The Annals of Family Medicine encourages readers to develop a learning community of those seeking to improve health care and health through enhanced primary care. You can participate by conducting a RADICAL journal club and sharing the results of your discussions in the Annals online discussion for the featured articles. RADICAL is an acronym for Read, Ask, Discuss, Inquire, Collaborate, Act, and Learn. The word radical also indicates the need to engage diverse participants in thinking critically about important issues affecting primary care and then acting on those discussions.1
HOW IT WORKS
In each issue, the Annals selects an article or articles and provides discussion tips and questions. We encourage you to take a RADICAL approach to these materials and to post a summary of your conversation in our online discussion. (Open the article online and click on “TRACK Comments: Submit a response.”) You can find discussion questions and more information online at: http://www.AnnFamMed.org/site/AJC/.
CURRENT SELECTION
Article for Discussion
This article provides a chance to consider an unintended consequence from a well-meaning and evidence-based clinical guideline change.
DISCUSSION QUESTIONS
What question is asked by this study and why does it matter?
How does this study advance beyond previous research and clinical practice on this topic?
How strong is the study design for answering the question? What alternative study designs might be possible?
To what degree can the findings be accounted for by:
How patients were selected, excluded, or lost to follow-up?
Temporal changes in screening rates due to factors other than the cervical cancer screening guideline change?
How the main variables were measured?
Confounding (false attribution of causality because 2 variables discovered to be associated actually are associated with a 3rd factor)?
Chance?
How the findings were interpreted?
What are the main study findings?
How comparable is the study sample to similar patients in your practice? What is your judgment about the transportability of the findings?
What contextual factors are important for interpreting the findings?
How might this study change your practice? Policy? Education? Research?
What are the implications of the study, and of urine tests and primary care office staffing and roles, for screening for sexually transmitted diseases?
Who are the constituencies for the findings, and how might they be engaged in interpreting or using the findings?
What are the next steps in interpreting or applying the findings?
What researchable questions remain?
- © 2015 Annals of Family Medicine, Inc.