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/AJC/.
CURRENT SELECTION
Article for Discussion
Korb K, Scherer M, Chenot JF. Steroids as adjuvant therapy for acute pharyngitis in ambulatory patients: a systematic review. Ann Fam Med. 2009;8(1):58–63.
DISCUSSION TIPS
This article provides an opportunity to consider an uncommon treatment for a common problem, and also to examine methods for systematic reviews.
DISCUSSION QUESTIONS
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What questions are addressed by this article? How do the questions fit with what already is known on this topic?
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How does the way the questions were framed affect the utility of the findings?
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How strong are the study designs for answering the questions?
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To what degree can the findings be accounted for by:
How studies were selected or excluded?
Heterogeneity in how the treatments or outcomes were assessed?
Confounding (false attribution of causality because 2 variables discovered to be associated actually are associated with a third factor)?
Researcher bias?
Chance?
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How does the quality assessment of the articles (shown in Table 3) relate to other methods for assessing study quality, such as the CONSORT Guidelines for clinical trials: http://www.consort-statement.org/consort-statement/, the Strength of Recommendation Taxonomy (SORT): http://www.aafp.org/afp/20040201/548.html, or other systems to rate the strength of scientific evidence: http://www.ahrq.gov/clinic/epcsums/strengthsum.htm?
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What are the main study findings?
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What can we learn from the subgroup analyses?
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How comparable are the study populations to your practice? What is your judgment about the transportability of the findings?
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How (if at all) could this study change your practice?
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What important researchable questions remain?
- © 2010 Annals of Family Medicine, Inc.
