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WoSCAN CPD GROUP. CRITICAL APPRAISAL RESOURCE GUIDE JULY 2007. What this guide covers. Definitions & introduction to critical appraisal Links to worked critical appraisal examples Sources of checklists and glossaries Information about interpreting statistics

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JULY 2007

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What this guide covers

  • Definitions & introduction to critical appraisal

  • Links to worked critical appraisal examples

  • Sources of checklists and glossaries

  • Information about interpreting statistics

  • Sources of formal training opportunities

    Use the arrows at the bottom of each page to move back and forward through the resource guide

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Definitions of critical appraisal

  • To weigh up the evidence critically to assess its validity (closeness to the truth) and usefulness (clinical applicability)

    [Sackett and Haynes, 1995]

  • The assessment of evidence by systematically reviewing it’s relevance, validity and results to specific situations [Ruth Chambers, 1998]

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Why is critical appraisal important?

  • To help us determine best evidence

  • To encourage objective assessment of the usefulness of information

  • To help us decide if published research is good enough to be part of the decision making process

  • To close the gap between research and practice and provide a systematic framework for interpreting research

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The critical appraisal process

  • Define problem or scenario

  • Search appropriate evidence sources

  • Identify studies at highest point on evidence hierarchy

  • Use appropriate critical appraisal checklist

  • Assess relative merits /demerits

  • Make overall assessment (strength of evidence)

  • Apply findings (strength of recommendations)

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The evidence hierarchy

  • Systematic reviews and meta-analyses

  • RCTs

  • Cohort studies

  • Case control studies

  • Case series / case reports

  • Opinions/ letters

  • Animal research

  • In vitro research

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Key critical appraisal questions

  • Are the results valid?

  • What are the results?

  • Will the results help locally?

    Validity / Significance / Relevance

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Worked critical appraisal scenarios

  • Centre for Health Evidence: user guides to evidence based practice

    Advice and worked examples of how to find, appraise and apply different types of research in practice. Originally published as a series in the Journal of the American Medical Association (JAMA)

  • Evidence Based Medicine (Michigan State University)

    Introduces the basic concepts of evidence-based medicine and critical appraisal. Includes worked examples for diagnosis, therapy, prognosis & meta-analysis.

  • Hunt, DL. Locating and appraising systematic reviews. Annals of Internal Medicine. 126(7), 1997. p532-8.

    Article includes an example of how to critically appraise a systematic review.

  • SCHARR (School of Health and Related Research, Sheffield)

    Worked examples of a Review, RCT and Qualitative study

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Checklists & Glossaries

  • CASP checklists from Public Health Resource Unit, Oxford

    Tools developed by the Critical Appraisal Skills Programme (CASP) for the NHS

  • Centre for Evidence Based Medicine (CEBM) Oxford

    Checklists for Reviews, RCTs, Diagnosis and Prognosis papers

  • Users Guides to Evidence based Practice

    Originally published in JAMA, covers all research methodologies

  • University of Glasgow checklists

    Checklists for appraising the main types of research article

  • Best Evidence Topics

    Checklists for main types of research from Manchester Royal Infirmary

  • An EBM glossary from Bandolier

    Covers wide range of terminology used in appraisal and EBM

  • Cochrane Reviewer’s Glossary

    Guide to terminology for those taking part in Cochrane Reviews

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Statistics explained

  • BMJ Statistics for non statistician part 1

    Taken from ‘How to read a paper’ by Greenhalgh

  • BMJ Statistics for non statistician part 2

    Taken from ‘How to read a paper’ by Greenhalgh

  • The ‘What is?’ series

    Includes short guides on NNTs, Confidence Intervals, Cox models

  • Centre for Evidence Based Medicine (CEBM), Oxford

    Interactive tools, explanations and examples of statistical methods

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Formal training opportunitiesClick on the title of the course to find out more information & contact details

  • ‘Understanding evidence’ at University of Glasgow

    Looks at concepts of ‘evidence’ and appraisal methods

  • Centre for Evidence Based Medicine, Oxford (CEBM)

    Provide a number of workshops and training days on evidence based practice and critical appraisal

  • CASP (Critical Appraisal Skills Programme)

    CASP workshops can be tailored to individual's/organisation’s needs and cover three key themes; finding the evidence, appraising the evidence and acting on the evidence

  • SIGN (Scottish Intercollegiate Guidelines Network)

    Offers courses in critical appraisal at two different levels; introduction to critical appraisal and interpreting evidence

  • SCHARR (School of Health and Related Research, Sheffield)

    Provides a range of training sessions including EBM and critical appraisal

  • UK Clinical Research Network: critical appraisal skills

    One day course providing an introduction to critical appraisal and evidence based practice

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Further Information

If you require any further information

about critical appraisal please contact

Kirsty Coltart , Beatson Librarian

0141 301 7285

Fran Schofield, NHSGGC Nursing Librarian

0141 211 1239