Critical Appraisal

Question 1

What is critical appraisal?

Answer 1

The process of systematically examining research evidence to assess its validity, results and relevance before using it to inform a decision
Allows us to make sense of research evidence and begin to close the gaps between research and practice

Question 2

What study design can be used to test therapeutic methods?

Answer 2

RCT (efficacy, alternative methods etc.)

Question 3

What study design can be used to test diagnostic methods?

Answer 3

Cross sectional study (efficacy, reliability etc.)

Question 4

What study design can be used to test screening?

Answer 4

Cross sectional study (value of tests which enable pre-symptomatic diagnosis)

Question 5

What study design can be used to test prognosis?

Answer 5

Longitudinal cohort study

Question 6

What study design can be used to see the relationship between exposure and disease (causation)?

Answer 6

Cohort/case control study/ case reports (environmental, lifestyle etc. factors and their impact on health)

Question 7

What questions should be considered when critically appraising?

Answer 7

Question: Is there a hypothesis? Is the question relevant?
Design: Is it cross-sectional, cohort, case-control, ecological, RCT? Hierarchy of studies. Is it appropriate?
Population: Sample size. Are results generalizable to other populations
Methods: Exposure measurements, interview, measure, questionnaire etc.
Analysis: Appropriate statistical tests. Chance? Confounding?
Confounders: Presence of any confounders and attempts to exclude or adjust
Bias:Measurement/Selection Ethics: Is the study ethical?
Interpretation: Do the authors interpret correctly? Do they make a causal inference? Bradford-Hill?

Question 8

What restricts use of EBM in practice?

Answer 8

time and information resources

Question 9

What does EBM provide?

Answer 9

an efficient and systematic way to locate the best evidence to answer clinical questions. Through simultaneous appraisal of that evidence (and inter-disciplinary collaboration), you can find the most relevant information to answer your question

Question 10

What study design can be used to assess multiple outcomes of disease?

Answer 10

Cohort studies

Question 11

What study design can be used to assess multiple exposures relating to a disease?

Answer 11

Case control study