Goals of a Journal Club
Anatomical and General Pathology
- Teach Critical Appraisal
- Keep current with the medical literature
- Provide a foundation for evidence‐based practice
- Review landmark or controversial papers
Characteristics of successful Journal Clubs
- Presented by residents or fellows and actively supervised by a Staff
- Attendance is mandatory
- Residents and Fellows
- Meeting lasts for less than 60 minutes
- Protected time (pager off!)
- Supported and endorsed by Program Director and departmental leaders
- Choose 2 relevant journal articles that:
- related to the specialty
- 20 minutes for presentation followed 10 minutes of critiques for each paper
- topics for discussion may be:
- Ask, “so what?”
- Will it change my practice?
- Is the question important?
- Research question, study objective, and specific hypothesis:
- Do the authors provide a clear and specific question and hypothesis?
- Is the research objective clear and unambiguous?
Critically Reviewing Articles
- Is the study design appropriate for the research question?
- Pros and cons of this design
- Pros and cons of alternative methodologies
- Advantages and disadvantages of chosen methodology
- Level of evidence
- Confounding, bias, and validity
- Characteristics of the study population:
Who are the participants?
- Time and place?
- Is the study population appropriate?
Characteristics of the sample
- Random versus convenience sampling
- Is the population similar to my patients?
- Specific inclusion and exclusion criteria
- Are these appropriate?
- Selection bias?
Measurement Issues and Bias
- How are variables measured?
- Misinformation bias?
- Detection bias?
- Masking or blinding?
- How were the data analyzed?
- Appropriate tests
- P values versus sizes and 95% confidence intervals (more informative)
- NS versus actual P values
- Multivariable methods
- Regression analysis?
Sample Size and Power
- Sample size calculation done a priori?
- Did the investigators specify a clinically important difference they would like to detect?
- Type I (α or alpha) and Type II (ß or beta) errors Power=1‐type II error
- What are the results?
- Are they clearly presented and understandable?
- How were the results interpreted?
- Are the interpretations appropriate?
- Threats of validity
- Loss to follow‐up
- Missing information
- Control of confounding
- Issues of bias
- Are the conclusions supported by the data?
- Relate findings to other studies in the medical literature
- Do the authors “stretch” too far?
- What are the strengths of the study?
- What are the study weaknesses or flaws?
- Do the authors recognize them?
- Come back to the key question: So what?
- Will it change how we practice?
- Will it change how we counsel patients?
- Where to from here?
- Do the findings contribute to our knowledge of the subject?
- How could we do better?
- What additional questions does the study raise?