Lecture 15 - Introduction to critical appraisal Flashcards
what is critical appraisal?
the process of systematically examining research evidence to assess its validity, results and relevance before using it to inform a decision
what is critical appraisal an essential part of?
evidence-based clinical practice to narrow the gap between research and practice
what is the ideal study design for researching efficacy of therapeutic methods or alternative methods?
RCT
what is the ideal study design for researching efficacy and reliability of method of diagnosis?
cross sectional study
what is the ideal study design for researching effectiveness of screening?
cross sectional study
what is the ideal study design for researching prognosis?
longitudinal cohort study
what is the ideal study design for researching causation from environmental/lifestyle factors?
cohort or case-control study
- case reports may be used but are not ideal
what factors should be considered when doing a critical appraisal?
QUESTION - in there a hypothesis? is the question relevant?
DESIGN - what kind of study design is it? is it appropriate?
POPULATION - what is the sample size? are results generalisable to other populations?
METHODS - were exposure measurements, interviews, questionnaires involved? were they appropriate?
ANALYSIS - were appropriate stats tests conducted? chance? confounding?
CONFOUNDERS - were confounders excluded or results adjusted for confounding factors?
BIAS - was there measurement/selection bias?
ETHICS - is it ethical?
INTERPRETATION - do the authors make a causal inference? do they align to the Bradford-Hill criteria?
what 2 things should ALWAYS be questioned in critical appraisal?
content and clarity
what role does critical appraisal have in EBM?
allows you to find relevant information and evidence that answers your question, however evidence alone is not enough: EBM should be combined with clinical judgement and patient preferences
