Journal Club PAD

February Journal Club Articles -Aortoiliac Occlusive Disease

Congratulations to Dr. Moqueet Qureshi who gave the best presentation at the January journal club. It was a close one as all the presentations were excellent analyses of their papers. This months journal club presenters are:

Dr. Daniel Lopez: paper link -Humphries et al. Outcomes of covered versus bare metal balloon expandable stents for aortoiliac occlusive disease. JVS 2014;60:337-44.

Dr. John Weber: paper link -Aihara et al. Long term outcomes of endovascular therapy for aortoiliac bifurcation lesions in the Real-AI Registry. J Endovasc Ther 2014;21:25-33.

Dr. Michael O’Neil: paper link -Vallabhaneni et al. Iliac artery recanalization of chronic occlusions to facilitate endovascular aneurysm repair. JVS 2012;56:1549-54.

The Journal Club will start at 6:30pm, congregating at 6pm for conversation, dinner and beverages, at the Foundation House, Cleveland Clinic and Foundation.

Journal Club

January 2015 Journal Club

Congratulations to Dr. Francisco Vargas for his December Journal Club presentation. January’s club meeting will be on the 20th.

Dr. Moqueet Qureshi: Open vs. Endo Popliteal Artery Aneurysm Repair

Dr. Deanna Nelson: VIASTAR Trial

Dr. Hazem El-Arousy: Cryografts in Infrainguinal Bypass

Journal Club

Journal Club Reformat

Screenshot - 12222014 - 07:54:40 AM

The December Journal Club was held last week with excellent attendance. The winner of the best presentation prize was Dr. Francisco Vargas who critiqued the CaVent trial. Many thanks to Leo Godlewski of Hanger Orthotics for sponsoring the club’s evening.

The score sheets had a misprint in the scaling factor. The scaling factor is highest for the substance of the critique (x3) and the next highest is the presentation substance (x2). Scoring was corrected for this.

To emphasize the importance of an in-depth understanding of the paper being presented and to keep the journal articles topical, the rules are being modified. First, the selected journal has to come from the past two years. The second modification is that every presentation has to end with a table of related or similar papers and their conclusions or results. These should be a listing of landmark papers or first of its kind papers, and the discussant should be prepared to comment on them. If there are too many papers, the discussant should be prepared to discuss a few landmark papers on the topic or discuss a meta-analysis or Cochrane review article on the topic.

The presented paper should be graded on the following scale:

  • Level 1 – High Quality – Randomized controlled trials with high power. Meta-analyses of multiple RCT’s.
  • Level 2 – Moderate Quality – Evidence from one well designed experiment. RCT’s with low power. Prospective cohort study.
  • Level 3 – Low Quality – Evidence obtained from well-designed, quasi-experimental studies such as non-randomized, controlled, single-group, pre-post, cohort, time, or matched case-control series.
  • Level 4 – Very Low Quality – Evidence from well-designed, non-experimental studies such as comparative and correlational descriptive and case studies. Evidence from case reports and clinical examples. Expert opinion.

Also, in the critique, a recommendation should be made and this recommendation also graded with the following scale:

A The USPSTF recommends the service. There is high certainty that the net benefit is substantial. Offer or provide this service.
B The USPSTF recommends the service. There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial. Offer or provide this service.
C The USPSTF recommends selectively offering or providing this service to individual patients based on professional judgment and patient preferences. There is at least moderate certainty that the net benefit is small. Offer or provide this service for selected patients depending on individual circumstances.
D The USPSTF recommends against the service. There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits. Discourage the use of this service.
I The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the service. Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined. Read the clinical considerations section of USPSTF Recommendation Statement. If the service is offered, patients should understand the uncertainty about the balance of benefits and harms.
Journal Club

December Journal Club

The November Journal Club was held with great attendance from the staff. Dr. Roy Miler was awarded the prize for most symposium-ready talk. December Journal Club will be held December 16, 2014 at Foundation House. The topic is thrombolysis, which has a rich history here at the Clinic. The papers to be discussed are:


Xiaoyi Teng, MD: Freischlag vTOS lysis

Lynsey Rangel, MD: TOPAS NEJM

Francisco Vargas, MD: CAVENT Trial

Journal Club

November Journal Club


November Journal Club is going to be on November 11, 2014, at the Foundation House. The October session was well attended and excellent discussion was had on the INSTEAD-XL, EVAR-1, and 3 year duplex surveillance papers. David Hardy, MD, won the prize for best presentation, a fine text book from our sponsors, WL Gore. The papers to be discussed and discussants are listed below for the November Journal Club which will be earlier than usual because of the Thanksgiving holiday and the VEITH Symposium.

Deanna Nelson, MD – ACAS link

Roy Miler, MD –Carotid stenting versus redo CEA link

Daniel Lopez, MD –Contralateral occlusion impact on carotid interventions link

Our sponsor for that club is yet to be determined, but the club rules remain the same, particularly the 15 slide limit.


Journal Club

October Journal Club

June 2014

October Journal Club (October 21, 2014) is approaching. The papers chosen by the presenters are linked below. Please refer to the club format and rules, also attached.

Guidelines for Journal Club

Journal Club 2014-2015


D. Hardy – Endovascular Repair of Type B Aortic Dissection

H. El Arousy – EVAR v Open

D. Virvilis – evarsurveillance3years

Scoring Sheet

Journal Club

Paper reading 101


The reading of papers can be just that -a passive run through received wisdom, or a critical exercise that can mean life or death when it comes to the medical literature. Dr. Mastracci last year did a wonderful thing by offering a few papers on how to judge the evidence. What the critical reader does is akin to what a pawn broker does when a purchase is considered. There are objective criteria, qualitative criteria, and the gut feeling of value. Do not discount the last, but apply the first because not all that shines is gold.

BMJ -how to read papers

Medscape link

OSU link

article cohort studies

cohort studies 2

stats article link