Mar 25, 2020
MDedge Psychcast host Lorenzo Norris, MD, interviews Sy Atezaz
Saeed, MD, MS, about his annual analysis of the key studies that
could change day-to-day psychiatric practice.
Norris’s conversation with Dr. Saeed is
based on a two-part evidence-based review that identified the top
12 research findings for clinical practice from July 2018 to June
Part 1, which Dr. Saeed wrote with Jennifer B. Stanley, MD, and
Part 2 were published in Current Psychiatry.
- Each year, Dr. Saeed identifies 10-20 high-quality journal
articles with direct impact on clinical practice that, if used
appropriately, can generate better outcomes for psychiatric
patients. The goal of the list is to close the gap between
cutting-edge science and clinical practice.
- Secondary literature (for example, Cochrane Reviews, NEJM
Journal Watch, and so on) is used to differentiate the clinically
relevant “signal” from the noise of all the research produced.
- Knowledge changes over time, so it’s important to be up to date
but flexible in how the knowledge is applied.
- The methodology used to generate the list is aimed at
identifying 10-20 useful articles. Dr. Saeed took a three-pronged
approach that reviewed research findings suggesting readiness for
clinical utilization published between July 1, 2018, and June 30,
2019; asked several professional organizations and colleagues:
“Among the papers published from July 1, 2018, to June 30, 2019,
which ones in your opinion have (or are likely to have or should
have) impacted/changed the clinical practice of psychiatry?”; and
looked for appraisals in postpublication reviews such as NEJM Journal Watch, F1000 Prime,
Evidence-Based Mental Health;
commentaries in peer-reviewed journals; and other sources that
suggest an article is of high quality and clinically useful.
- This approach generated a solid list of articles to consider
presenting at journal clubs or a topic to present at grand rounds.
- Studies on this list also might overlap with research covered
in popular media, so the list is a tool that clinicians can use to
answer questions patients raise.
- The secondary literature is used to differentiate the
clinically relevant “signal” from the noise of all the research
produced. Those secondary sources include
Cochrane Reviews, BMJ Best Practice, NEJM
Journal Watch, Evidence-Based Mental Health, and commentaries in
peer-reviewed journals to help distill the clinically useful
articles for a busy clinician.
- Four of the 12 articles that affected Dr. Saeed’s practice
covered the risk of death associated with antipsychotic medication
usage in children, the role of antipsychotic polypharmacy in
schizophrenia to decrease inpatient hospitalizations, the outcomes
associated with prescribing different adjunctive medications in
combination with antipsychotics, and the use of prazosin for
nightmares in PTSD.
Saeed SA et al. Top research findings of 2018-2019 for clinical
practice. Part 1.
Current Psychiatry. 2020 January;19(1):12-8.
Saeed SA. Top research findings of 2018-2019 for clinical
practice. Part 2.
Current Psychiatry. 2020 February;19(2):22-8.
Ray WA et al. Association of antipsychotic treatment with risk
of unexpected death among children and youths. JAMA Psychiatry.
Tijhonen J et al. Association of antipsychotic polypharmacy vs.
monotherapy with psychiatric rehospitalization among adults with
JAMA Psychiatry. 2019;76(5):499-507.
Stroup TS et al. Comparative effectiveness of adjunctive
psychotropic medications in patients with schizophrenia. JAMA Psychiatry.
Raskind MA et al. Trial of prazosin for posttraumatic stress
disorder in military veterans.
N Engl J Med. 2018;378(6):507-17.
Show notes by Jacqueline Posada, MD, associate producer of the
MDedge Psychcast. Dr. Posada is consultation-liaison psychiatry
fellow with the Inova Fairfax Hospital/George Washington University
program in Falls Church, Va.
For more MDedge Podcasts, go to
Email the show: firstname.lastname@example.org