Clarity and strength of implications for practice in medical journal articles: an exploratory analysis

Abstract

ObjectiveTo examine how leading clinical journals report research findings, aiming to assess how they frame their implications for medical practice and to compare that literature's patterns with those of the management literature.Data SourceClinically relevant research articles from three leading clinical journals (N Engl J Med, JAMA, and Ann Intern Med).MethodsReview of wording of a sequential sample from 2010, with categorisation, comparison among journals, and comparison with management literature.ResultsClinical journals usually state that one approach did or did not differ from another approach (35 of 51 articles, 68.6%), but they recommended a specific course of action (‘therefore, x should be done’) in just 25.5%. One article gave instruction on how to implement the changes. Two-thirds of the reports called for further research. Half used tentative language. Management research articles nearly always specified who should use the information and drew from over 60 types of potential users, whereas the clinical literature named the audience in only 23.5% of clinicians.ConclusionsAuthors and editors of the clinical literature could test being more clear and direct in presenting implications of research findings for practice, including stating when the findings do not justify changes in practice.

Independent discussion sections for improving inferential reproducibility in published research

“…37 If the Discussion were demonstrably reproducible with this parallel approach, the credibility of the implications for medical practice would be enhanced, and suggestions regarding whether or not the findings of a study warranted a change in clinical care. 38 Conversely, a divergent second Discussion would represent a challenge to inferential reproducibility that might prompt a cautious re-evaluation of the original interpretation. Table 2 Continued with a low severity of illness score also demonstrated no beneficial effects.…”

So what? Now what? Exploring, understanding and using the epistemologies that inform the improvement of healthcare

“…Joanne Lynn and colleagues, in Clarity and strength of implications for practice in medical journal articles: an exploratory analysis , empirically examined two literatures for practitioners—clinical and management—and found two different norms for recommending action. 13 The majority of original articles from three leading healthcare clinical journals (68.6%) simply stated that one intervention was (or was not) different from another in its effects. Reports in these journals directed a particular action (‘therefore, x should be done’) only 25.5% of the time.…”

Key messages are essential tools in communicating your topic

“…Anne Lynn, Allessia Owens and Jean Bartunek have recently explored how three journals ( New England Journal of Medicine, JAMA, and Annals of Internal Medicine ) frame their implications for medical practice 2 . They found that just 25% of the articles they reviewed recommended a specific course of action.…”

“…The issues raised by Lynn et al. 2 and Fleischacker et al. 3 were echoed in feedback received with HILJ when it canvassed its editorial advisory board and members of the HLG committee and discussion list.…”

“…The issues raised by Lynn et al 2 and Fleischacker et al 3 were echoed in feedback received with HILJ when it canvassed its editorial advisory board and members of the HLG committee and discussion list. Respondents felt that key messages were a very useful component of articles and said they made a point of reading them.…”