1. When 4 th Tuesday Core Conference of R1 Ortho Rotation

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

3. Journal Club TOPIC Date Presenter Advisor

4. Case 1 minute or less case presentation

5. 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

6. Literature Search Key terms used E.g. Fever AND adult Resources E.g. Medline, Cochrane Library Findings E.g. 2 studies that matched criteria Why you chose particular study

7. PICO-D 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

8. Cite Article and Authors

9. Hypothesis What’s being measured What’s the expected outcome State paper’s hypothesis E.g. We anticipate that use of Tylenol will lower temperature faster in febrile adults relative to watchful waiting

10. 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

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

12. Critique “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

13. CATMaker Insert screenshot of CATMaker htm file here.

14. 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?

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

16. Summary Clear conclusion – short and to the point E.g., Moderate study that does support the use of Tylenol to reduce fever in adults

17. EBM Resources Critical Appraisal Worksheets for different types of studies (CAT Maker): http://www.cebm.net/critical-appraisal/ http://www.cebm.net/critical-appraisal/ Critical Appraisal Worksheets: http://bestbets.org/links/BET-CA-worksheets.phphttp://bestbets.org/links/BET-CA-worksheets.php University of Alberta EBM toolkit with more appraisal worksheets: http://www.ebm.med.ualberta.ca/ http://www.ebm.med.ualberta.ca/ JAMA EBM practice guide: http://www.cche.net/usersguides/main.asphttp://www.cche.net/usersguides/main.asp BMJ guide – How to read a paper. Broken up by subtypes of studies: http://www.bmj.com/about-bmj/resources-readers/publications/how-read-paper http://www.bmj.com/about-bmj/resources-readers/publications/how-read-paper