Miller AH, Nazeer S, Pepe P, et al Acutely Decompensated Heart Failure in a County Emergency Department: A Double Blind Randomized Controlled Comparison of Nesiritide Versus Placebo Treatment

 SEE RELATED ARTICLE, P. 571.

 Editor's Note: You are reading the third installment of Annals of Emergency Medicine Journal Club. This bimonthly feature seeks to improve the critical appraisal skills of emergency physicians and other interested readers through a guided critique of actual Annals of Emergency Medicine articles. Each Journal Club will pose questions that encourage readers, be they clinicians, academics, residents, or medical students, to critically appraise the literature. Answers to this Journal Club will be published in the October issue.During a 2- to 3-year cycle, we plan to ask questions that cover the main topics in research methodology and critical appraisal of the literature. To do this we will select articles that use a variety of study designs and analytic techniques. These may or may not be the most clinically important articles in a specific issue, but they are articles that serve the mission of covering the clinical epidemiology curriculum.Journal Club entries will be published in 2 phases. In the first phase, a list of questions about the article will be published in the issue in which the article appears. Questions are rated “novice,” () “intermediate,” () and “advanced” () so that individuals planning a journal club can assign the right question to the right student. The “novice” rating does not imply that a novice should be able to spontaneously answer the question. “Novice” means we expect that someone with little background should be able to do a bit of reading, formulate an answer, and teach the material to others. Intermediate and advanced questions also will likely require some reading and research, and that reading will be sufficiently difficult that some background in clinical epidemiology will be helpful in understanding the reading and concepts.The second phase of each journal club consists of the publication of suggested answers. This will be done 5 months after the publication of the questions. However, residency directors can have immediate access to the answers for the purpose of guiding the journal club. US residency directors can access the answers through the Council of Emergency Medicine Residency Directors Share Point Web site. International residency directors can gain access to the answers by going to http://www.emergencymedicine.ucla.edu/annalsjc/ and following the directions. Thus, if an actual journal club is conducted within 5 months of the publication of the questions, no one will have access to the published answers except the residency director. The purpose of delaying the publication of the answers is to promote discussion and critical review of the literature by both residents and medical students and discourage regurgitation of the published answers.It is our hope that the Journal Club will broaden Annals of Emergency Medicine's appeal to residents and medical students. We are interested in receiving feedback about this feature. Please e-mail journalclub@acep.org with your comments.This is the first journal club in our series that considers a randomized controlled trial (RCT). For that reason, we include some basic questions about this fundamental study design. We will cover other topics about RCTs in future installments. Those planning a journal club should note that although 1a is a novice question, it requires a substantial amount of work to answer. This task could be divided among several participants.

PII: S0196-0644(08)00600-8

doi:10.1016/j.annemergmed.2008.03.008

© 2008 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.