Critically Appraising a Journal Article

Critically Appraising a Journal Article What is a Journal Club? An educational meeting in which a group of individuals read, evaluate and discuss current articles from the biomedical literature A collective forum to provide a venue to keep up with the literature

One of the most effective means by which students and professionals keep up with current biomedical literature Evidence based practice in action What is a Journal Club? Classic learning and information sharing format Focused on current literature

Just-in-time delivery Critically appraised information with commentary and discussion for applicability and relevance What is a Journal Club? The earliest reference to a journal club is found in a book of memoirs and letters by the late Sir James Paget, a British surgeon and one of the

founders of modern pathology. He describes a group at St. Bartholomew's Hospital in London in the mid-1800s with 'a kind of club ... a small room over a baker's shop near the Hospitalgate where we could sit and read the journals. Paget S: Memoirs and Letter of Sir James Paget. London: Long-mans, Green, and Co., 1901:42 What is a Journal Club? It is believed that Sir William Osler

established the first formal journal club at McGill University in Montreal in 1875, though Osler himself might have been aware of similar gatherings that were taking place elsewhere. The purpose of Osler's early journal club was 'for the purchase and distribution of periodicals to which he could ill afford to subscribe Linzer M: The journal club and medical education: over one hundred years of unrecorded history.

Postgrad Med J 1987,63:475-478. Successful Journal Clubs include: A well constructed clinical question Searching for evidence A critical appraisal Commentary and discussion Successful Journal Clubs include: A well constructed clinical question

Asking a well-built clinical question will facilitate your search for and acquisition of the answer. The clinical question being investigated is asked in the PICO format (Patient/population, intervention, comparison, outcome) More to come! Successful Journal Clubs include:

Searching for evidence Search for articles using your well-built question. Identify what type of question you are asking (therapy, prevention, cost-analysis, etc) and what type of studies (RCT, cohort, case reports) are best for evaluating the answer to your question

Successful Journal Clubs include: A critical appraisal Evaluate the articles you have selected You may use the Critical Appraisal Worksheet Benefits of Critical Appraisal An analytical summary and evaluation of a research study Standard approach: recognize important

information Standard format: easily digested, a quick read Usable by professionals in busy practices as summarized, synthesized evidence Method of Appraisal There are a number of methods used to critically appraise an article.

They all have the same basic format. The method that we are using is based on one developed by Duke University. It is a method that you will see in journal clubs in your 3rd year clerkships and in your residency program encounters. Successful Journal Clubs include: Commentary and discussion It is also helpful to look for any

accompanying editorial commentary, which can provide a unique perspective on the article and highlight controversial issues. Anatomy of a Scientific Article Abstract Introduction Materials and Methods Results

Discussion Conclusion Always Ask Six Things As you go through the anatomy of the article, you will always ask six things that will correspond to the various parts of the article. Always Ask Six Things

1) 2) 3) 4) 5) What is the clinical question? Why was the question asked? What did they do? Methods What was the answer ? Results

What did they say about the answer? Conclusion 6) What do I do with this information? Is this study of significant enough quality in method to change my practice one way or the other? - (Studies done different ways mean different things) (Look at commentary/discussion) Always Ask Six Things What is the clinical question?

Why was the question asked? What did they do? Methods What was the answer ? Results What did they say about the answer? Conclusion 6) What do I do with this information? Is this study of significant enough quality in method to change my practice one way or the other? - (Studies done different ways mean different things) (Look at commentary/discussion)

1) 2) 3) 4) 5) 1. What is the Clinical Question? What type of question is being asked in your article?

This is typically found in the Introduction (See Critical Appraisal Checklist based on Duke Universitys Evidence Based Practice) Diagnostic Test For clinicians to use a diagnostic test in clinical practice, they need to know how well the test distinguishes between those who have the suspected disease or condition and

those who do not. Diagnostic test studies evaluate a test for diagnosing a disease. Differential Diagnosis Differential Diagnosis involves the process of weighing the probability that one disease rather than another disease accounts for a patients illness.

The Differential Diagnosis Study tries to sort out what proportion of the patients with a single sign or symptom has various diseases. Economic Analysis An economic analysis can provide accurate values to assess the cost of disease and the cost-benefit of interventions.

Harm / Etiology A Harm/Etiology study addresses how to identify causes for disease (including iatrogenic forms ie caused by the healthcare system) Prognostic A prognostic study addresses how to estimate

the patients likely clinical course over time and anticipate likely complications of disease. Practice Guideline A practice guideline study is a systematically developed statement on medical practice that assists a practitioner and a patient in making decisions about appropriate health care for specific medical conditions.

Qualitative Study A qualitative study deals with phenomena that are difficult or impossible to quantify mathematically, such as beliefs, meanings, attributes, and symbols Systematic Review A systematic review is a literature review focused on a single

question that tries to identify, appraise, select and synthesize all high quality research evidence relevant to that question. A meta-analysis is a survey in which the results of all of the included studies are similar enough statistically that the results are combined and analyzed as if they were one study. Therapy A therapy study addresses how to select

treatments to offer patients that do more good than harm and that are worth the efforts and costs of using them. Question! Students participate in PollEverywhere Question

Always Ask Six Things 1) 2) 3) 4) 5) What is the clinical question? Why was the question asked? What did they do? Methods

What was the answer ? Results What did they say about the answer? Conclusion 6) What do I do with this information? Is this study of significant enough quality in method to change my practice one way or the other? - (Studies done different ways mean different things) (Look at commentary/discussion) 2. Why was the question asked?

What did the author/s want to know? This is typically found in the Introduction Always Ask Six Things 1) 2) 3) 4) 5)

What is the clinical question? Why was the question asked? What did they do? Methods What was the answer ? Results What did they say about the answer? Conclusion 6) What do I do with this information? Is this study of significant enough quality in method to change my practice one way or the other? - (Studies done different ways mean different

things) (Look at commentary/discussion) 3. What did they do? (Methods) You look for the validity of the study by checking the way it was carried out. 3. What did they do? (Methods)

Validity The degree to which the results of a study are likely to be true, believable and free of bias. 3. What did they do? (Methods) Bias Deviation of results or inferences from the

truth, or processes leading to such deviation. Recall Selection Cultural Conflict of Interest Economic Lead Time Length Time

Types of Studies There are various types of studies for evaluating the answer to your question TYPES OF STUDIES Activity Students participate in a group activity.

Always Ask Six Things 1) 2) 3) 4) 5) What is the clinical question? Why was the question asked?

What did they do? Methods What was the answer ? Results What did they say about the answer? Conclusion 6) What do I do with this information? Is this study of significant enough quality in method to change my practice one way or the other? - (Studies done different ways mean different things) (Look at commentary/discussion)

4. What was the answer? (Results) What was the consequence, effect, or outcome of the study? This is found in the Results Always Ask Six Things 1) 2) 3)

4) 5) What is the clinical question? Why was the question asked? What did they do? Methods What was the answer ? Results What did they say about the answer? Conclusion 6) What do I do with this information? Is this

study of significant enough quality in method to change my practice one way or the other? (Studies done different ways mean different things) (Look at commentary/discussion) 5. What did they say about the answer? Conclusion What was the decision reached? This is typically in the Conclusion Always Ask Six Things 1)

2) 3) 4) 5) What is the clinical question? Why was the question asked? What did they do? Methods What was the answer ? Results What did they say about the answer?

Conclusion 6) What do I do with this information? Is this study of significant enough quality in method to change my practice one way or the other? - (Studies done different ways mean different things) (Look at commentary/discussion) 6. What do I do with this information? Is this study of significant enough quality in

method to change my practice one way or the other? Look at the commentary and discussion that has been provided by the author/s in the journal article. Commentary and Discussion After you have appraised the

commentary/discussion part of the article, your Journal Club will end with the journal club participants engaging in commentary and discussion about the article. It is also helpful to look for any accompanying editorial commentary, which can provide a unique perspective on the article and highlight controversial issues. Look up your article and see if there are any comments affiliated with your article.

Where to find Commentary PubMed http://www.ncbi.nlm.nih.gov/pubmed/?otool=musmlib Google Scholar http://scholar.google.com.medlib-proxy.mercer.edu/ ACP Journal Club http://annals.org.medlib-proxy.mercer.edu/journalclu b.aspx

Cochrane Journal Club http://www.cochranejournalclub.com.medlib-proxy.me rcer.edu/ Evidence Based Medicine http://ebm.bmj.com.medlib-proxy.mercer.edu/

Recently Viewed Presentations

  • fracture Yield point Elas t regi ic on

    fracture Yield point Elas t regi ic on

    Supports gills (gill arches), In gnathostomes: jaws ear hyoid apparatus C. Dermatocranium. Dermal bones. Tetrapod Skull Two basic parts A. Braincase (elements touching brain). B. Face or Rostrum Neurocranium Protects brain Arises as cartilage (ontogenetically and phylogenetically) Replaced by ...
  • CPS Annual Meeting 2017 Demonstrating Va l u

    CPS Annual Meeting 2017 Demonstrating Va l u

    Pharmacy resources: Utilized current clinical pharmacy FTEs (4) Education and resources were provided to clinical staff regarding appropriate evidence-based management and interventions . In-services, Competencies, Shared Drive. I divided this into two slides and changed the font size. / COMPREHENSIVE...
  • A Uniform Approach to Analogies, Synonyms, Antonyms, and ...

    A Uniform Approach to Analogies, Synonyms, Antonyms, and ...

    There is past work on recognizing analogies, synonyms, antonyms, and associations, but each of these four tasks has been examined separately, in isolation from the others. As far as we know, the algorithm proposed here is the first attempt to...
  • The Existence of God - Clover Sites

    The Existence of God - Clover Sites

    Three Types of Arguments Against the Existence of God. The Empirical Argument. The Linguistic Argument. Evidential Arguments "Theology and Falsification," Flew's short essay on whether there is a God, was the most widely read philosophical essay for 50 years after...
  • School Portal Complete Reference Guide School Portal  Complete

    School Portal Complete Reference Guide School Portal Complete

    Online Advertising. Create great quality ads fast, and post them in a few clicks whenever it's convenient. Ad Performance Tracking. View your jobs' statistics and use the data to maximise their performance. School Career Site. Position your school as an...
  • Diapositiva 1 - Akademia Muzyczna w Krakowie

    Diapositiva 1 - Akademia Muzyczna w Krakowie

    Indonesian Kecak from Bali island Rhythmical Indian Cycles The family of percussion instruments is a worldwide network and it is easy for percussionist to communicate (prof. Wulf lecture, 24/07) Teachers and students was involved in evaluation concerts Opening concert J....
  • Travel - BYU Nursing

    Travel - BYU Nursing

    Brigham Young University . College of Nursing. Travel Types. Conference (most common) ... we can still have the Travel Office see if BYU is contracted with them to get you a cheaper rate. Extra Hotel Info . ... DOBs, netID,...
  • Models in Psychopathology

    Models in Psychopathology

    Classification and Assessment Why Classify? Why Not Classify? Major Diagnostic Systems DSM-IV DSM-IV Multiaxial System AXIS I Disorders AXIS I Disorders (Continued) Axis II Disorders Assessment in Abnormal Psychology Methods to conduct assessment Interview: Unstructured clinical interview Semi-structured or structured...