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Join in with @ADC_JC and become a better doctor

17 May, 16 | by dking

It is a rarely challenged dogma in clinical medicine that the more experienced you are, the better care you provide. The government is pushing for consultants to be in hospital on a more consistent basis over seven days and the RCPCH have a target that all children admitted acutely should be reviewed by a paediatric consultant within twelve hours.

But surprisingly there is no strong evidence in the literature that more experienced doctors provide better care, however that is defined. Indeed, it seems the converse may be true. more…

#ADC_JC: We’re Top 5 Material

26 May, 15 | by Bob Phillips

Shameless, we are. The now world-famous #ADC_JC – an online, Twitter-based, synchronous journal club addressing top articles of relevance to paediatrics & child health, has been Officially Recognised as in the Top 5 of such journal clubs. (Thanks @DrHillyHazel for pointing us to this.)

In this article, a systematic approach to the Twitter stats of such interactive journal clubs was undertaken, and showed that the gang that join in with ADC_JC are the most engaged and interactive of the lot.


Now that makes me pretty sure you’ll want to join in too … so please feel free to drag up a Twitter account, and set yourself, a glass of wine/beer/milk and a copy of the paper under discussion up on a comfortable surface and take part. For those who are unfamiliar with it, have a look at some of the storify links from the ADC_JC main page and maybe step through this tutorial.

See your tweets too, next time on @ADC_JC?

About that ‘normal’ capillary refill time…

28 Nov, 14 | by Bob Phillips

B0u4ZYqCIAAKsOBWell, it might be a few minutes since the last #ADC_JC called time of bile and surgeons, but do you recall all the fury around capillary refill times?

There is a lovely storify from @dralangrayson that tells us about how that expanded and exploded. It was, of course, based on a lovely systematic review and if you’re looking for a refresh on some of the key concepts you can brush up on:

– Look out for another summary coming up soon.

Guest Blog: Sampling bias and randomisation

20 Oct, 14 | by Bob Phillips

The blog series is expanding! No doubt soley inspired by now running the magnificent @ADC_JC, @davidking83 has taken up the challenge of exploring a critical appraisal nugget/thorn in response to an appraisal session.

You too could be part of our team – tweet @ADC_BMJ or find us on Facebook to get in touch – but for now, let’s settle back, imaging the warm smell of pastries and coffee, switch off our pagers and enter the Journal Club…


We were recently discussing a paper in my local journal club at Sheffield Children’s hospital,which was a double-blind randomised controlled trial (RCT) examining the effect of pulse oximetry on the admission rate of infants with mild or moderate bronchiolitis. This is a fascinating paper and well worth a read if you have not already. Essentially, it showed that in infants with mild to moderate bronchiolitis, clinicians are less likely to admit children if their oxygen saturations are artificially raised by 3%.

However, one of the points raised from the journal club was the possible effect of selection bias on the results of the trial. The authors state that the parents of a large number of eligible infants refused to take part and this may have introduced selection bias.

The question was raised as to if this made the study less valid.


The New-Look ADC_JC has arrived

25 Sep, 14 | by Bob Phillips

Bristling with new folk, layered with many layers of intellectual finery, and repeatedly pointed at by folk around the world as an example of high-class education the ancient public school of Eton College has few similarities  with our online, twitter-based, journal club @ADC_JC.

But both began new years, recently, and the Journal Club opened examining the question “Anxious mothers causing anxious babies?

There’s a lovely storify that curates the whole event if you want to re-run with your own thoughts and add comments to the blog post, or relive the hour and revel in your fame.

But what’s the bottom line, I hear you asking? more…

Bronchiolitis. The future? March’s #ADC_JC

4 May, 14 | by Bob Phillips


So – this blog is the beginning of a rather excellent “Storify” summary of the March’s #ADC_JC which debated an RCT examining the use of heated humidified high-flow nasal cannula (HHHFNC) instead of hypertonic saline (HSS) in the management of bronchiolitis in the emergency department.

(For those who don’t know, Storify is a lovely way of capturing social media-based events and giving them a context and a thread … which the moderator of this journal club, @DrAlanGrayson has done beautifully.)

For the real experience, pop over to the full version, but whet your appetites here …


Bronchiolitis. The future?

This is the paper. Thanks to the usual excellent work behinds the scenes by the ADC elves (who I have never met, but I guess they are hard working editorial staff, run ragged by authors and reviewers (sorry, on behalf of us all for the tight deadlines ;-)) it was made open access with plenty of time for a somewhat lively crew to assemble.


This is either a welcome return to the important ground of “hard” science from the “fluffy” human factors and qualitative papers that we’ve covered recently or me taking the easy way out from the more difficult aspects of MedEd. I reckon there’s plenty of room within FOAM for both.


For less-experienced readers, bronchiolitis is a viral illness, classically caused by Respiratory Syncytial Virus, occurring in the under-2 age group and in the winter months. The first “bronchy” cough of the year, usually in late September in the UK, is a clarion call to the children’s doctor and a reminder to order more caffeine – for the apnoeic kids and for the doc, as it may be a long winter of long shifts…

This beautiful illustration, from the wonderful site, shows the bronchioles filling with mucus, which leads to difficulty in breathing.


#ADC_JC discusses a controversial study

16 Jan, 14 | by tessadavis

December’s #ADC_JC looked at a paper suggesting that febrile seizures were linked to the development of ADHD.

Everyone enjoyed getting their teeth into this paper – read the key points (and main criticisms!) in our storify.

Next month will see us examining the role of doctors in end-of-life decision making, happening at 9pm (UK) on Thursday 23rd January. All you need to know about how to join in is posted here (and if you want a quick link to your electronic diary press the GoogleCal button above).

Another #ADC_JC in the bag

11 Dec, 13 | by Bob Phillips

As some of you will be aware from being involved or lurking (nothing Yewtree about that …) the ADC_JC has been a worldwide Twitter phenomenon.

Last month, we looked at Concussion presenting to the ED. The summary and story of the hour is captured brilliantly here :

(splellng mistakes and all).

Next month will see us examining the risk of AHDH after febrile seizures, happening at 9pm (UK) on Monday 16 December. All you need to know about how to join in is posted here (and if you want a quick link to your electronic diary press the GoogleCal button above).

– Archi

October #ADC_JC – can bruise location help us spot physical abuse?

29 Oct, 13 | by tessadavis

October’s #ADC_JC discussed this paper on bruising patterns in children with physical abuse.

Anyone working with children should be on the lookout for physical abuse – but can the number of bruises and the pattern of bruising actually tell us anything?

We were joined by Professor Alison Kemp, one of the study authors and I have storified the key discussion points HERE.

Our next #ADC_JC will be some time in November.  The paper and date will be announced shortly – keep your eye on our landing page, or follow us on twitter to find out.

September #ADC_JC – Those who can, do, those who can’t, teach?

10 Oct, 13 | by tessadavis

Last month #ADC_JC discussed this paper which looked at just how good APLS instructors are at performing neonatal CPR.

You may find the results a little surprising…

But I won’t spoil it for you, read Alan Grayson’s take on it via storify.

Our next #ADC_JC will be on Monday 21st October at 9pm.  The paper will be announced shortly – keep your eye on our landing page, or follow us on twitter to find out.

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