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PICO question In dogs with hyperadrenocorticism that are being treated with trilostane, does the measurement of basal cortisol levels have comparable diagnostic performance to the adrenocorticotropic hormone (ACTH) stimulation test? Clinical bottom line Category of research question Diagnosis (effectiveness of treatment monitoring) The number and type of study designs reviewed Four cross-sectional diagnostic accuracy studies were critically reviewed Strength of evidence Weak to moderate (level 2) Outcomes reported There is evidence of moderate strength suggesting that basal cortisol measured at 4–6 hours (and possibly 2–3 hours) post-trilostane can be a good test to exclude adrenal oversuppression, while its use is not suggested for diagnostic confirmation of oversuppression. There is evidence of weak strength that basal cortisol might be helpful for identifying dogs with inadequate adrenal suppression, but cannot be used to rule it out Conclusion Although the evaluation of the available evidence is difficult due to its heterogeneity, there is moderate evidence that a basal cortisol measured at 4–6 hours (and possibly 2–3 hours) post-trilostane dose can be a good test to rule out adrenal oversuppression, but that it cannot be used to definitively diagnose oversuppression. The current evidence suggests that basal cortisol is less useful for identification of inadequate control. Based on one included study, neither ACTH-stimulated nor basal cortisol levels correlate optimally with the actual clinical response of the patient. In this context, it can be concluded that none of the currently used laboratory tests should be used as a sole monitoring tool in dogs with hyperadrenocorticism receiving trilostane and thus, the assessment of the clinical response is of utmost importance How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.

In order to deal with the constantly and rapidly changing conditions of life, a decision-making capacity is needed. Critical thinking can help effectively in this, and that is why it is an ability that modern education seeks to cultivate. In Informatics-related education, critical thinking is essential. Consequently, in Informatics textbooks it is expected that the cultivation of the critical thinking skills will be promoted. This research is aimed to determine whether this is the case in the Informatics textbook of the A-class of the Greek General Lyceum and for this reason, the content of this textbook was examined. The method that has been used is the Content Analysis, which is an established method for analysis of texts in social sciences. The present research has revealed that in the text the promotion of the cultivation of critical thinking skills is insufficient and in such a way that these skills are not treated equally. These findings should be taken into account during educational use of the textbook.

PICO question What is the sensitivity and specificity of cytology as a test for canine osteosarcoma when compared to histopathology as a gold standard? Clinical bottom line Category of research question Diagnosis The number and type of study designs reviewed Overall, four diagnostic validity studies (two prospective and two retrospective) were critically appraised Strength of evidence Weak to moderate Outcomes reported There is evidence of moderate strength to support that cytology is highly sensitive and specific for diagnosing histologically confirmed osteosarcomas as mesenchymal malignant neoplasms (cytological diagnosis of sarcoma). Evidence of weak strength suggests that the sensitivity and specificity of cytology for identifying the exact histotype (cytological diagnosis of osteosarcoma) are low and high, respectively. Finally, there is currently evidence of weak strength indicating that the sensitivity and specificity of cytology are comparable to that of preoperative histopathology after incisional biopsy for the diagnosis of canine osteosarcoma Conclusion Based on the available evidence, the diagnostic accuracy of cytology in diagnosing histologically confirmed osteosarcomas as sarcomas is high, whereas a confident conclusion cannot be drawn regarding the diagnostic accuracy of cytology for the identification of the exact histotype (cytological diagnosis of osteosarcoma). There is currently scant evidence suggesting that cytology has comparable diagnostic accuracy to preoperative histopathology (i.e. after incisional biopsy) for the diagnosis of canine osteosarcomas, however, more studies are warranted to confirm these results How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.

To solve problems, specific skills are needed. Critical thinking can help develop such skills. It can contribute to improving problem-solving skills, developing communication skills and cultivating decision making skills. Critical thinking is considered to be a key pedagogical goal in education. Education of informatics and critical thinking have a strong relationship since students cannot develop skills related to Informatics if they cannot think critically. Therefore, within the informatics textbooks the cultivation of critical thinking skills should be promoted. The present paper aims to determine to what extent the cultivation of critical thinking skills is promoted in the Informatics textbook of the first class of the Greek lyceum. This textbook contains thematic units referring to hardware-software and applications, programming environments-applications development and communication collaboration and security within Internet. The method that was used is the quantitative content analysis. The present research revealed that within the examined textbook cultivating critical thinking skills is promoted insufficiently, since in the whole text, the cultivation of critical thinking skills is promoted in a small percent of the text it covers. In the examined material, the critical thinking skills whose cultivation is promoted are the interpretation skill, the analysis skill, the evaluation skill, the inference skill and the explanation skill. The interpretation skill is represented by the categorization sub-skill and the clarifying meaning sub-skill. The analysis skill is represented by the examining ideas sub-skill. The evaluation skill is represented by the assessing claims sub-skill. The inference skill is represented by the querying evidence sub-skill, the conjecturing alternatives sub-skill and the drawing conclusions sub-skill. The explanation skill is represented by the stating results sub-skill and the presenting arguments sub-skill. Moreover, it was found that within the examined text, the cultivation of the self-regulation skill is not promoted. The only parts of the examined text in which the cultivation of critical thinking skills is promoted in the largest percentage of the text they cover are the teaching objectives and in the activities.