For modern medical students and physicians, learning pathophysiology or pharmacologic mechanisms is critical, but it’s still not quite enough. In our era of evidence-based medicine, we must often know not only the facts but also the scientific studies that back them up. The AFFIRM trial, ALLHAT trial, SPRINT trial, COURAGE trial... As a medical student, I could feel these names sloshing around in my brain. I struggled to keep them straight. Of course, the optimal way to learn these trials is to spend time with them, discuss them, grapple with their criticisms and limitations. That said, when you’re a third-year medical student grappling with UWorld and Step Up to Medicine in addition to the dozens of clinical trials tossed around by residents and attendings, I’ve found it helpful to have simple tricks for keeping them straight at the outset. Fortunately, mnemonics work wonderfully here. I’ll share five examples which illustrate a few different approaches I’ve experimented with through the years. (I took most of these from the book 50 Studies Every Doctor Should Know: The Key Studies that Form the Foundation of Evidence Based Medicine, which neatly summarizes the findings, criticisms, and limitations of each trial. Highly recommend.)
SPRINT trial: the benefits of intensive (<120) vs standard (<140) blood pressure control in non-diabetic patients at risk for cardiovascular events. I went for a standard keyword image-based mnemonic here, imagining a sprinter running a 100y dash. He has a BP cuff attached to his arm, and the BP is shooting through the roof as he pounds down the track. SPRINT = BP.
AFFIRM trial: the equivalence of rate control vs rhythm control for atrial fibrillation. In keeping with our “go with the first thing that springs to mind” rule, I simply used a phonetic mnemonic here, imagining AFFIRM as AFFIRRRM, as a pirate might say. Of course, it helps to know that AFFIRM stands for “Atrial Fibrillation Follow-Up Investigation of Rhythm Management.” AFFIRRRM makes the “Rate vs Rhythm” part just a little bit easier to recall.
DOSE trial: diuretic strategies in acute decompensated heart failure. Another keyword image. I imagine a decompensated CHF patient whose lungs are filling with fluid. A hose—for DOSE—is blasting yet more water into the lungs.
COMET trial: carvedilol is superior to metoprolol tartrate for chronic systolic heart failure. Let’s not overthink it. It’s in the name: Carvedilol Or Metoprolol European Trial (COMET). If a trial’s name is an acronym, I always search for the full name to see if the acronym alone works as a sufficient mnemonic.
TRICC trial: a restrictive transfusion strategy (hemoglobin <7) is at least as effective as a liberal transfusion strategy (Hgb <9) in critically ill patients without acute coronary syndrome. Another keyword image: TRICC reminds me of “trick or treat,” so I imagine a trick-or-treater dressed as Dracula, sucking blood—for blood transfusion— from an unsuspecting neighbor. TRICC also sounds similar to TRIGGER, which reminds me of a related trial, the TRIGGER trial, which examined transfusion strategies in upper GI bleeds.
As usual, I enter all of these into Anki cards for spaced retrieval practice. In the case of clinical trials, I like to use a forward-and-reverse setting, which creates two cards for each trial. One might say, “SPRINT trial?”, while the other says, “trial showing the benefits of intensive (<120) vs standard (<140) blood pressure control in non-diabetic patients at risk for cardiovascular events?” I’ve found it useful to drill these both ways. As I’ve written previously, I tend to ditch the mnemonic once I’m able to recall the information without it. If you’re in the early stages of learning and trial names seem to be falling through the cracks, as they did for me, I’ve found the combination of keyword or phonetic mnemonics with spaced retrieval practice (via Anki) to be quite handy.