NEJM Publishes Erratum After Social Media Peer Review

I stumbled across this blog post a week ago and thought it was a wonderful example of the way social media can be used to better biomedical science.

The New England Journal of Medicine published an article in June on the prevention of MRSA in the ICU.  The study was very large, 74,256 patients, and the results looked impressive, BUT nobody could get the stats didn’t add up.  The numbers given in the published paper didn’t correlate with the Number-Needed to Treat (NNT)

A blog post on Intensive Care Network posted the following about the stats in the NEJM article:

ARE THE STATS CORRECT?

We were hashing this out in our journal club, but could not get the stats to add up.

If you can PLEASE COMMENT HERE!

The NNT’s of 54 and 181 seem impossibly small, with huge clinical implications.

Please try it yourself; look at Table 3. Frequency and Rates of Outcomes during the Baseline and Intervention Periods, According to Study Group

With bloodstream infection from any pathogen, the Group 1 (standard care) number of events per 1000 patient days is 4.1. With Group 3, the number of events is 3.6 per 1000 patients days. Even taking change from baseline into account and assuming these NNTs have been calcuated AFTER randomization, between Group 1 and Group 3, we get nowhere close to their NNT’s.

PLEASE have a go and see if you can match their NNT’s.

IF you can’t there is a serious problem, with practice changing implications.

It’s too late to write letters to the NEJM, so a robust discussion in a peer reviewed forum seems a good way to go.

 

The authors of blog post intention was to discuss the problem in “a peer reviewed forum” and according to them “there was lots of insightful commentary from around the globe.”

The fact that they were able to discuss problem with others around world is big but not unheard of, more and more scientists are discussing issues online.  To me the biggest thing is that the paper’s lead author, Susan Huang engaged in a discussion with the social media reviewers with a “prompt and gracious reply” agreed the published calculation was an error and showed “true scientific and academic integrity by contacting the NEJM as soon as there was a suggestion that the stats were incorrect.” NEJM responded by publishing an correction to the paper.

It is very cool how scientists discussed online a paper’s validity and work together to essentially provide world wide peer review.  However, what I find even cooler is that the author was engaged with the social media process AND a respected journal addressed and responded to the findings.  This is an example of everything that is right with social media and professional communication.  It will be interesting to see if we will see more of this type of world peer review in the future especially now that  PubMed Commons can also foster this kind of scientific inquiry and discussion.

NEJM is a big journal with lots of very smart authors contributing papers that are subjected to very peer reviewers, but still there can be mistakes.  World peer review via social media could help improve the process.  One question I keep wondering is, if we have this type of world peer review, could this cut down on the academic fraud that sometimes eludes the careful eyes of publishers’ peer reviewers?  What would have happened had Wakefield’s fraudulent study linking vaccines and autism (published in 1998) been published today?  Would that paper have had a chance to make it the general public’s consciousness and be as unfortunately influential as it still is today?

 

CE Stipends for Midwest Librarians

The Midwest Chapter’s latest membership survey indicated a need for better access to continuing education.  What could  help with better access than a stipend for CE?!  The Board of the Midwest Chapter has announced that two $125 stipends are availalbe for 2014 to help fund library skills and CE attendance.

How do you get this stipend!?

  1. Be a Midwest MLA member.
  2. Send email to nreedx[atsign]midwestern[dot]edu to be entered in the drawing for it.
  3. The email must have your name, postal address, and whether you are a solo librarian or not.  (Indication of solo librarian is not used for determining the winner, just for statistics and to help determine the need for future funding.)

EASY PEASY!

All names will be put in a hat and one lucky winner will be drawn and announced Feb 3, 2014.  A call for a new drawing will happen in June and that winner will be selected July 1, 2014.

An individual will only be eligible to win once/year.

 

The Future of Libraries: Free Discussion

American Libraries Live will be hosting a panel discussion on the challenges and changes within the libraries for the near and distant future.  It is Thursday January 9, 2014 at 2:00-3:00 Eastern.  It is FREE to register and “attend” the discussion.

David Lee King, digital branch and services manager at the Topeka & Shawnee County Public Library will lead the panel which also includes:

  • Marshall Breeding, Library Technology Consultant, Speaker and Author
  • Buffy Hamilton, Librarian at Norcross High School in metropolitan Atlanta, Library Technology Writer and Speaker
  • Bohyun Kim, Digital Access Librarian at Florida International University Medical Library
  • Joseph Murphy, Director of Library Futures, Innovative Interfaces

 

Register for this episode so you get email reminders at http://goo.gl/1p5dpV .

Preregistration is not required to attend. You can also attend by simply going to the site at the time of the event. If you’re unable to attend live, it will be recorded and available at http://www.americanlibrarieslive.org shortly afterwards.

Innovative Interfaces is sponsoring this episode. AL Live is the popular free streaming video broadcast from American Libraries, covering library issues and trends in real time as you interact with hosts via a live chat and get immediate answers to your questions. With the help of real-time technology, it’s like having your own experts on hand. Find out more, including how to catch upcoming episodes, at  http://www.americanlibrarieslive.org .

 

Future 2014 broadcasts will be:

  • February 13: The Library Website
  • March 13: E-Books: The Present and Future
  • April 10: Copyright Conundrum

 

Sounds interesting.  While they don’t have an medical librarians, I’m sure there will be something that will also apply to us.  Since our ILS is an Innovative Interfaces system, I am curious as to what Joseph Murphy of Innovative has to say.  I often think integrated library systems including Innovative’s are overly complicated and fail to address typical user needs. I am also interested in the March 13th E-Books discussion but I fear this will be more public library related and less related to the unique mess the medical publishers have created.

 

Librarians, Welcome to the New Age

Perhaps I have been listening to my son’s music a bit too much or perhaps I am just overly tired from celebrating the New Year with friends and family.  Whatever the cause, when I heard Imagine Dragon’s “Radioactive” this morning it really hit a my librarian brain.

Granted, the lyrics have a post apocalyptic vibe to them that is more akin to Walking Dead or Terminator than the state of libraries. But it just hit a chord with me this morning.  I feel like we are in a new age of information and completely revolutionizing the way people find things.  Things have completely changed, and are still changing. The old way of doing things (the old world) is gone. We are waking up to the new age of information.

Just to prove I am not completely cracked (only half cracked), the singer, Dan Reynolds said the “song is about having an awakening; kind of waking up one day and deciding to do something new, and see life in a fresh way.”  We have to see librarianship in a fresh way if we are going to continue.

According to Reynolds, “A lot of people hear it [Radioactive] in a dark way.” The song is meant to be an empowering song, and I definitely hear it that way.  The changes in libraries can be empowering as well. Like music, it is all up to interpretation. Some may “hear” the library changes in a dark way.  Some may “hear” the changes as an anthem to wake up and do something new in the wake of all the changes.  They will end up shaping their world the way they hear the changes.

To quote a favorite line, “there’s no fate but what we make.”

 

 

Congratulations to All

MLA Focus just emailed the election results and I want to congratulate the new Board Members and Nominating Committee.  But I want to steal a quote from Nikki Dettmar which summarizes my thoughts completely.

Nikki was on the Nominating Committee that help select the people on the ballot this year.  As she mentions below she is on her NomCom13 Soapbox.

“<Spontaneous Me-on-NomCom13 Soapbox>Yes, a very hearty congrats to those who were elected to Medical Library Association positions! HOWEVER, I would like to offer an even warmer expression of gratitude to all those who were NOT elected: Both those who were actually on the ballot, and those who responded in the affirmative to our initial inquires about willingness to BE on the ballot. For as often as I have heard so many in our field bitch & moan about how ‘MLA needs to do something about…’ YOU WERE WILLING TO! And I hope you don’t stop just because it didn’t work out this time. Now join in the #medlibs chat at the top of the hour about our future. Peace out. </Spontaneous Me-on-NomCom13 Soapbox>”

Nikki you said it perfectly that I have no better way to express it other than to re-post it on my blog (for those of you wondering, yes I did ask her permission).

The greatest way to get MLA to do more or to change is for you to volunteer and do something.  Don’t sit on the sidelines or be a back seat driver!  Get out take charge and shape the organization.  For all the medical librarians who aren’t members of MLA but also complain that MLA doesn’t help them and that is the reason they aren’t members…..  I have one thing to say…. PTTHBBBBBBB! What have you done to change that?! What have you done to shape MLA?!

That is why I want to join Nikki and thank EVERYBODY who was on the ballot or who agreed to be nominated to be on the ballot, because they were willing to step up and take action. Keep it up!

Friday Fun: Happy Holidays

I do not plan to post next week because I will be spending time with the family and because I assume most of you will be doing the same and won’t be thinking of reading a blog about medical library stuff.

So I wanted to wish everyone a Happy Holidays and New Year.  I will leave you with this fun little library holiday cartoon.

Santa just might be a librarian. Dude already has some mad indexing and database skills if he has been able to maintain a list of the world’s naughty and nice children.

Santa just might be a librarian.

 

 

 

 

 

 

 

 

 

 

 

Perception of Libraries

I heard someone say, “Change the way you look at things and the things you look at change.”  This is easier said than done, especially for librarians.  The results from the Pew Internet and American Life survey “How Americans Value Public Libraries in Their Communities” were recently released.  I have seen many in the library world praising what are definitely good results. Such as:

  • 95% of Americans ages 16 and older agree that the materials and resources available at public libraries play an important role in giving everyone a chance to succeed
  • 94% say that having a public library improves the quality of life in a community
  • 81% say that public libraries provide many services people would have a hard time finding elsewhere

These are definitely things to be proud of.  However, there are some statistics that concern me and I don’t seem to be hearing about them from the library world as much.

  • 52% of Americans say that people do not need public libraries as much as they used to because they can find most information on their own, while 46% disagreed.
  • 54% of Americans have used a public library in the past 12 months
  • 77% of those who have ever used a public library said they know only some of what it offers.  (Of that 77% about one in five say they don’t know very much about what is offered, and 10% say they know “nothing at all.”)

If 94-95% believe libraries are so important then why have only 54% used a library in the last year?  Doesn’t quite make sense.  So while people love their libraries, they don’t know much about their offerings and they don’t use them very often.

This is frustrating because it seems as though people like the idea of the public library as it exists in their heads, but have no idea what it does in practice.  Sounds familiar medical librarians?  I think in order for us to survive we have to do a better job of changing their perception of the library.  Thankfully they like us….but liking us isn’t going to get the tax levy renewed or the keep administration from cutting our budget.  We need to do a better job of demonstrating to our users and non-users how we can help them.  Informing users is tricky enough, but non-users…yikes!  But that is needed for us to turn the perception of a library and the know more about our other services and resources (not just that we have books).

This Thursday #medlibs will discuss the what we see coming to libraries in 2014 and beyond. What is the future of the library?  What do we need to do and where will be going?

Some ideas for the discussion are:

These are all important things to consider, but I also believe part of our future rests with changing perceptions.  If we don’t do that we are going to be the Norman Rockwell of professions. Nice to remember, or as somebody on Twitter said,  “an emotional remembrance.”So tune in on Thursday http://medlibschat.blogspot.com/ as we discuss the library of the future.

Needed: Projects for MLA Rising Stars

While the official deadline has past, MLA is still looking for projects to match with Rising Stars.  If you have ideas or would like to mentor a Rising Star for a project you are working on please contact MLA.

Rising Star Host/Mentor Application Information and Form

The MLA Rising Star program has been developed for MLA members who are interested in attaining leadership roles in MLA but who have not yet become active at a national level. The one-year leadership development program matches each Rising Star with a mentor in a curriculum that includes:

  • learning how MLA succeeds through the volunteer efforts of its members;
  • the roles of the MLA Board and staff; and
  • project management skills applied to an actual MLA project.

To get an idea of the kind of projects Rising Stars do, here is a list of the most recent Stars, Menors and their projects.

  • Rising Star: Heather L. Brown
    Mentor: Julia Shaw-Kokot, AHIP
    Project: Work with a Chapter Council team to implement recommendations for interactive web features in the communications plan drafted by 2010 Rising Star Karen L. Hanus, AHIP.
  • Rising Star: Elizabeth V. Fine
    Mentor: Diane G. Cooper, AHIP
    Project: Work with the Federal Libraries Section web committee to evaluate the section’s website.
  • Rising Star: Rolando Garcia-Milian
    Mentor: Mary Riordan, AHIP
    Project: Work with the Awards Committee to increase the number of nominations for MLA awards.
  • Rising Star: Kristi L. Holmes
    Mentor: Jerry Perry, AHIP
    Project: Serve on and work with the Task Force on MATE.
  • Rising Star: Annabelle Nunez
    Mentor: Nancy Allee, AHIP
    Project: Work with the Leadership and Management Section’s New Members/Emerging Leaders Survey Project

For more information on past projects and Stars go here to see a longer list.

So if you are a Section or Chapter leader and you have something you have been working on and would like to have a Star work on the project with you, contact MLA ASAP!

Killing Cows: #Medlibs Summary

Last Thursday a group of medical librarians got together online via Twitter to discuss the issue of change in libraries.  Specifically they discussed evaluating the sacred cows in libraries and librarianship within our institutions and whether they should be continued (successful programs) or killed (unsuccessful programs).

I thought I would briefly summarize the discussion for those who were unable to participate. Transcript is available here.

We had 30 people who participated in the chat and each participant tweeted an average of 11 tweets.  (Lively discussion.)

In an effort to set the tone or get some context for the discussion. Nikki Dettmar (@eagledawg) reminded us of Mark Funk’s (@funkme77) 2008 Presidential Address, where the gist, “We Have Always Done It That Way” is not the way we want to continue the business of libraries.

Several librarians gave examples of sacred cows they have either killed off or would like to kill off in their libraries.  These include:

  • Reference desk
  • Checking in hard copy journals
  • The catalog and cataloging
  • Regularly scheduled classes
  • Face to face classes
  • Table of contents lists
  • Reference collection
  • Printed books

Many had various thoughts on each of the above topics.  For some getting rid of the refernce desk was a sacred cow that was killed or needed to be killed. However, for others, their library’s reference/front desk was still doing a brisk business and killing it would be unwise.

The topic of cataloging while a lively topic at other discussion venues didn’t draw as much ire or skepticism.  Several thought small hospital libraries with solo librarians may want to re-consider the idea of an online catalog in favor of something easy, agile, and less time consuming.  Almost everyone agreed that the act of cataloging could be done much more quickly and simply that librarians stop fussing with minute details of cataloging and look at user tagging/catalgoing. Tony Nguyen (@TonyNguyen411) mentioned he was “Totally ok with collective cataloging. Original, just the easiest access points to get it quickly on the shelf.”

The rise of electronic collections caused many in the group to discuss alternatives to book and journal purchasing, collection development and management.  Teressa Knott (@tlknott) mentioned their circulation numbers has caused her to start thinking of a “strictly e-book collection.”  I mention how our institution got rid of our reference section.  Reference books were shelved next to the circulating collection.  Patrons don’t have to go to different shelves or locations within the library to find books on a topic depending on the book’s loan rules (which patrons don’t know).  All of the books are together making them easier to find.  A red dot on the spine indicates the book doesn’t leave the library.

The library classes seemed to be a bit of a problem among the #medlibs librarians.  As Amy Blevins (@blevinsa) stated, “(I) have mixed feelings about schedule classes. Love them when people randomly show up. Not so much when 0 show.”  This seems to a problem shared by several in the chat.  There were some librarians who got rid of their scheduled classes and only taught classes by appointment while others tried to get rid of them but had to bring them back because “admin wants to bring (them) back b/c other AAHSL libs do it.” I am not sure whether Stephanie Schulte’s (@s_schulte) referrence to admin was institutional administration or library administration.

In the second half of the hour the discussion seemed to venture away from the library and on to the profession itself and sacred cows within the profession such as:

  • The name librarian
  • Associations, organizations, societies, and certifications
  • Academic journals
  • Impact factors
  • Peer review

Besides our job title of librarian, I’m not sure how much impact we have in with the other sacred cows within the profession.  Additionally there were many that said the issue wasn’t the title of “librarian” but it was people’s out dated notions of librarians.  The issue of librarian vs. informationist, vs PubMed Whisperer, vs information specialist is probably a larger issue that could be discussed on another Thursday.

Overall it was a very interesting and fun discussion.  I challenge all librarians, not just the 30 on the chat, to think about our sacred cows.  I want to quote Mark Funk’s last Presidential blog post, “Remember that ‘We have always done it that way’ isn’t an answer, it’s an excuse. Boomers didn’t like that response in the 1960s, and we shouldn’t like it now.”

#Medlibs Killing Cows

Join us tomorrow for what is sure to be a lively discussion on killing sacred library cows on #medlibs this Thursday at 9pm Eastern.

As I mentioned in my post on the #medlibs blog

The library environment has changed drastically and is continuing to do so.  The library of 5 years ago is different from the library today.  For example, the iPhone had just been released, there were no iPads and the idea of a “downloadable” ebook had just been introduced by Amazon Kindle.  There were a very limited number of Kindle and certainly not intended for medicine. Yet many of us are doing the same things we did as librarians 5, 10, 15, 20 yrs ago.  We were stretched thin back then, so there is no way we can now add things to our repertoire without giving up something in return.  We must look at what we do in our own libraries and evaluate whether it is necessary, whether it helps our patrons or helps us.  To really evaluate our services we need to look at EVERYTHING including the sacred cows of the library.  We need to ask ourselves, do we need to check in journals, catalog books, make copies, eliminate the reference desk, fuss with circulation, etc.  The right answers will depend on the library. A large academic library might need to still do cataloging but does a small solo hospital library with 4 shelves (not ranges) really need a catalog system much less spend time cataloging books?  Some of these ideas are dangerous and even somewhat heretical librarian thinking, but I feel we need to discuss them.  For more background on sacred cows and heretical librarian thoughts check out my summary of my keynote address I gave at the Midwest Chapter annual meeting.

 

We need to look at, evaluate and slaughter some sacred library cows.  IT makes no sense for us to spend our time doing things that are no longer relevant or used by our patrons.  That isn’t to say that we should have never done them. Everything has its time and place.  It might be hard to give up, but we can’t just do things because we always have.  We need to think like our patrons and for many of us that means completely taking off our librarian hat and looking at ourselves from a patrons view point.  That may mean we come up with answers that are uncomfortable, that borderline on librarian heresy.  But that is what is needed.

This Thursday’s #medlibs discussion at 9pm Eastern will discuss the idea of thinning the herd of library services so that we can grow healthy new opportunities.

Molly Knapp (@dial_m), Amy Blevins (@blevinsa) and I (@krafty) will be moderating the discussion.  As always we will be using the hashtag #medlibs but if you want to further the discussion before/during/or after the regular Thursday night time use the hashtag #moo.