About Tools for Practice
Proudly sponsored by ACFP, Tools for Practice is a valuable service for our members. The biweekly articles summarize medical evidence on a clinical question with a focus on information that can modify your day to day practice.
Articles are reviewed for current evidence and updated on a two- to three-year cycle.
Free From Industry
TFP content is developed free of industry bias and is based on the best available evidence. Each article is peer-reviewed, ensuring it maintains a high standard of quality, accuracy, and academic integrity. Family physicians that consult the TFP resource can be assured that they are accessing a wealth of established, verified knowledge.
Tools for Practice is coordinated by Dr. G. Michael Allan (Mike), Professor and Director of Evidence Based Medicine in the University of Alberta’s Department of Family Medicine. Dr. Allan is a highly respected practitioner and educator. He has been a popular and recurring speaker at the College’s Annual Scientific Assemblies, and has agreed to share his knowledge and experience with colleagues through Tools for Practice.
The Making of Tools for Practice
Authors for each article must include at least one practising family physician (for a primary care focus). Other authors have included medical/pharmacy students, specialists (general internal medicine, geriatrics, endocrinology, psychiatry, gastroenterology, neurology, and pulmonology), pharmacists, and nurse practitioners.
All questions must be focused and clear and the topics must have a broad or large application to clinical practice. Topics are selected by a variety of mechanisms including recent issues in the news (e.g. CCSVI surgery for MS), emerging evidence (e.g. cardiovascular risks of calcium), new products with primary care impact (e.g. Dabigatran), topics written in by readers (e.g. association of autism and MMR vaccine), external topic selected by potential author (e.g. high-dose statin), questions from CME meetings (e.g. VT risk with hormonal contraception), where guideline recommendation deviates from the evidence (e.g. frequency of bone mineral density testing), or where standards of care have lagged behind current evidence (e.g. ibuprofen vs acetaminophen for pediatric fever).
Evidence Selection and Article Formatting
Tools for practice are targeted to be 300 words (without title or references) and have a maximum word limit of 350. Three to five drafts are common before the article goes to peer review. Citations are done in abbreviated style (journal, year, volume, and pages) and, since May 2012, the first three authors are included. Articles are divided into four sections:
- Bottom Line
Authors perform a search of Medline-PubMed and frequently Google scholar. They also review guidelines and track references or cited articles. Relevant studies are then critically appraised and summarized as much as possible into the Evidence section.
The Bottom Line is a plain language summary to address the question and provide clinicians a focused answer for the clinical issue.
The Evidence section starts, whenever possible, with the highest levels of evidence (Systematic Review & Meta-analysis and/or Randomized Controlled Trials).
The Context section includes limitations of the evidence, weaker evidence (e.g. cohort or case-control studies) related to the question, guidelines, and important aspects of application.
Each article is assigned to one of the three editors who is not an author of the article. The article is then sent to two peer-reviewers (selected by the assigned editor with authors’ suggestions as needed) who then complete a brief electronic peer review form and submit it to the assigned editor. The assigned editor critiques the Tools for Practice article, reviews the peer reviewers’ comments, and provides directive feedback to the authors on content. Once the authors address issues raised by reviewers/editor, it is formatted for style and copy-edited, following which is is sent away for translation, before being published on the ACFP website in English and French, and mailed to over 30,000 family physicians and allied health care providers across Canada and internationally.
Translation and Publication
Following peer review and final approval by the article’s assigned editor and authors, Tools for Practice are sent for translation. Since the summer of 2015, articles have been translated into French to increase reach and accessibility.
With the introduction of GoMainpro in the summer of 2014, the ACFP also extended partnership opportunities to other provincial Chapters of the CFPC. Presently, the ACFP partners with the following Chapter offices to send out articles to over 30,000 physicians across the country:
- British Columbia
- New Brunswick
- Nova Scotia
- Price Edward Island