Department of General Practice
An Introduction to Critical
Appraisal
Teresa Burgess
Department of General Practice
Critical Appraisal
Department of General Practice
“Forays into the library can be
exhausting, as the reader is
overwhelmed by the papers on offer”
(1)
What is critical appraisal?
Department of General Practice
All critical appraisal means is being able to
look at a piece of research in a very objective
and structured way in order to decide
.
how valid it is compared
to other research (2)
It provides you with skills to help you interpret
research and make decisions about the
quality of an information source
What is critical appraisal?
Department of General Practice
There are two elements in critical appraisal:
• A general skill for everyday academic work
.
• A more comprehensive and in depth skill to
assist in the implementation of Evidence
Based Practice
Critical Appraisal
Department of General Practice
• Much of Critical Appraisal is common sense!
What sort of questions might we ask ourselves
about the research to decide if we think this is
useful research?
• If we are going to buy a car - do you just read the
brochure from the car manufacturer?
Abstract Information
Department of General Practice
BOOK/ DATABASE INFORMATION:
Author
.
Date
Edition
Journal
Publisher
Written description
Content Information
Department of General Practice
BOOKS/JOURNALS
Intended Audience
Objective reasoning.
Coverage
Results
Implications
Writing Style
Critically Appraising Literature
Department of General Practice
Imagine you have read in the newspaper about this
amazing new program which has a 95% success rate in
helping participants to give up smoking. It involves a
mixture of behaviour modification, support and a
wonderful new drug and you wonder whether you
should introduce it into your area.
You do a quick literature search and find an article that
describes the research.
What questions might you ask about this paper?
Critically Appraising Literature
Department of General Practice
1. Who wrote the paper?
2. Did they come from what seems like a reputable
research organisation? (university, health service,
CSIRO)
3. Who funded the research? (eg was it the drug
company that had developed the wonderful new drug?)
4. If it was, what does this mean?
5. How many people were involved in the research?
6. What country did they come from? Can this
context be transferred to the Australian context?
7. Has there been any other research in this area?
8. Is one study enough for you to commit resources?
Critically Appraising Internet Resources
Department of General Practice
• Internet sources very timely and useful
• Evaluating Internet sources is particularly
difficult because anyone can put up anything
he or she wants to on the Internet.
• This is particularly so in the area of grief and
bereavment
• Internet information should not be your sole
source of information.
Critically Appraising Internet Resources
Department of General Practice
•
•
•
•
•
Authorship
Accuracy of information
What is the purpose of the site
Access
Include the date you accessed the material since
it can be changed or updated later on
Critical Appraisal and Evidence Based
Practice
Department of General Practice
• What is evidence based practice?
“Evidence based practice is a systematic
process for using research findings to improve
practice” (3)
• How does critical appraisal link to evidence
base practice?
Critical Appraisal and Evidence
Based Practice
Department of General Practice
• Critical Appraisal is a technique that increases the
effectiveness of your reading by enabling you to
exclude research studies that are too poorly designed
to inform practice (4)
• Appraising the paper for the things discussed above,
tells us whether the research is useful and appropriate
for the purposes we are looking at it for. If however,
we want to use the paper as “evidence” - ie to say that
what we are going to do has strong research
supporting it, we need to be able to assess the validity
of the research which has been done.
Critical Appraisal Questions
Department of General Practice
The questions we need to ask then are:
• Were the participants in this research appropriate?
• Were there enough of them?
• Did they use the right methods to answer their
questions?
• Did they analyse their data correctly?
• Did they draw the correct conclusions from their data?
• What were the results of the intervention?
.
Critical Appraisal and Evidence
Based Practice
Department of General Practice
In some areas, the critical appraisal has already
been done for us.
The Cochrane Collaboration has been established
for medical research and uses data from many
studies analysed together (meta analysis) and
systematic reviews.
A systematic review is where a group of researchers:
• identify all the research related to a particular
review
• assess the value of that research
• look at what all the results put together mean
and if possible reach a conclusion.
Critical Appraisal and Evidence
Based Practice
Department of General Practice
• Unfortunately, there’s not a lot of
evidence in the area of Grief and
Bereavement (compared to the more
concrete and clinical areas - eg
smoking, cervical smears, cancer etc)
• There is one very recent excellent
example of a systematic review in your
area.
References
1.
2
Department of General Practice
3.
4.
Crombie, I. A Pocket Guide to Critical Appraisal. London:BMJ
Harper, J. Critical Appraisal Resources for assessing Health and Medical Research
http://library.kent.ac.uk/library/info/subjectg/healthinfo/critapprais.htm.
AORN. 2002 Evidence-based Practice FAQs.
http://www.aorn.org/research/ebpfaqs.htm
Say, L. From research to practice: Postgraduate training in reproductive
health/chronic disease.
http://www.gfmer.ch/Endo/Course2003/PDF/Critical_appraisal.pdf
Useful Resources:
Olin and Uris Libraries. Cornell University
http://library.cornell.edu/olinuris/ref/research/skill28.htm
Owl Online Writing Lab. Purdue Universiyt.
http://owl.english.purdue.edu/handouts/print/research/r_evalsource.html
What Is Critical Appraisal? www.evidence-based-medicine.co.uk