November 2008 LIHNN Trainers Study Day Michelle Maden Clinical Information Specialist Aintree Library & Information Resource Centre

November 2008 Exercises for facilitation Match the definition to the study design Match the study design to the abstract Discussing the bias in RCTs Identifying the search strategy for systematic reviews

November 2008 Identifying the search strategy for systematic reviews Discuss in pairs/small groups: What resources you would search How would you define your search criteria Search terms/MeSH

November 2008 Facilitating critical appraisal Discussion: Who is delivering critical appraisal training? What do you cover in critical appraisal training? What stops you delivering critical appraisal training?

November 2008 Methods of facilitation Provide overview of study design, statistics(!) and potential bias Collaborate with Statistician, clinicians Use exercises to strengthen understanding: Match study design to definition/abstract Match bias to RCT methodology Randomisation exercise (Debra) Appraise small sections of a paper at a time to demonstrate bias Talk through a guided example of a forest plot Provide examples of statistics and how to interpret them

November 2008 Choosing your paper Multi-disciplinary Choose one with or without statistics – it’s your choice!! Send out in advance of course – but give them 5-10 mins at the start of the session to familiarise with content focusing on main aspects of paper (abstract, methods, results, etc.) Use a scenario to allow generalisation of results

November 2008 Critical Appraisal Databases UCL Institute of Child Health _based_child_health/Custom%20Menu_01 _based_child_health/Custom%20Menu_01 BestBETs Birmingham Women’s Hospital JAMA User Guides with examples

November 2008 Appraisal and feedback Appraising the whole paper in same/split groups same paper different papers (good vs. bad) – good for small exercises focusing on particular aspects – eg. Comparing the completeness of literature searches in 2 articles Rapid appraisal Allocate specific questions to the 2 groups Focus on specific aspects of the paper (e.g. exclude introduction/literature review)

November 2008 Feedback and impact ‘Smileys’/Traffic lights Ask people to identify where in the paper they found the answer (page/column/paragraph) Flipchart to record feedback Record pre/post rating out of 10

November 2008 Dealing with non-responders Ask where in the paper you would expect to find the answer to the question asked Prompt with brainstorming: How would you randomise? How would you record data from an interview? Do they understand the question? - rephrase if necessary

November 2008 Dealing with questions Is the question relevant (needs to know vs likes to know)? On statistics: emphasis is on interpretation not calculation refer them to statistician handy list of references for referral Health R&D Northwest workshops If you don’t know then either ask the group as a whole or be honest

November 2008 Reflect Make a note of… Any questions asked and whether you need to follow-up Timing of workshop Things that worked well/not so well and why

November 2008 A note on statistics… Research design is much more important than statistics – if the research is flawed the statistics will be invalid Statistics is easy to check and will have been peer-reviewed The emphasis is on the INTERPRETATION not the CALCULATION Choose a study design with few or none statistics (e.g. systematic review/qualitative)

November 2008 Training materials for you… Health R&D Northwest UHL e-learning ARIF CA slides with notes on the CA process

November 2008 Facilitating Critical Appraisal Setting up a Critical Appraisal Workshop (Booth 1997) Tips and Techniques of Critical Appraisal Facilitation