The purpose of this review is to present a guide to help readers critically appraise the methodologic quality of an article or articles describing a clinical decision rule. This guide will also be useful to clinical researchers who wish to answer 1 or more questions detailed in this article. We consider the 6 major stages in the development and testing of a new clinical decision rule and discuss a number of standards within each stage. We use examples from emergency medicine and, in particular, examples from our own research on clinical decisions rules for radiography in trauma.

Iconographies supplémentaires de l'article : Methodologic Standards for the Development of Clinical Decision Rules in Emergency Medicine

The Social Media Revolution in Nephrology Education

Objective In 2015 and 2016, the Canadian Journal of Emergency Medicine (CJEM) Social Media (SoMe) Team collaborated with established medical websites to promote CJEM articles using podcasts and infographics while tracking dissemination and readership. Methods CJEM publications in the "Original Research" and "State of the Art" sections were selected by the SoMe Team for podcast and infographic promotion based on their perceived interest to emergency physicians. A control group was composed retrospectively of articles from the 2015 and 2016 issues with the highest Altmetric score that received standard Facebook and Twitter promotions. Studies on SoMe topics were excluded. Dissemination was quantified by January 1, 2017 Altmetric scores. Readership was measured by abstract and full-text views over a 3-month period. The number needed to view (NNV) was calculated by dividing abstract views by full-text views. Results Twenty-nine of 88 articles that met inclusion were included in the podcast (6), infographic (11), and control (12) groups. Descriptive statistics (mean, 95% confidence interval) were calculated for podcast (Altmetric: 61, 42-80; Abstract: 1795, 1135-2455; Full-text: 431, 0-1031), infographic (Altmetric: 31.5, 19-43; Abstract: 590, 361-819; Full-text: 65, 33-98), and control (Altmetric: 12, 8-15; Abstract: 257, 159-354; Full-Text: 73, 38-109) articles. The NNV was 4.2 for podcast, 9.0 for infographic, and 3.5 for control articles. Discussion Limitations included selection bias, the influence of SoMe promotion on the Altmetric scores, and a lack of generalizability to other journals. Conclusion Collaboration with established SoMe websites using podcasts and infographics was associated with increased Altmetric scores and abstract views but not full-text article views.

/pdf/the-impact-of-social-media-promotion-with-infographics-and-53tj911hln.pdf

The impact of social media promotion with infographics and podcasts on research dissemination and readership.

Traditionally, scholars focused their efforts in the domains of clinical care, research, and education; however, the last decade has witnessed the rise of novel areas of development such as innovation, quality improvement, informatics, and recently, digital scholarship. Academic institutions adapted and began considering these fields for academic promotion and tenure. Social media has become a critical space for the dissemination of knowledge and outreach to community and policy makers and also for the creation of communities of practice. This new realm brings multiple challenges, such as the appraisal of the quality and appropriateness of the content, the evaluation of impact on the academe and general populations, coupled to the creation of a system to reward scholars engaged in this novel endeavor. In this article, we describe the current state of academic promotion and the definition, nature, and merit of digital scholarship. We outline new strategies and tools for the assessment of dissemination and impact of these works, such as altmetrics, and finally, we reference innovative concepts on how to organize and use this digital academia on career promotion and tenure.

Social Media Scholarship and Alternative Metrics for Academic Promotion and Tenure

The integration of new knowledge into clinical practice continues to lag behind discovery. The use of Free Open Access Medical education (FOAM) has disrupted communication between emergency physicians, making it easy for practicing clinicians to interact with colleagues from around the world to discuss the latest and highest impact research. FOAM has the potential to decrease the knowledge translation gap, but the concerns raised about its growing influence are 1) research that is translated too quickly may cause harm if its findings are incorrect; 2) there is little editorial oversight of online material; and 3) eminent online individuals may develop an outsized influence on clinical practice. We propose that new types of scholars are emerging to moderate the changing landscape of knowledge translation: 1) critical clinicians who critically appraise research in the same way that lay reviewers critique restaurants; 2) translational teachers adept with these new technologies who will work with researchers to disseminate their findings effectively; and 3) interactive investigators who engage with clinicians to ensure that their findings resonate and are applied at the bedside. The development of these scholars could build on the promise of evidence-based medicine by enhancing the appraisal and translation of research in practice.

/pdf/evidence-based-medicine-in-the-era-of-social-media-scholarly-5er2fv3s6e.pdf

Evidence-based medicine in the era of social media: Scholarly engagement through participation and online interaction.

Author(s): Chan, MD, MHPE, Teresa M.; Thoma, MD, MA, Brent; Krishnan, BHSc, Keeth; Lin, MD, Michelle; Carpenter, MD, MSc, Christopher R.; Astin, MD, Matt; Kulasegaram, PhD, Kulamakan | Abstract: Introduction: Online education resources (OERs) like blogs and podcasts frequently augment or replace traditional medical education resources such as textbooks and lectures. Trainees’ ability to evaluate these resources is poor, and no quality assessment aids have been developed to assist them. This study derived a quality evaluation instrument for this purpose. Methods: We used a three-phase methodology. In Phase 1, a previously derived list of 151 OER quality indicators was reduced to 13 items using data from published consensus-building studies (of medical educators, expert podcasters, and expert bloggers) and further evaluation by our team. In Phase 2, these 13 items were converted to seven-point Likert scales used by trainee raters (n=40) to evaluate 39 OERs. The reliability and usability of these 13 rating items was determined using responses from trainee raters, and top items were used to create two OER quality evaluation instruments. In Phase 3, these instruments were compared to an external certification process (the ALiEM AIR certification) and the gestalt evaluation of 39 blog posts by 20 faculty educators. Results: Two quality-evaluation instruments were derived with fair inter-rater reliability: the METRIQ-8 Score (Inter class correlation coefficient [ICC]=0.30, pl0.001) and the METRIQ-5 Score (ICC=0.22, pl0.001). Both scores, when calculated using the derivation data, correlated with educator gestalt (Pearson’s r=0.35, p=0.03 and r=0.41, pl0.01, respectively) and were related to increased odds of receiving an ALiEM AIR certification (Odds Ratio=1.28, p=0.03; OR=1.5, p=0.004, respectively). Conclusion: Two novel scoring instruments with adequate psychometric properties were derived to assist trainees in evaluating OER quality and correlated favourably with gestalt ratings of online educational resources by faculty educators. Further testing is needed to ensure these instruments are accurate when applied by trainees. [West J Emerg Med. 2016;17(5)574-584.]

/pdf/derivation-of-two-critical-appraisal-scores-for-trainees-to-42r1zxbjbi.pdf

Derivation of Two Critical Appraisal Scores for Trainees to Evaluate Online Educational Resources: A METRIQ Study.

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Derivation of Two Critical Appraisal Scores for Trainees to Evaluate Online Educational Resources: A METRIQ Study.