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Journal Club

Guidelines for Selecting an Article

  • Article should be distributed at least one week prior to the journal 

  • With new block lecture format, please try to pick an article relevant to that 

  • Please confirm that at least one content expert will attend the journal 

  • Selected articles should be some type of study (eg randomized controlled study, cohort study, case-control study, cross-over study); please do not select a review article, guideline, or meta-

  • Consider sharing the article you would like to review with a content expert or journal club attending one week prior to distribution date to help ensure good article selection

Journal Club Worksheet

  1. What is the study question? Please attempt to format question using PICOT: Population, Intervention (or test or risk factor as appropriate), Control/Comparator, Outcome, Time.

  2. What study design is used to answer the question?

  3. What is the exposure, risk factor, or intervention being studied?

  4. What is the outcome (or disease) and how is it measured (or defined)?

  5. How were participants selected or recruited for the study?

  6. What are the inclusion/exclusion criteria?

  7. Were the groups randomized? If so, was there concealed allocation? For observational studies (eg case control studies, cohort studies, cross-sectional studies), was the person determining the outcome blind to the presence or absence of the risk factor?

  8. What do the authors say about the power/sample size of the study?

  9. Are the study groups’ characteristics comparable at baseline?

  10. What statistical tests/methods are used in the analysis of the results? Did they do an “intention to treat” analysis (if the study is a clinical trial)?

  11. What are the results of the study?

  12. Are the results statistically significant? Please look at confidence intervals, not just p-values.

  13. Are the results clinically significant?

  14. What are the biases/limitations of the study? Do not just list those mentioned by the authors.

  15. Comment on the overall internal validity of this article. Did the authors rule out chancebias, and confounding as explanations for their findings

  16. Comment on external validity or generalizability of this study. Would these results change your practice? How do these results fit into what we already know about this subject? (Understand that to achieve internal validity discussed above researchers often sacrifice external validity)

  17. How does this fit our current knowledge? (refer to current practice, previous beliefs, and/or previous studies)

 

Potential Limitations/Biases by Study Design

Cross-Sectional

  • No way to establish temporal  relationship

  • Selection bias

  • Self-reporting bias

  • Response bias

Case Control

  • Selection bias (of cases and controls)

  • Recall bias

  • Questionable temporal relationship

  • Inadequate bliding of those assessing outcomes and risk factors

Cohort

  • Selection bias

  • Lost to follow-up

  • Change in habits over time

  • Inadequate blinding of investigators to risk factor

Experimental Design

  • Selection bias

  • Lost to follow-up

  • Improper or biased randomization or allocation concealment

  • Inadequate bliding of participants and investigators to exposure/treatment

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