Critical Appraisal

Question 1

What is critical appraisal? (Victor)

Answer 1

Standardized process of assessing the quality, rigor and strength of the methods and outcomes of a research publication.
Enables you to systematically assess the trustworthiness, relevance and results of published papers.

Question 2

What are the objectives of critical appraisal of scientific research? (Victor)

Answer 2

1. Help in clinical decision making.
2. Enable best clinical practice.
3. Determine the rigour and validity of the research methods.
4. Determine the objectivity (absence of bias) of the researchers.
5. Determine the validity of the research results.
6. Determine the applicability of the research results to specific contexts and situations.

Question 3

Critical review components 11

Answer 3

• Citation
• Study Purpose
• Literature
• Appropriateness of study design
• Biases
• Sample
• Outcomes
• Intervention
• Results
• Drop outs
• Conclusions and clinical implications

Question 4

Study Purpose

Answer 4

Was the purpose stated clearly?

• Usually in abstract and/or intro
• Research question or hypothesis
• Clear statement
• Relevance to what you are looking for.

Question 5

Literature

Answer 5

Was relevant background literature reviewed?

• Literature review should be included.
• Synthesis of relevant information such as previous work/research (timing of publications).
• Justification for need of study, identify gaps - innovative research.

Question 6

Appropriateness of Study Design

Answer 6

Was design appropriate for research question?
- Little knowledge → Exploratory
- Lots of knowledge → Rigor design
- Outcomes:
Little knowledge → Exploratory
Easily qualified/well developed assessment tools → Rigor design.
- Ethical issues: e.g. pulmonary rehabilitation - mortality
- Study purpose/question: Testing effectiveness: RCT.
Learning about an issue: Case control, cross sectional

Question 7

Bias

Answer 7

• Sample bias
• Measurement bias
• Intervention bias

Question 8

Sample Bias

Answer 8

• Volunteer/referral bias: volunteers motivated
• Seasonal bias: summer vs winter time assessments
• Attention bias: more attention → better results

Question 9

Measurement Bias

Answer 9

• Number of outcome measures:
  Too low → not representative
  Too high
• Lack of masked or independent evaluation: Blinding
• Recall bias: recall positive memories better than negative memories.

Question 10

Intervention Bias

Answer 10

• Contamination: Control group also receives treatment
• Co-intervention: e.g. medication that can contribute to treatment
• Timing of intervention: Aging of children can effect treatment over a long period.
• Site of treatment: Home setting can be favorable, should e consistent with all groups.
• Different therapists: Different motivation level.

Question 11

Sampling 8

Answer 11

• Nr. of participants should be clear
• Sample described in detail?
• Characteristics of sample - appropriate for research
• How was sampling done
• Equal group size
• Similarities between groups
• Sample size justified
• Ethics procedure described, informed consent

Question 12

Outcome Measurements

Answer 12

• Clearly described? objective?
• Frequency of measurement: pre intervention, post, long/short term.
• Relevant to your field? Well-known measures?
• Validity of used measures
• Reliability of used outcome measures

Question 13

Intervention

Answer 13

Described in detail:

• Focus of intervention
• Who delivered it
• How often
• Setting
• Replication of treatment

Contamination/Co-intervention