Critical Appraisal Flashcards
What is critical appraisal?
Critical appraisal is the process of carefully and systematically examining research to judge is trustworthiness, and its value and relevance is a particular context
- need to remember that not all published research is good research of justifies changes in current practice or policy
Why is the skill of critically appraising research important to you?
- large amount of literature to read
- need to keep up to date with evidence (and be efficient in making our way through the research)
- important skill in many (including non-health related) degrees and professions
- part of the peer-review process
- aid you in making evidence baed decisions in you professional life and personal life
Describe the anatomy of an epidemiological research paper - abstract
- provides a summary of the paper contents (is a summary ONLY, does not contain all the information required to do a critical appraisal, does not substitute or reading and appraising the whole paper)
- includes the main findings
- used to briefly see what the paper about and decide if it meets the requirements for what we want to read about and make decisions on
Describe the anatomy of an epidemiological research paper - introduction
- provides background to this research
- what was already known on the subject (and if this evidence is strong or not, and if more evidence is needed. sometimes mentions biological plausibility)
- what they wanted to investigate with this study
- aims and objectives of this study
Describe the anatomy of an epidemiological research paper - methods
- selection of participants
- structure of the study
- definition of exposures and outcomes measured
- how demographics, exposures and outcomes were measures/classified
- methods used to control for confounding and for statistical analysis
- should be provided with enough information that you can replicate the study design
- will sometimes reference other papers that can give more information on how this study was done
Describe the anatomy of an epidemiological research paper - tables and figures
Table 1 - participants baseline characteristics (used to decide if the groups are comparable, looking for similarity, not that they are the same)
Table 2 - results (need to read all the stuff around the table as well, headers, footers etc. as they have valuable information)
- tables are labelled 1,2,3 in order and are for displaying group characteristics
- figures are any type of illustration (like charts, or graphs, etc.) and are sometimes labelled differently (but still with 1, 2, 3 etc.)
Describe the anatomy of an epidemiological research paper - results
- reporting of all results in text, tables and figures (need to relate the text and the tables together, also compare the results they re reporting to the original aims and objectives of the study)
- are they crude or adjusted results, and if they are adjusted, what are they adjusted for?
- assessment of chance, bias and confounding
Describe the anatomy of an epidemiological research paper - discussion
discussion has heaps of stuff in it that is useful for critical appraisal
- strengths and challenges experience during the research study (may discuss issues with bias and mention things to do with confounding)
- evidence for causation
- the researchers’ assessment of the implications of the results
- importance of this information (Public health/Clinical practice)
Describe the anatomy of an epidemiological research paper - conclusion or key points
- not always included but usually outlines what this study adds to current knowledge, and where to from here
describe what can be used for internal validity and causation when looking at a research paper
Internal validity: are these study findings a good estimate of the truth?
- chance
- bias
- confounding
Once you have decided the study findings are valid, you use the causal guidelines
Bradford Hill Causal Guidelines:
- Biological plausibility
- Experimental evidence (RCT only)
- Strength of association
- Temporal sequencing
- Consistency with other studies
- Dose response (need to have levels of the exposure, as exposure increases the risk of outcome either increases or decreases)
- Specificity (not used as often now but wad for when we were looking at communicable diseases, is when an exposure is responsible for one outcome only)
Describe the anatomy of an epidemiological research paper - references, acknowledgements and conflicts of interest
References: a list of research papers referred to in this paper
Acknowledgements: thank contributors, to the writing of this paper and contributing to the research itself including the funding of the research
- need to know where the money comes from and if they have a financial interest in the outcome, did they control what was publisher or contribute to the research?
Conflicts of interest: identifies potential conflicts of interest
how do frameworks help with critical appraisal?
GATE frame and PECOT help you consider aspects of study design while you do critical appraisal, helps you look into the details
- where could their be bias? need to know the study design
