Critical Appraisal

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Critical Appraisal Evidence Based Practice
Introduction

• Mark Mullee
• RDSU Director

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Critical Appraisal Morning Programme

• 09.0009.30 Introduction to Critical Appraisal
• Helen Elsey
• 09.3010.15 Critical Appraisal Skills for
  Quantitative Research- Mark Mullee
• 10.1510.45 Workshop Critical Appraisal of a
  Published Paper Mark Mullee
• 10.4511.00 Tea/Coffee Break
• 11.0011.30 Feedback and Discussion
• Mark Mullee
• 11.3012.15 Critical Appraisal Skills for
  Qualitative Research Helen Elsey
• 12.1512.40 Workshop Critical Appraisal of a
  Published Paper Helen Elsey
• 12.4013.00 Feedback and Discussion
• Helen Elsey

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Learning outcomes

• Learning outcomes by the end of the day
  participants will be expected to
• To understand how critical appraisal can inform
  evidence based practice
• To be able to use critical appraisal tools for
  both quantitative and qualitative research
  studies.

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Plan of the day

• Introduction
• Critical appraisal skills for quantitative
  research.
• Workshop quantitative study
• Feedback and discussion
• Lunch
• Critical appraisal skills for qualitative
  articles
• Workshop qualitative study
• Feedback and discussion
• Final summary

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Why do we read papers?

• Literature search- research proposal/study
• Evidence based practice
• Personal development/ interest

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What is Critical Appraisal?

• Process of systematically examining research
  evidence to assess its validity, results and
  relevance before using it to inform a decision
• Essential part of evidence-based practice.
• Enable us to draw conclusions from and act on the
  evidence presented.

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Critical appraisal attempts to

• Identify the strengths and weaknesses of studies.
• 1. The internal validity of the information. I.e.
  how the information was collected and/or
  summarised.
• 2. The external validity of the information. I.e.
  how relevant information is to any specific
  question posed by the reader.

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Pros of critical appraisal

• A systematic way of assessing the validity,
  results and usefulness of papers.
• One step in the process of evidence-based
  practice, along with finding the evidence and
  changing practice.
• Encourages objective assessment of the usefulness
  of information.
• Common sense approach, user friendly tools are
  available

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Cons of critical appraisal

• Time-consuming initially, although with time it
  becomes automatic.
• Does not always provide the reader with the
  easy answer or the answer one might have hoped
  for it may highlight that a favoured
  intervention is in fact ineffective.
• It highlights a lack of good evidence.

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CASP

• CASP (Critical Appraisal Skills Programme)
• aims to enable individuals to develop the skills
  to find and make sense of research evidence
• http//www.phru.nhs.uk/casp/casp.htm

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CASP
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Critical Appraisal

• Part of a continuum

Critical Appraisal Skills Programme (CASP)

• Asking an answerable question
• Searching for the best evidence
• Critically-appraising the evidence
• Acting upon the evidence

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Literature search question

• Answerable
• In three parts
• Population / patients
• Intervention / treatments / tests
• Outcomes

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Literature searching

• Using electronic sources
• National Electronic Library for Health
• Summarised evidence of effectiveness (e.g.
  Cochrane Database of systematic reviews,
  Bandolier)
• Individual studies using databases through
  Dialogue (e.g. Medline, Embase, CINAHL)
• Current issues of journals

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Information required within seconds

• Systematic reviews, periodically updated, of
  randomised trials of the effects of health care
  (from all sources, and in all languages)

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Information required within seconds

• Evidence-based journals of 2º publication
• screen 50-70 clinical journals per week for
  clinical articles that pass critical appraisal
  quality filters è conclusions likely to be true
• selects subsets that are clinically relevant
• summarised as more-informative abstracts
• added commentaries from clinical experts
• introduced with declarative titles

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CASP Learning Resources
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CASP Critical Appraisal Tools