1. Journal Club

2. Goals  Increase critical understanding of the literature  Learn how to use basic tools to evaluate data  Understand how to apply data to clinical care  Meet ACGME RRC scholarly activity requirements  Leave with a 1 page handout on the study and take home points  Post on the website  Article  PPT  CAT Worksheet for archiving/searching

3. Why do JC?  Improves understanding of applying evidence based medicine  Pitner et. Al F1000Research 2013, 2:15 Last updated: 07 AUG 2013  How to make it not…well…lame?  The 10 minute JC  Schwartz et. Al July/August 2007 | Volume 147 Number 1 ACP Journal Club  Regular, mandatory, clear long/short term purpose, trained faculty to lead discussion, circulating paper prior to meeting, internet for storage and dissemination, using critical appraisal tools  Y. Deenadayalan et al. Journal of Evaluation in Clinical Practice ISSN 1356-1294

4. When  R1: 4 th Tuesday CC of Ortho rotation  Select article:  Within the last 5 years  Major peer reviewed journal  Original research  Advisor should approve article

5. Template  Case  Background  Hypothesis  Design  Results  Critique/CAT  Significance  Application  Q/A 1 Minute 10 Minutes 2 Minutes

6. Case  1 minute or less case presentation

7. Background and Aim  Background  What you already know  E.g., Standard practice is to rx Tylenol for fever as it likely helps reduce it faster than waiting  What you want to achieve (AIM)  What evidence is lacking?  E.g., Find evidence that Tylenol is better than watchful waiting to reduce febrile temperature

8. Hypothesis  What’s being measured  What’s the expected outcome  Identify PICO-D facets clearly  E.g.:  Patient or Population: Adults with fever  Intervention: PO Tylenol  Comparison: watchful waiting  Outcome: reduce fever  Design: double blind RCT

9. Design  What type of a study?  Why this type?  Size of study?  Advantages and disadvantages to this model.  Is this design appropriate?  How were patient selected?  Inclusion/Exclusion criteria  How were variables defined and measured?  Use images to describe study flow

10. Results  Brief description of results  Images  Figures  Outcomes  Primary  Secondary  Other

11. Critique/CAT “The conclusions giveth but the methods taketh away!” ~ACP Journal Club 7-2007  Controls?  Confounders?  Other approaches you would have liked to see?  Alternative explanations for results?  What would you like to see in the future?  Critical appraisal tools and CATMaker

12. Significance  How has this added to what’s already out there?  Has it supported what we already know?  Has it changed anything that we already know?

13. Application  Put it to use  Briefly refer back to case  Does this change your management in this case?  Will it change your future management?

14. END