Critical appraisal Flashcards
what is critical appraisal used for
make clinically informed decisions
describe the transdisciplinary model of EBM
best research evidence
population - does it work in adolescents etc
environmental and organisational context - lab texts and finance
resources available
to determine if the content is appropriate you need to look at:
exposure eg salt on Bp
outcome
population eg middle age men huge effect, older generations less - how define middle age
study design, sampling and methods eg biomarkers are more accurate - use papers with more accurate research
whether the results help you answer the qn - can you interpret them, what did I already know
defining a critical appraisal
process of systematically examining research evidence to assess its validity, results and relevance before using it to inform a decision
close gaps between research and practice
how do you start a critical appraisal
ask focussed questions - break it down, papers are most likely going to answer the question
find the evidence
critically appraise it
include information on randomisation - if not there, does it impact results
what is the problem with redrafts of articles
more possible for errors
what should a good scientific method include
systematic research process
logical - induction/deduction
empirical - evidence based
reductive - generalisation, apply research to other environments, association
replicable - methodology
deductive - qualitative then empirically test it - have information and then look for pattern
inductive - have theory then find information
what is basic research
questions at cellular level
see if there is an effect
more difficult and controlled than applied research
what is applied research
accept basic research
look what happens in a clinical environment
confounding involved
describe the research process
review literature available - need to know what is common knowledge
formulate qn - recognise the need for new information
select appropriate research design - find the evidence - wrong evidence=wrong ans
collect relevant data
interpret findings - appraisal - evaluate validity and usefulness of details
publish findings
repeat - act on evidence - what going to do with new findings
evaluation and reflection - did the changes have the desired effect, look at clinical knowledge
why is critical appraisal important
put new information into practice
keep up to date - what is the best treatment
patients can’t look beyond initial research so are not fully informed
what are the responsibilities of scientists
need to publish nil results
timely - inform other people’s practice
conduct work with honesty and integrity
ensure results and methods conducted in timely orderly and open fashion
research evidence
need to control everything that affects exposure
have solid question, structure search comprehensively, keep good notes
have questions that you want the papers you find to answer
approaching a critical review
find models - guided by others
problem formulation - which topic is under consideration and what are the constituent issues, have theory and biological understanding behind the theory
literature reviews
evaluation of findings - against your criteria
analysis and interpretation of literature
critical and evaluative account - not description
describe and analyse existing data and what has been added
recall similarities and differences, consistancies
explain reasons for these - from biological understanding
merge papers and see what learnt overall
Hierarchy of study designs
cohort study - see if treatment has improved over time, more confidence in results
ideal design for outcome
look at diagnostics - use cross sectional study - how many people with mammograms were sent to biopsy
prognosis - longitudinal cohort study - follow people though
therapeutic methods - RCT
screening - cross-sectional study
causation - cohort/case control study
use of review checklists
different ideas what to present in paper
eg randomised control trial use CONSORT checklist
what authors what to write, why need to share info, and if they don’t what affects that has
obs studies: cohort, case-control and cross section - STROBE
what done, what they found, how we can learn from that
what does a review that is done well do
help decide decision making, highlight good practice
learn from peoples mistakes
gaps in literature
important notes
understand checklist what did and why do they know what else was in research are all the results included does conclusion help you ans your question is bias controlled for is study blinded were appropriate statistics applied
checklist for a critical appraisal
Summarise the paper first: with a sentence for each of the following: Why did they do it? What did they do? What did they find? What did they conclude? Then consider the following: Question Design Population Methods Analysis Confounding Bias Ethics Interpretation
