Clinical investigation in intensive care. One step forward, two steps back

International participation in major intensive care journals. "The smaller the better"

OBJECTIVE

This study seeks to assess the scientific contributions in the field of intensive care medicine from each of the major countries (per million inhabitants) and discusses the possible factors which may contribute to any differences.

DATA SOURCE

Review of scientific journals.

STUDY SELECTION

We examined the total number of published papers (between 1989 and 1993) in five major respiratory and intensive care journals: Intensive Care Medicine, Critical Care Medicine, Chest, The American Review of Respiratory Disease, and Circulatory Shock.

DATA SYNTHESIS

Amongst the American journals, USA and Canada were the predominant contributors followed by the other countries in the following order: Switzerland, Sweden, Belgium, the Netherlands, Finland, Austria, Denmark, UK, France, Spain, Italy, Norway, Japan and Germany.

CONCLUSIONS

The present study reveals that the smaller European nations have a greater participation than the larger European nations in the major intensive care journals. This phenomenon could be due to different submission practices in these countries compared with the larger European countries, where a considerable number of papers are submitted to local renowned journals. There was no absolute correlation between a nation's gross national product and the total number of publications.

Evidence based critical care medicine; what is it and what can it do for us? Evidence Based Medicine in Critical Care Group

OBJECTIVE

To describe the philosophy and approach to patient care called evidence based medicine, and to highlight how it can enhance the practice of intensive care.

DATA SOURCES

We searched MEDLINE, reference lists, and our personal files to identify relevant literature.

STUDY SELECTION

Articles on intensive care practice, critical appraisal, clinical research, and healthcare delivery were selected for discussion.

DATA SYNTHESIS

We summarize the rationale for evidence based medicine, its applications and future developments, and suggest several methods for intensivists to use evidence based medicine in their practice and teaching.

CONCLUSIONS

Evidence based medicine can complement other foundation disciplines in intensive care. This is the first article in a series entitled "Evidence Based Critical Care Medicine" which will demonstrate how this approach can be used at the bedside.