CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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To examine the evidence that the teaching of critical appraisal (evidence-based medicine) skills to undergraduate medical students or residents will result in significant gains in knowledge and increased use of the literature in clinical decision-making. ⋯ Studies of the effect of teaching critical appraisal skills on gains in knowledge at the undergraduate level showed consistent improvement. By contrast, changes in knowledge at the residency level were small. Several suggestions from the educational literature are offered to increase effectiveness of critical appraisal interventions.
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Four years ago the tobacco-smuggling situation was so bad that the federal government reduced its tobacco taxes. All provinces in the East save Newfoundland followed suit by lowering provincial taxes as well. ⋯ Today, cartons of cigarettes that sell for $26 in Ontario cost roughly $45 west of the Ontario border. The result, says David Square, is that tobacco smuggling is now a thriving industry in western Canada.
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To validate a score based on clinical symptoms and signs for the identification of group A Streptococcus (GAS) infection in general practice patients with score throat. ⋯ An age-appropriate sore throat score identified GAS infection in children and adults with sore throat better than usual care by family physicians, with significant reductions in unnecessary prescribing of antibiotics. A randomized trial comparing the 2 approaches is recommended to determine the ability of the score approach to reduce unnecessary prescribing of antibiotics during routine clinical encounters.