1. CRITICAL APPRAISAL OF A JOURNALBy
Dr. Enid Elizabeth Thomas

2. 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
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3. 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
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4. 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
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5. Critical appraise? Advantages : systemic way Improve quality/ practice
Objective assessment of information
Easy to develop skills
Disadvantages: time consuming
Answers you hoped to find?
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6. What do I need to know? ² 1. Awareness of study designs
2. Levels of evidence
3. Statistics
4. Critical appraisal checklist
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7. Observational study design measures of disease, measures of risk, and temporality ³
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8. 2.Levels of evidence
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9. 3. Statistics Assess the weight of the evidence Odds ratio p value
Confidence interval
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10. 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?
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11. 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)
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12. What is the clinical question?
Diagnostic test
Differential diagnosis test
Economic analysis test
Harm/ etiology test
Prognostic test
Practical guideline study
Qualitative study
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13. Why was the question asked?
Objectives
Rationale
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14. What did they do? Validity Bias Type of study controls cases Are they
reasonably
comparable?
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15. What was the answer?
Consequence/ effect/ outcome- how are they measured?
Any measurement errors?
Any confounders?
Results
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16. What did they say about the answer?
Decision taken?
Conclusion?
Recommendations
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17. What do I do with this information?
Significant enough to change my practice?
Discussion
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18. Examples! 5
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19. References
J Snelling Susan. Critical appraisal of literature [INTERNET]. Ontario Public Health LibrariesAssociation(OPHLA)2007 May. Available from:
M Young, J Solomon. How to critically appraise an article. Nature clinical practise gastroenterology & hepatology [INTERNET].2009 [Cited on 2016 June 18];6(2): available from:
Jean Baptist du prel Dr, Bernd Rohrig. Critical appraisal of scientific articles.Duetsches Arzteblatt [INTERNET].2009 February 13 [ cited on2016 June 20];106(7); Available from:
F G Fowkes, P M Fulton. Critical appraisal of published research.BMJ [INTERNET].1991 May 11 (cited on 2016 June 20);v.302(6785): available from :
5. CASP (Critical Skills Appraisal Programme) .[INTERNET]. Avvailable from:
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