Annals Journal Club: Pedometers for Promoting Walking and Weight Loss
=====================================================================


The *Annals of Family Medicine* encourages readers to develop the 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/misc/AJC](http://www.AnnFamMed.org/misc/AJC).

## CURRENT SELECTION

### Article for Discussion

Richardson CR, Newton TL, Abraham JJ, Sen A, Jimbo M, Swartz AM. A meta-analysis of pedometer-based walking interventions and weight loss. Ann Fam Med. 2008;6(1):69–77.[Abstract/FREE Full Text](http://www.annfammed.org/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6ODoiYW5uYWxzZm0iO3M6NToicmVzaWQiO3M6NjoiNi8xLzY5IjtzOjQ6ImF0b20iO3M6MjI6Ii9hbm5hbHNmbS82LzEvaWlpLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 

## DISCUSSION TIPS

The following article provides helpful background information on meta-analyses. It is available at [http://www.bmj.com/cgi/content/full/315/7121/1533](http://www.bmj.com/cgi/content/full/315/7121/1533). Egger M. Meta-analysis: principles and procedures. BMJ. 1997;315(6):1533–1537.[FREE Full Text](http://www.annfammed.org/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6MzoiYm1qIjtzOjU6InJlc2lkIjtzOjEzOiIzMTUvNzEyMS8xNTMzIjtzOjQ6ImF0b20iO3M6MjI6Ii9hbm5hbHNmbS82LzEvaWlpLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==)

## DISCUSSION QUESTIONS

*   What questions are addressed by the article? Why do they matter?

*   Is a meta-analysis a reasonable way to answer the research questions? Why?

*   What are the main findings?

*   To what degree can the findings can be accounted for by:
    
    
    
    1.  How studies were selected (inclusion criteria and search strategy)?
    
    2.  How data were extracted from the parent studies for analysis?
    
    3.  Limitations in the original studies or their reporting of key information?
    
    4.  Confounding (false attribution of causality because 2 variables discovered to be associated actually are associated with a 3rd factor)?
    
    5.  Publication bias (that is, positive studies being more likely to be published)?
    
    6.  Chance?
    
    

*   How transportable are the findings to your practice setting? How might they be adapted?

*   What questions do you have for further research or application?

*   © 2008 Annals of Family Medicine, Inc.

## REFERENCES

1.  Stange KC, Miller WL, McLellan LA, et al. *Annals* Journal Club: It’s time to get RADICAL. Ann Fam Med. 2006;4(3):196–197. [http://annfammed.org/cgi/content/full/4/3/196](http://annfammed.org/cgi/content/full/4/3/196).
    
    [FREE Full Text](http://www.annfammed.org/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6ODoiYW5uYWxzZm0iO3M6NToicmVzaWQiO3M6NzoiNC8zLzE5NiI7czo0OiJhdG9tIjtzOjIyOiIvYW5uYWxzZm0vNi8xL2lpaS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=)