CRITICAL APPRAISAL

Question 1

what is a critical appraisal?

Answer 1

the process of systematically examinining research evidence to assess its validity, results and relevance before using it to inform a decision

Question 2

outline the process of making an evidence based decision?

Answer 2

choose an answerable question (PICO), search for the best evidence, appraise the evidence and then make a decision on the basis of that evidence, available resources, patient preference and clinical experience

Question 3

what study design should you use for a question on diagnosis?

Answer 3

cross sectional analytic study

Question 4

what study design should you use for a question on aetiology?

Answer 4

cohort study

population-based case-control study

Question 5

what study design should you use for a question on prognosis?

Answer 5

coort study

Question 6

what study design should you use for a question on treatment?

Answer 6

RCT

systemtic review of RCTs

Question 7

what study design should you use for a question on evaluation?

Answer 7

qualitative research

Question 8

what are the benefits of systematic reviews?

Answer 8

• includes all availabel research to answer a question
• includes research that is unpublished
• increases total sample size = increases levels of certainty and recision
• increases variation amongst studies
• can indicate need for further researcg
• permits sub-group analyses and sensitivity analyses

Question 9

what are CASP checklists?

Answer 9

checklists to help prompty questions to help evaluate research studies

Question 10

what are the 3 discrete steps of critical appraisal?

Answer 10

are the results of the study valid?
what are the results of the study?
can i apply the results to this patient’s care?

Question 11

what is GRADE?

Answer 11

a system for grading quality of evidence and making recommendations

Question 12

what are the pros of critical appraisals being used in practice?

Answer 12

its a systematic way of assessing validity, results and usefulness of published research papers
route to closing the gap between research and pratice
makes an essential contribution to improving healthcare quality
encourages objective assessment of usefulness of info

Question 13

what are the cons of using criitcal appraisal in practice?

Answer 13

initially time consuming
doesnt always provide a straight foreward answer
can be dispiriting if it highlights a lack of good evidence

Question 14

what are the steps of the CASP checklist for a systematic review?

Answer 14

1. did the review address a clearly focussed question?
2. did the authors look for the right type of papers?
3. do you think all important, relevant studies were included?
4. did the review’s authors do enough to assess quality of the included studies?
5. if the results of the review have been comvines, was it reasonable to do so?
6. what are the overall results of the review?
7. how precise are the results?
8. can the results be applied to the local population?
9. were all important outcomes considered?
10. are the benefits worth the harms and costs?

Question 15

what are the steps of the CASP checklist for a RCT?

Answer 15

1. did the study address a clearly focused research question?
2. was the assignement of participants to interventions randomised?
3. were all participants who enteres the study accounted for at its conclusion? (losses)
4. were participants blind? were investigators blind? were people assessing blinded?
5. were the study groups similar at the start of the RCT?
6. did each study group receieve the same level of care/treated equally?
7. were the effects of the intervention reported comprehensively?
8. was the precision of the estimate of the intervention or treatment effect reported? (confidence intervals)
9. do the benefits of the experiemental intervention outweight the harms and costs?
10. can the results be applied to your local population?
11. would the experimental intervention provide greater value to the people in your care than any existing interventions?