***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To help people who give health information to the public develop the skills they need to make sense of evidence about effectiveness . DESIGN Educational approach , preceded by careful planning with representatives of possible participants . SETTING AND STUDY OF PARTICIPANTS : Staff in consumer health information services and members of maternity self-help groups in the UK in summer 1995 . INTERVENTIONS Pairs of half-day workshops introducing participants to r and omised controlled trials and systematic review s and to their critical appraisal . The workshops were run participatively and had at their centre a critical appraisal session in small groups . MAIN OUTCOME MEASURES Attendance at workshops , satisfaction and enjoyment of workshops ; comments at a follow-on event . RESULTS Four pairs of workshops were held ( three for consumer health information services , one for maternity self-help groups ) , 54 people attended a pair of workshops and a further 34 attended individual workshops . The workshops were enjoyed and found to be a good use of time . CONCLUSIONS It is feasible to introduce critical appraisal skills to people whose primary role is to give health information to the public . There is a need for comparative evaluation of different approaches Abstract Objective : To evaluate the READER model for critical reading by comparing it with a free appraisal , and to explore what factors influence different components of the model . Design : A r and omised controlled trial in which two groups of general practitioners assessed three papers from the general practice section of the BMJ . Setting : Northern Irel and . Subjects : 243 general practitioners . Main outcome measures : Scores given using the READER model ( Relevance , Education , Applicability , Discrimination , overall Evaluation ) and scores given using a free appraisal for scientific quality and an overall total .  Results : The hierarchical order for the three papers was different for the two groups , according to the total scores . Participants using  the READER method  ( intervention group ) gave a significantly lower total score ( P⩽0.01 ) and a lower score for the scientific quality ( P⩽0.0001 ) for all three papers . Overall more than one in five ( 22 % ) , and more men than women , read more than 5 articles a month ( P⩽0.05 ) . Those who were trainers tended to read more articles ( P⩽0.05 ) , and no trainers admitted to reading none . Overall , 58 % ( 135/234 ) ( 68 % ( 76/112 ) of the intervention group ) believed that taking part in the exercise would encourage them to be more critical of published articles in the future ( P⩽0.01 ) . Conclusion : Participants using the READER model gave a consistently lower overall score and applied a more appropriate appraisal to the methodology of the studies . The method was both accurate and repeatable . No intrinsic factors influenced the scores , so the model is appropriate for use by all general practitioners regardless of their seniority , location , teaching or training experience , and the number of articles they read regularly Objective : To teach internal medicine residents key principles of clinical epidemiology that are necessary to read critically the medical literature . Design : Two-phase , non-r and omized , controlled educational trial . Setting : University-based training program for residents ( PGY-l-PGY-3 ) in internal medicine . Participants : All 83 residents participated in the trial . Seventy residents completed a test in clinical epidemiology at the end of Phases I and II . Interventions : Residents were assigned to one of eight ambulatory care clinics for half a day each week . A literature -based curriculum in critical appraisal was the subject of a weekly pre-clinic conference for four clinics ( Group A ) . The other four clinics ( Group B ) had a weekly conference on topics in ambulatory care medicine . At the end of Phase I , both groups were given a test of basic knowledge of clinical epidemiology . The curriculum was then modified with the addition of written questions to emphasize important educational points and to stimulate resident participation . The modified curriculum became the subject of the preclinic conference for Group B , while Group A changed to topics in ambulatory medicine . At the end of Phase II both groups were again tested on basic knowledge of clinical epidemiology . Results : Group B performed significantly better on the second test than on the first , 68.5 % vs. 63.3 % ( p=0.034 ) , while Group A did not improve ( 64.5 % vs. 65.9 % ) . The differences in test scores for Test II minus Test I were+5.17 % in Group B and −1.44 % in Group A ( p=0.019 ) . Twenty-one percent of Group B residents vs. 5 % of Group A residents improved their scores by 18 % or more . Conclusions : The residency period is a difficult but important time to teach critical appraisal skills . Educational gains may be small and need to be critically evaluated to stimulate the development of more effective educational programs Background The ability to critically appraise the calibre of studies in medical literature is increasingly important for medical professionals . Aim This prospect i ve controlled study evaluated the impact of a 6-h Evidence Based Medicine ( EBM ) Workshop on the critical appraisal skills of medical trainees . Methods Individuals attended three 2-h workshops over a 3-week period , incorporating didactic lectures in statistics , clinical trial design , appraising research papers and practical examples .  Appraisal skills were assessed pre- and post-training based on grading the quality of r and omised control studies ( level 1 evidence ) , cohort studies ( level 2 evidence ) and case – control studies ( level 3 evidence ) [ From Oxford Centre for Evidence Based Medicine Levels of Evidence ( 2001 ) , http://www.cebm.net/critical _ appraisal .asp ] . Results Overall grading improved from 39 % ( pre-course ) to 74 % ( post-course ) , P = 0.002 , with grading of levels 1 , 2 and 3 studies improving from 42 to 75 % , 53 to 61 % and 21 to 84 % , respectively . Conclusions We conclude that a 6-h formal EBM workshop is effective in enhancing the critical appraisal skills of medical trainees The merits or otherwise of publishing hospital specific death rates are much debated . This article compares the relative sensitivity of measures of process and outcome to differences in quality of care for the hospital treatment of myocardial infa rct ion . Aspects of hospital care that have a proved impact on mortality from myocardial infa rct ion are identified , and the results from meta- analysis and large r and omised controlled trials are used to estimate the impact that optimal use of these interventions would have on mortality in a typical district general hospital . Sample size calculations are then performed to determine how many years of data would be needed to detect significant differences between hospitals . A comparison is then made with the amount of data that would be needed to detect significant differences if information about process of care was being collected . Process measures based on the results of r and omised controlled trials were found to be able to detect relevant differences between hospitals that would not be identified by comparing hospital specific mortality , which is an insensitive indicator of the quality of care Objective : To determine whether an interactive seminar could affect medical student  knowledge of research design , basic critical appraisal skills , and attitudes toward and clinical use of the medical literature . Design : Controlled , nonr and omized clinical trial Participants : Third-year clinical clerks ( n=146 ) during their core medicine clerkship . Interventions : Two 90 minute interactive seminars . Measurements and main results : Pre- and post question naires were used to assess knowledge and attitudes regarding the use of the medical literature among 65 study and 81 control students . Blinded review of write-ups assessed actual use of the medical literature . Overall , 80 % of the students subscribed to one or more journals and reported reading three or more journal articles per month . After the intervention , the study students were more likely than the control students to consider : 1 ) study design important in article selection and 2 ) use of medical literature critical to patient care decisions . Knowledge scores were significantly improved in the study group ( p=0.0001 ) . The intervention yielded no increase in the actual use of medical literature in patient write-ups over that encouraged by usual clerkship goals . 51 % of the study and 48 % of the control students cited literature at baseline , and 53 % of all the students did so after the intervention . Of these citations , 50 % were for journal articles and the remainder were for textbooks . The students infrequently mentioned the quality of the cited literature . Conclusions : An interactive seminar design ed to introduce medical students to critical appraisal improved student knowledge and attitudes but did not increase the actual use of literature in patient writeups BACKGROUND Evidence Based Review s in Surgery ( EBRS ) is an Internet journal club that is effective in teaching critical appraisal skills to practicing surgeons . The objective of this r and omized controlled trial was to determine whether teaching critical appraisal skills to surgical residents through the Internet is as effective as a moderated in-person journal club . STUDY DESIGN Twelve general surgery programs were cluster-r and omized to an Internet group ( 6 programs ; 227 residents ; 23 to 47 residents/program ) or a moderated journal club ( 6 programs , 216 residents , 21 to 72 residents/program ) . Each EBRS package includes a clinical and method ological article plus clinical and method ological review s. Residents in the Internet group were required to complete 8 EBRS packages online plus participate in an online discussion group . Residents in the moderated group were required to attend 8 journal clubs moderated by a faculty member . All residents completed a vali date d test assessing expertise in critical appraisal . RESULTS In the Internet group , only 18 % of residents completed at least 1 EBRS package compared with 96 % in the moderated group . One hundred and thirty ( 57.8 % ) residents in the Internet group completed the test compared with 157 ( 72.7 % ) in the moderated group . The residents in the moderated group scored considerably better on the critical appraisal test , with a mean score of 42.1 compared with 37.4 in the Internet group ( p = 0.05 ) , with a moderate effect size of 0.6 SD . CONCLUSIONS A moderated journal club is considerably better in teaching critical appraisal skills to surgical residents . This is likely because of the low participation in the Internet journal club BACKGROUND The effectiveness of interventions for developing critical appraisal skills in practicing physicians has not been studied , despite the documented importance of reading the literature in caring for patients and in continuing professional development . The objective of this study was to evaluate whether an Internet-based intervention would lead to enhanced critical appraisal skills in practicing surgeons . METHODS General surgeons who agreed to participate were r and omized into 2 groups . The intervention was a curriculum in critical appraisal skills that included a clinical and method ologic article , a listserve discussion , and clinical and method ologic critiques . The control group received only the clinical articles . The primary outcome measure was a previously vali date d 2-hour test of critical appraisal . RESULTS Of the 55 surgeons who completed the examination , subjects in the intervention group performed better on the test of critical appraisal skills than those in the control group ( mean score : intervention group , 58 % + /- 8 vs control group , 50 % + /- 8) , with a large effect size of 1.06 st and ard deviation units ( t+3.92 , P < .0001 ) . Training conditions accounted for 22 % of the variance in total scores . CONCLUSIONS A multifaceted , Internet-based intervention result ed in improved critical appraisal skills of practicing general surgeons OBJECTIVE 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 . DATA SOURCES Articles published from 1966 to 1995 , retrieved through a MEDLINE search supplemented by manual search es ; review of bibliographies maintained by individuals involved in teaching critical appraisal skills ; and a previous method ological review . STUDY SELECTION Articles were selected if the study involved some form of control group , although strict r and omization was not required , and a measure of performance followed the intervention . Articles were excluded if they simply reported the process of teaching critical appraisal skills or used some form of " happiness index . " DATA SYNTHESIS There were 10 studies of the impact of teaching critical appraisal skills  , 6 involving medical students and 4 involving residents . Results from 3 of the studies were nearly uninterpretable and thus were excluded ; the remaining 7 were method ologically acceptable . Analysis showed that interventions implemented in undergraduate programs result ed in significant gains in knowledge , as assessed by a written test ( mean gain 17.0 % ; st and ard deviation [ SD ] 4.0 % ) . Conversely , studies at the residency level consistently showed a small change in knowledge ( mean gain 1.3 % ; SD 1.7 % ) . Two studies that examined residents ' use of the literature were unable to demonstrate any positive changes . CONCLUSIONS 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 Medical students taking a course in epidemiology for clinical practice were taught by either lectures , small group seminars or self-learning packages .  Examination performances were no different for the three groups , but self-perceived mastery of learning objectives , and satisfaction with the course were higher for students who received self-learning packages . Sixty per cent of  self instruction students found the teaching method was successful compared with 37 % of the seminar students and only 19 % who received lectures . A combination of self-instructional package and seminar would seem to hold most promise for a workable and effective course BACKGROUND Critical reading is an important skill for those trying to practice evidence -based medicine . There are a number of recognized structures for critical reading , including the READER model . These 
    Output:
    
Low-intensity critical appraisal teaching interventions in healthcare population s may result in modest gains .