CME Update

Some of you may wish to do a Topical Review, or a non-systematic review of a clinical topic. While a non-systematic search of the literature will be done, the review should still be evidence-based, to the greatest extent possible. Examples of Topical Reviews include Up To Date, CME Topic Updates in Canadian Family Physician, or Wikipedia articles. (The quality varies greatly for Wikipedia articles, of course.)

The American Family Physician has an excellent article summarizing the key points of writing a Topical Review (1). The checklist below was developed from (1) and also from Canadian Family Physician Guidelines for Authors (2).

Checklist

  • The topic is fairly common in family practice, especially topics in which there is new, fairly important information about diagnosis and treatment.
  • The introduction defines the topic and the purpose of the review, and its relevance to family practice.
  • A table of Continuing Medical Education objectives is included in the review.
  • The review states how you did the literature search and indicates what sources you searched to ensure a comprehensive assessment of relevant studies (e.g., MEDLINE, Cochrane, TRIP Database, etc.). In contrast to a systematic review, you will not be expected to do an exhaustive search of the “grey” literature, or conference abstracts/proceedings, or other obscure databases.
  • Several sources of evidence-based reviews on the topic are evaluated.
  • Where possible, Patient Oriented Evidence that Matters (POEM) should be used to support key clinical recommendations, as opposed to Disease Oriented Evidence (DOE). See (1) for a more detailed explanation regarding POEM and DOE.
  • Studies of patients in primary care settings rather than specialty referral centres should be emphasized.
  • Studies that are not only statistically significant but also clinically significant should be emphasized.
  • Therapeutic recommendations should not only indicate the level of evidence but also indicate the magnitude of benefit and harm that would be expected (eg. NNT, NNH or ARR).
  • The level of evidence for key clinical recommendations is labeled as follows: level A (Randomized Controlled Trials/Meta-analysis); level B (other evidence); level C (expert opinion).
  • Acknowledge controversies, recent developments, other viewpoints, and any apparent conflicts of interest, or instances of bias that may affect the evidence presented.
  • Highlight the key points about diagnosis and treatment in the discussion and include a summary of key take home points.
  • Use tables, figures to highlight key points and present a step-wise algorithmic approach to diagnosis and treatment when possible.
  • Emphasize evidence-based guidelines and primary research studies, rather than other review articles, unless they are systematic reviews.
  • References are current, relevant, complete and accurate.

References

  1. How to Write an Evidence-Based Clinical Review Article – American Family Physician [Internet]. [cited 2016 Aug 16]. Available from: http://www.aafp.org/afp/2002/0115/p251.html
  2. Guidelines [Internet]. [cited 2016 Aug 16]. Available from: http://www.cfp.ca/site/Authors/Guidelines.xhtml

Method and Written Report Guidelines

(based on instructions for authors, Canadian Family Physician journal, July 12, 2011)

CME Update

Manuscripts must be prepared in accordance with the “Uniform Requirements for Manuscripts Submitted to Biomedical Journals” available on the International Committee of Medical Journal Editors (ICMJE) website.

Abstract: Include Introduction (Review of clinical topic and objective of program), Description, Discussion and Conclusion and should not exceed 300 words. Up to 4 key words (MeSH headings) should be included.

CME Update should not exceed 2500 words, excluding abstract, tables and references.

Introduction: Define the clinical topic and the purpose of the review, and its relevance to family practice.

Method: Indicate how you did the literature search and indicate what sources you searched to ensure a comprehensive assessment of relevant studies (e.g., MEDLINE, Cochrane, TRIP Database, etc.). State how several sources of evidence-based reviews on the topic are evaluated.

Discussion: Discuss evidence-based review of a clinical topic by highlighting the key points about diagnosis and treatment. Acknowledge controversies, recent developments, other viewpoints, conflicts of interest, or instances of bias that may affect the evidence presented. When making therapeutic recommendations, indicate the magnitude of benefit and harm that would be expected.

Conclusion: Provide a summary of clinical topic and key points from review.

References: Must be current and complete. Check references for accuracy, completeness, and proper format (according to the Uniform Requirements for Manuscripts Submitted to Biomedical Journals; http://www.icmje.org/). References should be numbered in the order they appear in the text and should be limited to works cited in the article. List all authors when there are 6 or fewer; when there are 7 or more, list the first 6, followed by et al.

Key Points: Include a short, point-form “key points” section including 1 to 4 points in 50 to 100 words. Key points should not duplicate the abstract or summarize the article; they should highlight what is new, different, unexpected or surprising in the article.

Tables and figures: Attach separately from the main manuscript. Tables and figures should clarify and supplement, but not duplicate, the text. Tables must be self-explanatory and concise. Prepare each table or figure on a separate page. Give titles to tables and captions to figures and other illustrations. Ensure that all tables, figures, and illustrations are cited at appropriate places in the text. Prepare tables in Word; not spreadsheets. Use table structure, not spaces and tabs to format tables.

Images and any other visual material: Attach separately as separate electronic files (do not paste them into the manuscript). These may include photographs, digital illustrations or extra photographs for use if space is available. Images should be sent in a JPG file format.

Authorship: Include a description in written report of what each resident/author contributed to their Resident Scholar Project. In addition, if several residents are involved in one Resident Scholar Project, include a statement to describe the processes they underwent to decide the order of the authors on the Resident Scholar Project written report.

Acknowledgements: Name everyone (e.g. faculty, professionals, research assistants) who contributed to the work of the Resident Scholar Project who are not authors in the Acknowledgements section, describing what they did. Also, describe all financial support of the Resident Project in the acknowledgements.

 

Guidelines for Authorship and Acknowledgements

Please follow the latest authorship definition provided by the Uniform Requirements for Manuscripts Submitted to Biomedical Journals listed below from the website: www.icmje.org as follows:

“All persons designated as authors should qualify for authorship, and all those who qualify should be listed. Each author should have participated sufficiently in the work to take public responsibility for appropriate portions of the content. One or more authors should take responsibility for the integrity of the work as a whole, from inception to published article. Authorship credit should be based only on 1) substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data; 2) drafting the article or revising it critically for important intellectual content; and 3) final approval of the version to be published. Conditions 1, 2, and 3 must all be met. Acquisition of funding, the collection of data, or general supervision of the research group, by themselves, do not justify authorship.”

In addition, all residents and faculty should refer to the Department of Family Practice Authorship and Collaboration policy that was approved by the Post-Graduate Education Committee in 2003. This policy guides the order of authors for faculty and residents who work together on a Resident Scholar Project.