CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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Review Practice Guideline Guideline
Adjuvant systemic therapy for women with node-positive breast cancer. The Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer.
To facilitate the choice of systemic adjuvant therapy for women with node-positive breast cancer. ⋯ The author's original text was revised by a writing committee, primary and secondary reviewers, and by the Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer. The final document reflects a substantial consensus of all these contributors.
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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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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.