2. Purpose of Critical Appraisal
Evaluate level of evidence and quality of evidence to support clinical decision-making
How certain are we about the results? (validity)
How applicable are the results to the practice? (applicability; translational capacity)
Schemas exist for critically appraising quantitative research and qualitative research
Take advantage of tools to permit RAPID critical appraisal of evidence

3. More Practical Reasons for Critical Appraisal of Evidence
Judge worthiness of study
Understand reliability and relevance for practice
Make objective decisions about patient care
Make sense of the results
TO EFFECTIVELY PRACTICE AS AN EVIDENCE BASED PRACTICE PROVIDER…

4. Critical Appraisal of Evidence: Key Questions to Consider
Are the results of the study valid?
What are the results?
Do the results apply to my patients?

5. Let’s Use Appraisal Tools to GUIDE Response to the KEY Questions…

6. For N513… Johns Hopkins Rating System
Aggregates evaluative criteria as
Research
Non-research
Because JH system captures qualitative research as “non-research,” we are using Melnyk, et al. Rapid Critical Appraisal Form for Qualitative Studies in addition to JH tools
Rate Level of Evidence first
Rate Quality of Evidence second

7. For N513…
If you need additional guidance to determine level of evidence and quality rating
Use Appendix D from Melnyk & Fineout-Overholt textbook
Checklists specifically address
Case-control studies
Cohort studies
Randomized clinical trials
Systematic reviews
Qualitative evidence
Evidence-based clinical practice guidelines

8. Here is How I Would Approach Rapid Critical Appraisal of Evidence…
Read the study (more than one read is necessary)
Determine the study design FIRST
Prepare a JH Rating System form for the study
Access Appendix D to guide quality evaluation of study
Refer to textbook chapters 5-8 for detailed considerations addressing validity, interpretation of results, and clinical applicability

9. Case Control Studies
Examines why certain people develop disease, experience adverse event, or behave in a certain way (CASES)
By selecting cases and comparing these cases to “controls” (those without the characteristic/condition/behavior) of interest, differences are assumed to explain why CASES ARE CASES and CONTROLS ARE CONTROLS
Remember though…no manipulation or intervention so CAUSE AND EFFECT cannot be conclusively determined with such a design

10. Go to Appendix D
To address the 3 overarching questions for rapid critical appraisal…
Are the results of the study valid?
How were cases obtained?
Were appropriate controls selected?
Were data collection methods same for both?
What are the results?
Is an estimate of effect given (do numbers add up)?
Are there multiple comparisons of data?
Is there any possibility of bias or confounding?
Will the results help me in caring for my patients?
Were the study patients similar to my own?
How do the results compare with previous studies?
What values/expectations do my patients have for the outcome?

11. Go to JH Rating System for Research Form
Because Case Control Studies have two groups for comparison, these studies should be evaluated as research
The checklist should guide your evaluation of the LEVEL
Then QUALITY
Place overall rating at top of JH Rating System form for each study