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Desert Island Texts: The ACP Journal Club

I cannot clearly remember the rules about the type of written material that the castaway is allowed to take to his desert island and do not therefore know if a subscription to a journal is allowed, but if I could take a journal subscription with me then I would undoubtedly choose the ACP Journal Club.

The ACP Journal Club's general purpose is "to select published articles according to explicit criteria and to abstract those studies and reviews that warrant immediate attention by physicians attempting to keep pace with important advances in the treatment, prevention, diagnosis, cause, prognosis or economics of disorders managed by internists". These articles are summarised in "value added abstracts" and commented on by clinical experts.

Each page of the journal contains an abstract and a commentary, often with additional references. The author of the original article is shown the commentary and asked if they want to respond.

The journals covered are the main general medicine journals and the ACP Journal Club is published every two months. There is often a very useful editorial on topics such as "how to harness MEDLINE for aetiology problems".

Not surprisingly much of the intellectual firepower for the journal derives from McMaster University in Ontario and the Editor is Brian Haines, with the Editorial Office being in the Health Information Research Unit in McMaster's Department of Clinical Epidemiology and Biostatistics.

One of the most useful features of the ACP Journal Club is the way in which the abstracts are titled. Although the abstracts are short, succinct and readable, a survey of readers shows that some readers still only read the conclusions or the last sentence of the conclusions, so the last sentence has been turned into the title, providing very practical and easy to read titles; for example, an abstract of a trial of omeprazole states that "omeprazole was better than H2 antagonists in reflux oesophagitis".

The titles elegantly allow one to distinguish between a systematic review and a clinical trial. Clinical trial titles are summarised in the past tense, as epitomised in the omeprazole title. Abstracts of systematic reviews, which summarise the present state of knowledge on a particular topic, are given titles in the present tense, for example "anticoagulants and anti-aggregants prevent strokes in high risk patients".

The ACP Journal Club is wonderful and I would like to take it to my desert island. An agonising choice may, however, face me in 1995 because the British Medical Journal intends to launch a European Journal of Evidence-Based Medicine, about which Bandolier will write in the near future. Which one should I choose? Can I have both? Can I have either? Surely the desert island will be an evidence-based health care service, if only to ensure evidence-based self care.

J.A. Muir Gray



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