JOURNAL CLUB CLASSIC

Please prepare a 10-15 minute PowerPoint presentation to teach your peers about your assigned journal article. You may follow the below format:

1. Describe the research question. A well-built research question has four components (PICO): Population (who was studied), Intervention (or exposure; what therapy, risk factor, tests), Comparison or control (what alternative to intervention or exposure), Outcome (clinical, functional, economic).  For example:  Over a five-year period, does high-dose atorvastatin (I) compared to placebo (C) reduce the incidence of stroke of stroke (O) among patients with recent stroke or TIA who have no known coronary artery disease (P)? 

2. State the importance/relevance/context of the question.  This background information provides the context for the research question (background). 

3. Describe the methods by giving more detail on the components of the research question.  One way to accomplish this is to provide more detail on the PICO: 
1. P: This study included 4371 patients, 60% men with an average age of 63 years and mean LDL-cholesterol of 133 mg/dL.  All patients had a recent stroke (69%) or TIA (31%).  Those with atrial fibrillation, embolism from other cardiac causes, and subarachnoid hemorrhage were excluded.” 
2. IC: Atorvastatin 80mg daily or matching placebo. 
3. O: After a median of 4.9 years of follow-up, the primary outcome was incidence of fatal or non-fatal stroke and all-cause death.  Secondary endpoints included a composite endpoint of stroke, TIA, major coronary event, major CV event, acute coronary event, and coronary event, revascularization, and any CV event.” 

4. State your answers to the critical appraisal questions on validity. 
1. Were the treatment and control groups similar at the start of the study? 
2. Were patients randomized and was that process concealed (blinded) 
3. Were patients analyzed according to assignment group? (Intention to Treat) 
4. Were the two groups treated similarly otherwise? 
5. Was follow-up complete? 
6. For studies of diagnostic tests, was the test compared to an accepted Gold Standard?  Did all patients receive the Gold Standard independent of the test results? 

5. Summarize the Primary Results, including relative and absolute effects and numbers needed to treat calculations where applicable.  For diagnostic tests this will include an estimate of positive and negative likelihood ratios. 

6. Describe why you think the results can or cannot be applied to your patients/situation and the utility of the study results in practice. 

 Please contact CMR Meryl Colton (meryl.colton@cuanschutz.edu) with any questions regarding journal club.