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Welcome to the World Shared Practice Forum. I'm Dr. Jeff
Burns, Chief of Critical Care at Boston Children's Hospital and
professor at Harvard Medical School. I'm very pleased to have
with us again for part two of our visit with Dr. Robert
Tasker. Dr. Tasker, as you all know, is Editor-in-Chief of
Pediatric Critical Care Medicine. He also has academic
titles at Boston Children's Hospital and Cambridge
University in the UK. He is professor of anesthesia and
pediatrics at Harvard Medical School and founding chair in
neurocritical care at the Department of Anesthesiology,
Critical Care and Pain Medicine at Boston Children's Hospital
and he is college lectureship in medicine and postgraduates tutor
fellow at Selwyn College, Cambridge University in the UK.
Robert, thank you for coming back for part two. In part one,
you shared with us some really fascinating data about the
journal and in particular articles that were highly cited
in 2021 in the journal. Can we go to 2022 and let's do the same
review. What were the notable articles, either by citation or
by Altmetrics? What are people talking about? And of course, as
we're recording this, today it's early October, so the year is of
course not completed. What should we know about what's been
published in 2022?
Thank you, Jeff. It's a pleasure to be here again. I can talk
about the first six months. It is too early to tell from
citations, although I'm getting some data on citations. But
we're very much led by what have people latched on to in terms of
talking about and letting other colleagues know about? So as I
mentioned, last time, we use the Altmetrics score, and anything
above 30 In PCCM is doing really well. So January 2022, what are
people talking about? They're talking about the consensus
summary and recommendations from the transfusion practice and
control stroke avoidance of bleeding guidelines, the so
called TAXI-CAB. That had 62 on the Altmetric score. So really
good. February 2022, what are people talking about? They're
talking about the SCCM clinical practice guidelines on
prevention and management of pain, agitation, neuromuscular
blockade and delirium and consideration of the ICU
environment and early mobility, the so called PANDEM guidelines.
Wait for it, the Altmetric 253. This has gone everywhere. So
that's done really well. It has beautiful summary tables and
illustrations, and something like a 300 page supplemental
file just filled with useful things to know and help
practitioners. So a lot of material there, and it's all
open. March 2022, this is a narrative essay, Altmetric score
57. Maya Dewan writing a narrative essay on "I Cannot Let
It Go". And it's about her reflections and experience in
COVID 19. Again, you know, readers are eclectic in their
interests, and well worth looking closely at because lots
of our supporters and readers are looking at it. April 2022,
last year, I invented a new format. What I wanted was
authors to provide for me a concise clinical science review
or a concise clinical physiology review. So short text, maybe a
couple of 1000 words, one huge illustration covering a page.
It's an idea borrowed from the NEJM type of basic science
review. Well, we have our clinical science review, and in
April, a group from SCCM and PALISI, and BloodNet wrote about
MIS-C and host immunological responses Altmetric score 191.
If you haven't seen it, do have a look at it, and I'd encourage
people to look at it. May 2022, another format that I sort of
reintroduced, which is the technical note. This is a
technical note about real time ultrasound guidance for
umbilical venous cannulation in neonates with congenital heart
disease. And it comes from two hospitals in Pennsylvania. And
the idea that when the authors first submitted this, the idea
that I suggested to them was tell us how you did it and give
us some illustrations of how you do this. And so it's beautifully
illustrated, but as well as that tell us about the process that
you go through at your hospitals for introducing a new technique.
What are the checks and balances within your hospitals for doing
something like this? And how do you go about training your
colleagues and your trainees in doing this technique, and they
took it on board. And that's the article that we've got. So it
doesn't surprise me that everyone's talking about it,
Altmetrics of 51 in May. And then finally, in June, we had a
feature article that had an Altmetric of 79. And this was a
prospective cohort study on blood sampling and the impact of
that on anemia in the PICU prospective cohort study. And
it's a theme of research. This, I believe, is coming from
Canada. So we're seeing more from these groups. So that's,
that's where we are in the first six months. And there are more
surprises coming later on.
Really terrific. Well, Robert, as you list each interesting
article, I just find myself thinking I gotta go home and
look at that. So I know, as an editor, you're preparing
journals, three months or so in advance, and all the material
that's made it into PCCM right now is valuable, and we look
forward to all of it, especially as PCCM has become more
competitive to publish in. That said, is there anything you
could share with us about what's coming in October, November and
December in those issues of 2022, of course?
You know, Jeff there's lots of things coming out. Some people
may have seen some of the material already, because before
a journal makes it into a particular issue, or print or
ePages, some of these will have been posted on the web and into
PubMed already so called ePub ahead of print. So people will
get an idea of what's going on. Part of what I like to do
though, with a journal issue is actually construct what I think
would be a good read as a generalist taking all materials
together and trying to make connections between articles
that are within a particular month. So you know, what's going
to be your read for October, November, December, it seems as
though a CPR resuscitation theme is picking up in the last three
months, use of knocked over use of epinephrine as a flat dose or
per kilo dosing, use of sodium bicarbonate, what about calcium.
So we'll see a large studies on that. There's the whole topic of
decision making and moral distress. We've had a theme
about decision making at the time of initiating ECMO that has
run through the year, where we have an article from Italy on
moral distress, and we have an article about ECMO in patients
with disability and their outcomes. Then another theme
that's gathering momentum is outcome measurements and a core
data set and what we should be doing about outcomes. So we're
seeing information from outcomes in MIS-C cases, we're seeing
outcomes in sepsis and modeling various parameters that may
influence that. Other themes, we have a great nursing research
prioritization article using a Delphi approach that's coming
from the Asia and Oceania groups. For some reason, we seem
to be seeing a lot of articles about tranexamic acid and trauma
and pre-hospital administration. I mention this, because we've
got probably three or four articles talking about an
emergency department or pre-hospital and PICU continuum.
And we have an editorial from Children's Hospital of
Philadelphia, focusing on the idea perhaps as pediatric
intensivists and those working within the pediatric intensive
care. We should be thinking more about that continuum in terms of
research questions. And then of course, there's lots of CICU.
CICU, makes up 50% of what we publish and maintain those
articles. And then mechanical ventilation, everyone might
think that mechanical ventilation has all been
answered. Well, it hasn't. And there's going to be lots more
articles to read about that.
Well, Robert, that's notable, and I think understandable that
50% of the journal is now concerning the expanding field
of cardiac intensive care. Can I ask you this, how many readers
of the journal appear to be reading the print version? And
perhaps even more importantly, I was recently on the online site,
and I noticed, as you mentioned in the last podcast, there's
collections and there's really a number of options to read the
material online in a very useful way. Could you take us through
both of those questions, print, and then what do you suggest if
we visit the online portal for PCCM?
I think the print question is a very interesting question. I
don't know the numbers of people who just read the print. I think
that subscribers, which is around 2,000 are entitled to
receive print or pay for print. I'm of a generation that I like
to have print. I get seven journals sent to my home, which
are all print, because I like to mark them up as I read them. And
it's difficult to do that online. But I'm the first to
admit that that's a generational thing. One of the innovations
that we've started as sort of beta testing this year is to
have someone read abstracts that you can get as a podcast. And I
don't know if that's where we're going to land eventually. But
people like to listen to content whilst they're doing other
things, exercising or going to work. And clearly, having something
on a page is not the solution to that. So there will
be an evolution. And that's very much dependent upon the
subscribers and what subscribers want to do with the material
that they're getting. On the website there are lots of things
that are available. There's an item called collections where
you can find the items called PCCM notes, methods and
statistics. You can find the editor's choices. And so there
are curated items. You can go back to each journal and scan
through a journal. I think once we move to online, we have to
address the question of what is a journal and you know, this
concept that we have of a journal dates back to 1850s and
before. Things have changed, and what end users want has changed.
So I'm sure there will be an evolution. As to your question
about how much use is there, each year, there's about 300,000
visits, separate visits to the journal, and they're called
unique visits. And I'll have to check with the publishers as to
what a unique visit means. I'm sure there must be a time
element to that. But that sounds a lot to me. So it's it's either
a few people doing a lot of searching, or it's a lot of
people doing little searching. What we seem to have is that
there's roughly they look at one and a half papers per visit. I'm
not sure how you can look at half a paper, so it's between
one and two.
Recently, I recall reading editorial in Cardiology and the
editor noted that approximately 13% of the total subscribers
read print and the remainder were reading the content online,
interesting. Robert, in the time remaining could we talk about
2023? What do you forecast for PCCM in 2023?
It's not really a forecast because I'm already filling
material into journals for 2023 or issues for 2023. But you
know, there are themes that are coming through: outcomes
research, follow up with quality of life, late morbidity,
psychological vulnerability and the impact of that,
organization, workload performance, bundled care
safety. That's going to be a theme that emerges from 2022 to
2023. And as I've mentioned already, respiratory is going to
be big. Bronchiolitis airway management, the question of high
flow nasal cannula versus CPAP, and the appropriate use of that.
And pediatric ARDS, these are all coming through and we will
have solid material.
Well Dr. Robert Tasker, once again, it's just always
fascinating to catch up with you. And to find out what's
being published in the journal. What questions are people
asking. Where's the research in the field. And this has been a
wonderful overview. I know that you devote an enormous amount of
time to this effort as Pat Kochanek did all during his
leadership. And on behalf of all your colleagues around the
world, we thank you. And we deeply appreciate the care and
the attention, the thoughtfulness that you're
bringing to the journal to make our field stronger, and to bring
more light to the care provided to children around the world. So
Robert, thank you for all you do as editor in chief of Pediatric
Critical Care Medicine. And thank you for joining us today
on the OPENPediatrics podcast.
Thank you, it's been a pleasure.
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