Trick of the Trade: Searching for Comments to a Published Article

One day back in 2005 during my PGY-1 pharmacy practice residency, I remember a conversation with my residency director. He was a Surgical/Trauma ICU pharmacist. There had been a recent article published (I think it may have been one linking 'tight' glucose control to decreased mortality in ICU patients). Funny how times change...

Anyway, he mentioned all of the 'discussion' surrounding the article in terms of comments submitted to the journal. It was my first introduction to the idea that published literature could be challenged through an avenue provided by the journal.

Just this past week during EM residency journal club, we were discussing the recent Etomidate/Sepsis Meta-Analysis published in Critical Care Medicine (more to come on that soon in another post). I mentioned to my group how one could search for submitted comments. Most seem surprised to learn this trick of the trade.

Medical Education Trick of the Trade: Look for comments at bottom of Pubmed citation

• Locate the article of interest on PubMed.
• At the bottom will be any comments submitted to and published by the journal.
• Click on the link and it will bring you to the comment.

Test out these "Comment In" links from the above example:

• Comment: frequency of medication errors with intravenous acetylcysteine for acetaminophen overdose. [Ann Pharmacother. 2009]
• Comment: Frequency of medication errors with intravenous acetylcysteine for acetaminophen overdose. [Ann Pharmacother. 2008]

Some comments are written to suggest solutions to a problem identified by the article (see above). Others are more contentious when controversial topics are published and/or subpar methods, statistics, results, or conclusions are reported (see below).

Links for the "Comment In" section:

• Safety of etomidate bolus administration in patients with septic shock. [CJEM. 2011]
• The safety of single-dose etomidate. [Intensive Care Med. 2010]
• Is etomidate really that bad in septic patients? [Intensive Care Med. 2010]

I highly recommend reading them. The tone is generally more pointed then the original article. Typically, the author(s) are given a chance to reply and those are also listed. It's a great learning exercise to read how other experts in the field critique a study and how the author responds.