specialties covered. In 2000, the ACP Journal Club itself expanded, coverage paralleling Evidence-Based Medicine, and became the product for sale in North America. ACP Journal Club is also the template for Evidence-Based Mental Health, a quarterly started in 1998.
Like many other publications, the ACP Journal Club offers a few teasers from each issue on the Internet—appetizers but no free lunch. For example, from the July/August 2001 issue, seven of the 37 articles are provided in full at www.acponline.org/ journals/acpjc/jcmenu.htm. All pages available for free via the ACP–ASIM web site are indexed in the TRIP (Transferring Research Into Practice) site at www.tripdatabase.com/.
The cumulation of all past issues is published as Best Evidence. The 5th edition, just received on CD-ROM, covers the ACP Journal Club 1991 to 2000 and Evidence-Based Medicine 1995 to 2000. The full text of all articles is available through Ovid’s Evidence-Based Medicine Reviews: ACP Journal Club. Note that the electronic version lags behind; March/April 2001 is the latest update available a month after the July/August printed issue was received. At this time, institutional licences give access only to College members in some health regions or with UBC affiliation, unless they have purchased personal subscriptions. The College Library can provide searches of the Best Evidence CD-ROM upon request.
Other current awareness choices
There are numerous other services (list available upon request) both general, such as Journal Watch, and specialist. Our own Cites & Bytes alerts College members to articles relevant to BC practice. As well, the Library can supply, upon request, monthly updates on specific topics via MEDLINE and other databases. Most major journals offer free e-mails of the contents of new issues, and the Library can supply photocopied tables of contents. However, for the busy clinician, it is hard to beat the focused, systematic worldview of ACP Journal Club. I have spoken out in the past against practising medicine based on abstracts, and I leave it to readers to determine if the single-page synopsis in ACP Journal Club replaces reading the full article.
The annual subscription for six printed issues of ACP Journal Club is US$71 plus GST, approximately $120, from ACP–ASIM at 1 800 523-1546. The Library has a number of sample issues for those wishing to evaluate before purchase.
—Jim Henderson, Director
Medical Library Service
College of Physicians & Surgeons of BC