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The worldwide dissemination of mobile phones, now reaching more than 5 billion connections,1 enables healthcare providers to reach medical information resources on the internet. This is particularly significant because most doctors now believe that the internet is essential to the practice of medicine.2 An abundance of clinical practice resources previously unavailable to clinicians in remote locations – journal citations and abstracts from the MEDLINE/PubMed at the National Library of Medicine among them – are now accessible at the point where care is given.
An unintended consequence of MEDLINE abstracts, originally developed only for indexing journals, is that they have become the de facto source of evidence for many.3,–,5 The reasons are obvious – they are easy to read and readily accessible, and they give the reader a quick summary of the article. The IMRAD (Introduction, Methods, Results and Discussion) format which provided the logical structure to the abstract mirrored the full-text article and made them more informative.6 7 Recent innovations, like BMJ's pico8 format, offer even more detailed information although they are not critically appraised, unless they are derived from systematic research.
For clinicians and academicians who want to practice evidence-based medicine (EBM) in an environment with unfettered access to full-text articles, the classical approach of deriving evidence through critical appraisal of the full-text article is still the ideal. However, it is not for everyone. It is difficult to practice and is disruptive and challenging to integrate into the daily workflow especially in a non-academic environment. It also requires expertise acquired through years of practice. Even the teachers of EBM at McMaster University acknowledge after years of experience with residents in their training programmes that high-level complex appraisal is not suited for everyone.9
However, clinicians who have some appraisal …