How to critically appraise the clinical literature (original) (raw)
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Principles of critical appraisal in evidence-based medicine
The term critical appraisal of the literature, as used in the context of evidence-based medicine (EBM), refers to the application of predefined rules of evidence to a study to assess its methodological quality and the clinical usefulness of its results. Critical appraisal represents the most technical step in the process of EBM and can be quite demanding for the practitioner. The aim of this paper is to provide the reader with the theoretical skills necessary to understand the principles behind critical appraisal of the literature. These include: (a) the description of the main types of study design used in epidemiological research, (b) the basic statistical procedures used in data analysis, (c) the principles of causal inference and (d) the description of the types of health outcome and measures of effect. These issues are discussed in the present paper and illustrated with several examples from the relevant literature.
Critical Appraisal in Clinical Practice: Sometimes Irrelevant, Occasionally Invalid
Journal of the Royal Society of Medicine, 2001
A core activity of evidence-based practice is the search for and appraisal of evidence on specific clinical issues. Clinicians vary in their competence in this process; we therefore developed a 16-item checklist for quality of content (relevance and validity) and presentation (useability, attribution, currency and contact details). This was applied to a set of 55 consecutive appraisals conducted by clinicians and posted at a web-based medical journal club site. Questions were well formulated in 51/55 (92%) of the appraisals. However, 22% of appraisals missed the most relevant articles to answer the clinical question. Validity of articles was well appraised, with methodological information and data accurately extracted in 84% and accurate conversion to clinically meaningful summary statistics in 87%. The appraisals were presented in a useable way with appropriate and clear bottom-lines stated in 95%. The weakest link in production of good-quality critical appraisals was identificatio...
Critical appraisal of medical literature: second update
Canadian family physician Médecin de famille canadien, 1990
This skill-testing exercise was created for the purpose of updating the teaching package, Critical Appraisal Package: Therapy, published by the College of Family Physicians of Canada in 1986. This exercise follows the same format as the original package: presentation of a clinical scenario, an article, a worksheet, and methodology notes. The article being evaluated concerns the effectiveness of antihistamine decongestants in the prevention of acute otitis media in children with colds.
2014
Background Recently there has been a significant increase in the number of systematic reviews addressing questions of prevalence. Key features of a systematic review include the creation of an a priori protocol, clear inclusion criteria, a structured and systematic search process, critical appraisal of studies, and a formal process of data extraction followed by methods to synthesize, or combine, this data. Currently there exists no standard method for conducting critical appraisal of studies in systematic reviews of prevalence data. Methods A working group was created to assess current critical appraisal tools for studies reporting prevalence data and develop a new tool for these studies in systematic reviews of prevalence. Following the development of this tool it was piloted amongst an experienced group of sixteen healthcare researchers. Results The results of the pilot found that this tool was a valid approach to assessing the methodological quality of studies reporting prevalence data to be included in systematic reviews. Participants found the tool acceptable and easy to use. Some comments were provided which helped refine the criteria. Conclusion The results of this pilot study found that this tool was well-accepted by users and further refinements have been made to the tool based on their feedback. We now put forward this tool for use by authors conducting prevalence systematic reviews.
Critical appraisal on journal of clinical trials
Acta medica Indonesiana, 2012
Critical appraisal is an element of evidence-based medicine, which is defined as the process of carefully and systematically examining a research article to determine its reliability, validity and value in clinical practice. The major components evaluated in critical appraisal are validity, importancy, and applicability. The level of reliability of study results depend on the design of study, in which clinical trial has the highest rank. Critical appraisal includes all components of the research starting from the introduction, method, results and discussion. Each component has similar value to establish whether the results can realistically be applied as a reference. The results of statistical significance should also been compared with its clinical significance.
In search of the evidence: informing effective practice
British Journal of Clinical Governance, 1996
Despite the abundant journal literature the challenge for the health care professional is in retrieving clinically relevant information. Critical appraisal is a useful tool in meeting this challenge. This article examines the five stages of the critical appraisal process and the information implications associated with each stage. The role of health information workers, together with their training and development requirements, is also outlined. Clinicians and information workers need to work together to provide further evidence in support of the effectiveness of literature-based approaches and their contribution to patient care.