Week 10 Flashcards
What is Critical Appraisal
Critical appraisal is the process of systematically examining research evidence to assess its validity, results and relevance before using it to make clinical decisions
What does critical appraisal do, why is it important?
Evaluate validity
- methodology (internal validity)
- generalisability (external validity)
Weighs up the evidence to see how useful it is to make a clinical decision
It is a balanced approach, looks at the flaws and strengths.
Critical appraisal advantages and disadvantages
ADVANTAGES
- systematic process of evaluating validity and generalisability
- able to objectively assess the evidence presented
DISADVANTAGE
- time consuming
- requires skills
- can be difficult if information is not presented well or unclear
What Critical Appraisal is NOT
- negative dismissal of research
- assessment purely based on results
- undertaken by only experts
Why do we Critically appraise
All research is essentially flawed and can be done incorrectly, therefore still appraise, even level 1 evidence systematic review.
How to appraise research (two approaches)
Assessment of risk of bias
- how believable are the results when weighed up the bias
Assessment of methodological quality
- the extent at which the researchers conducted the research, was it too the highest standard?
Overall, we are questioning the research methodology to assist the aim of critical appraisal which is to evaluate the validity, results and relevance.
Critical Appraisal Tools (CAT’s)
These are checklists used to review the reporting of the study methodology.
They are either design specific (for studies that are using the same design) or generic (for multiple types of study designs being appraised)
TWO TYPES
- domain based (evaluate the risk of bias)
- scales or checklists (ease of comparison across multiple studies)
The CAT chosen is dependent on
- the research question
- reason for doing the critical appraisal
- types of research/design used
How do we appraise primary research
Question the:
- research methodology
- generalisability of the research
How do we appraise RCT’s
question (analyse)
- recruitment and sample size
- randomisation method and controls
- cofounding factors
- blinding
- attrition
How do we appraise Cohort/Case control
Question:
- recruitment
- exposure
- cofounders
- timeframes
- plausibility
How do we appraise Qualitative research
question:
- sampling
- triangulation
- reflexivity
- saturation
- respondent validation
How do we appraise Systematic reviews
question :
- clear review question-
- was a thorough literature research carried out
- selection of studies chosen
- how was the quality of the studies assessed
- was combined results appropriate if they did they
