CRITICAL APPRAISAL OF A JOURNAL By Dr. Enid Elizabeth Thomas
What is Critical Appraisal? “Critical appraisal is the process of systematically examining research evidence to assess its validity, results, and relevance before using it to inform a decision” ¹ (Hill and Spittlehouse, 2001, p.1) Consideration of quantitative and qualitative aspects 7/7/2016
Critical Appraisal is: Balanced assessment of strengths of research against its weaknesses Assessment of research process and results To be undertaken by all health professionals as part of their work 7/7/2016
WHY SHOULD WE BOTHER? Published research is not always reliable Patients are better informed and come to us having read material on the web or in the media 7/7/2016
Critical appraise? Advantages : systemic way Improve quality/ practice Objective assessment of information Easy to develop skills Disadvantages: time consuming Answers you hoped to find? 7/7/2016
What do I need to know? ² 1. Awareness of study designs 2. Levels of evidence 3. Statistics 4. Critical appraisal checklist 7/7/2016
Observational study design measures of disease, measures of risk, and temporality ³ 7/7/2016
2.Levels of evidence 7/7/2016
3. Statistics Assess the weight of the evidence Odds ratio p value Confidence interval 7/7/2016
4. Checklist—FORMAT ⁴ Credibility of the journal & authors Title –clinical question Clear & informative (explained well about the paper) Abstract – How it was done? Structured or non-structured. How the study was summarised? Do you feel the information provided adequate? Introduction – Study justified (rationale); objectives clearly stated Methodology – Design, Sampling method, Sample size, Data definition, Data collection, Statistical analysis, Ethical issues Results – Answers the objectives, Consistent, Clear illustrations or tables Discussion – Answers the objectives, Discuss the strength & weakness of the study, study limitations Conclusion of the appraisal- how useful is it? 7/7/2016
Always Ask Six Things 1) What is the clinical question? 2) Why was the question asked? 3) What did they do? Methods 4) What was the answer ? Results 5) What did they say about the answer? Conclusion 6) What do I do with this information? Is this study of significant quality in method to change my practice one way or the other? - (Studies done different ways mean different things) (Look at commentary/discussion) 7/7/2016
What is the clinical question? Diagnostic test Differential diagnosis test Economic analysis test Harm/ etiology test Prognostic test Practical guideline study Qualitative study 7/7/2016
Why was the question asked? Objectives Rationale 7/7/2016
What did they do? Validity Bias Type of study controls cases Are they reasonably comparable? 7/7/2016
What was the answer? Consequence/ effect/ outcome- how are they measured? Any measurement errors? Any confounders? Results 7/7/2016
What did they say about the answer? Decision taken? Conclusion? Recommendations 7/7/2016
What do I do with this information? Significant enough to change my practice? Discussion 7/7/2016
Examples! 5 7/7/2016
References J Snelling Susan. Critical appraisal of literature [INTERNET]. Ontario Public Health LibrariesAssociation(OPHLA)2007 May. Available from:www.publiccommons.ca/publicuploads/caore.pdf M Young, J Solomon. How to critically appraise an article. Nature clinical practise gastroenterology & hepatology [INTERNET].2009 [Cited on 2016 June 18];6(2):82-91. available from:www.medscape.com/viewarticle/706399 Jean Baptist du prel Dr, Bernd Rohrig. Critical appraisal of scientific articles.Duetsches Arzteblatt [INTERNET].2009 February 13 [ cited on2016 June 20];106(7); 100-105. Available from:www.ncbi.nlm.nih.gov F G Fowkes, P M Fulton. Critical appraisal of published research.BMJ [INTERNET].1991 May 11 (cited on 2016 June 20);v.302(6785):1136-1140. available from :www.ncbi.nlm.nih.gov 5. CASP (Critical Skills Appraisal Programme) .[INTERNET]. Avvailable from: http://www.phru.nhs.uk/casp/critical_appraisal_tools.htm 7/7/2016
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