Episode 1: An introduction and critical appraisal of randomised controlled trials
Welcome to the first episode of the Northern School of Paediatrics Journal Club podcast. This was established in May 2020 as it became clear that there would be no rapid solution to the Covid-19 crisis. It was becoming challenging to continue with the usual training activities that we would deliver as a postgraduate school of paediatrics, and we wanted to have some form of activity that brought trainees in the north east of England together in a shared training environment.
After discussion amongst trainees and trainers we felt that a journal club, operated virtually using the rapidly improving video conferencing facilities that were becoming much more familiar to everyone, was something that there was an appetite for. We are a training school with trainees working in widespread geographical settings, and this was something that appealed to trainees based on feedback provided before lockdown began.
The first journal club was held in May 2020 and it was decided to look at an important early paper to emerge from China that showed how the world had turned upside down in such a short a space of time.The study reported was conceived in early January 2020, patients were recruited from late January through to April, and the paper was published at the end of April 2020 (in the new normal of pre-print un-peer reviewed early publication). By the end of May 2020 it was out of date as new, more definitive evidence emerged from studies in Europe and North America.
The podcast is comprised of an introduction and discussion of approaches to critical appraisal of randomised controlled trials, followed by review of the paper : "Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial"
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31022-9/fulltext
There is a critical appraisal tool (CAT) from the Centre for Evidence Based Medicine in Oxford, designed to help you analyse a paper describing a randomised controlled trial, which was the basis for the discussion during the podcast. https://www.cebm.net/wp-content/uploads/2018/11/RCT.pdf
We believe that evidence should be the basis for rational clinical decision making. It has been in some parts reassuring to see the level of discussion of evidence that has emerged at times during the Covid-19 crisis, and at other times deeply worrying that strong wills and opinions , even within scientific circles, often lead to poor decision making, despite there being evidence that counteracts those opinions. We hope this podcast can be a small beacon of light (or as an audio medium maybe that should be a foghorn sounding in the night), helping listeners develop a their personal skill set in reading the medical literature and considering their own potential to contribute to work that increases knowledge and understanding.
The podcast is edited to try and provide a sense of the way the journal club ran on the day. The recording was undertaken using a Presonus Firestudio Mobile digital audio workstation. Some of the dialogue was recorded using an MXL 990 condenser microphone, but some of the contributions were recorded directly from the Microsoft Teams stream, which led to some variable sound quality at times.
Opinions expressed in this podcast are based on the principles of evidence based medical practice, but are the individual's opinions and not those of the School of Paediatrics. Listeners are strongly advised to come to their own conclusions, based on the evidence.
