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 7/7/2016
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 7/7/2016
4 WHY SHOULD WE BOTHER? Published research is not always reliablePatients are better informed and come to us having read material on the web or in the media 7/7/2016
5 Critical appraise? Advantages : systemic way Improve quality/ practiceObjective assessment of information Easy to develop skills Disadvantages: time consuming Answers you hoped to find? 7/7/2016
6 What do I need to know? ² 1. Awareness of study designs2. Levels of evidence 3. Statistics 4. Critical appraisal checklist 7/7/2016
7 Observational study design measures of disease, measures of risk, and temporality ³7/7/2016
8 2.Levels of evidence 7/7/2016
9 3. Statistics Assess the weight of the evidence Odds ratio p valueConfidence interval 7/7/2016
10 4. Checklist—FORMAT ⁴ Credibility of the journal & authorsTitle –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
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) 7/7/2016
12 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
13 Why was the question asked?Objectives Rationale 7/7/2016
14 What did they do? Validity Bias Type of study controls cases Are theyreasonably comparable? 7/7/2016
15 What was the answer? Consequence/ effect/ outcome- how are they measured? Any measurement errors? Any confounders? Results 7/7/2016
16 What did they say about the answer?Decision taken? Conclusion? Recommendations 7/7/2016
17 What do I do with this information?Significant enough to change my practice? Discussion 7/7/2016
18 Examples! 5 7/7/2016
19 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): 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); 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): available from :www.ncbi.nlm.nih.gov 5. CASP (Critical Skills Appraisal Programme) .[INTERNET]. Avvailable from: 7/7/2016
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