50 Studies Every Anesthesiologist Should Know.

April 2020 • Volume 130 • Number 4 www.anesthesia-analgesia.org e107 DOI: 10.1213/ANE.0000000000004668 O must admit to a certain gloominess when asked to review a book entitled 50 Studies Every Anesthesiologist Should Know. In this era of clickbait, “10 things you didn’t know about headaches. Number 5 will blow your mind! ” the notion that there are 50 studies that every anesthesiologist should know might be fanciful. The reader is invited to read on and make their own conclusion. The editor, Anita Gupta, has a distinguished curriculum vitae. She is an anesthesiologist with a doctorate in Pharmacy and a Masters in Public Policy from Princeton University’s Woodrow Wilson School of Public and International Affairs. In her preface, she makes the argument for an accessible, evidence-based foundation on which we can carry out our day-to-day work. The final 50 were chosen based on “what matters most to anesthesiologists and what may have a significant impact on our patients” (p. xvii). The book is divided into 50 short chapters in 9 sections (chapters per section): General Anesthesiology (8), Cardiac Anesthesia (7), Neuroanesthesia (3), Critical Care (6), Perioperative Medicine (9), Pain Anesthesiology (8), Regional Anesthesiology (3), Obstetric Anesthesiology (2), and Pediatric Anesthesiology (4). The chapters follow a template which, due to its simplicity and readability, could be an exemplar for scientific journals. Each study is encapsulated within a single quote, followed by a 1-sentence research question. Additional study details in terms of numbers of participants, location, endpoints, and so on, are then provided. A particularly useful addition is the study overview, which details the study design in a simple diagram. The study description provides the results in bullet-point format, followed by criticisms, other relevant studies, and a summary. Each study also provides a clinical case that allows the reader to consider the real-world implications of the study findings. As an example of real-world impact, this reviewer’s hospital’s aim for same-day discharge for laparoscopic cholecystectomies will be supported by the evidence from chapter 41. It may be that this book will provide other anesthesiologists with the impetus, excuse, or evidence to start discussions within their own departments. It is difficult to comment on the selection process for inclusion in this book as it was not based on quantitative data, such as number of citations. There is no doubt that some reader’s favorite study will have been omitted and that others will question the inclusion of a study that they do not see as essential knowledge. The studies, as suggested by the section headings, represent a wide range of topics. Landmark studies such as Action to Control Cardiovascular Risk in Diabetes (ACCORD),1 Perioperative Ischemic Evaluation (POISE),2 and Transfusion Requirements In Critical Care (TRICC)3 are featured, as well as perhaps less well-known studies on perioperative medication errors, parental presence during induction, and Project Re-Engineered Discharge (RED). 4 This book does not currently have a direct competitor in terms of content in this format. The closest competitors are perhaps websites such as UpToDate or BMJ Best Practice. While the websites are likely to contain more information in more areas, the advantage of this book is in its readability and editorship of narrowing down the thousands of articles to 50. There is a digital version (eBook) available; however, it adds very little functionality other than being able to download the figures used in the book as PowerPoint slides. A suggestion for improvement includes casting a wider net for journal articles. It could be argued that, for the New England Journal of Medicine (NEJM) in particular, authors aim to publish in the highest impact journals. However, US-based journals provide more than 60% of the chosen studies (18 of the 50 are from the NEJM), while the British Journal of Anaesthesia, for example, provides only 1. In addition, some of the section headings may confuse some readers. The section on Cardiac Anesthesia, for example, does include a study on transesophageal echocardiography, which is associated with cardiac surgery, yet also includes studies on beta-blockade and rhythm versus rate control in atrial fibrillation, studies which are of interest to all general anesthesiologists. Does this book then provide “50 studies that every anesthesiologist should know”? Perhaps not, however, the majority of anesthesiologists will find something of interest in this book, and it may be particularly useful for those in training who may wish to quote well-known studies in their exam answers. On this occasion, initial gloominess was replaced with a feeling of respect for Gupta. They have succeeded in their quest to provide anesthesiologists with an easy-to-read, well laid-out book, which will introduce practitioners to studies that they may have not read about and encourage others to challenge some of their practices.