WoSCAN CPD GROUP CRITICAL APPRAISAL RESOURCE GUIDE JULY 2007

What this guide covers Definitions & introduction to critical appraisal Links to worked critical appraisal examples Sources of checklists and glossaries Information about interpreting statistics Sources of formal training opportunities Use the arrows at the bottom of each page to move back and forward through the resource guide

Definitions of critical appraisal To weigh up the evidence critically to assess its validity (closeness to the truth) and usefulness (clinical applicability) [Sackett and Haynes, 1995] The assessment of evidence by systematically reviewing it’s relevance, validity and results to specific situations [Ruth Chambers, 1998]

Why is critical appraisal important? To help us determine best evidence To encourage objective assessment of the usefulness of information To help us decide if published research is good enough to be part of the decision making process To close the gap between research and practice and provide a systematic framework for interpreting research

The critical appraisal process Define problem or scenario Search appropriate evidence sources Identify studies at highest point on evidence hierarchy Use appropriate critical appraisal checklist Assess relative merits /demerits Make overall assessment (strength of evidence) Apply findings (strength of recommendations)

The evidence hierarchy Systematic reviews and meta-analyses RCTs Cohort studies Case control studies Case series / case reports Opinions/ letters Animal research In vitro research

Key critical appraisal questions 1.Are the results valid? 2.What are the results? 3.Will the results help locally? Validity / Significance / Relevance

Worked critical appraisal scenarios Centre for Health Evidence: user guides to evidence based practice Advice and worked examples of how to find, appraise and apply different types of research in practice. Originally published as a series in the Journal of the American Medical Association (JAMA) Evidence Based Medicine (Michigan State University) Introduces the basic concepts of evidence-based medicine and critical appraisal. Includes worked examples for diagnosis, therapy, prognosis & meta-analysis. Hunt, DL. Locating and appraising systematic reviews. Annals of Internal Medicine. 126(7), p532-8.Hunt, DL. Locating and appraising systematic reviews. Annals of Internal Medicine. 126(7), p Article includes an example of how to critically appraise a systematic review. SCHARR (School of Health and Related Research, Sheffield) Worked examples of a Review, RCT and Qualitative study

Checklists & Glossaries CASP checklists from Public Health Resource Unit, Oxford Tools developed by the Critical Appraisal Skills Programme (CASP) for the NHS Centre for Evidence Based Medicine (CEBM) Oxford Checklists for Reviews, RCTs, Diagnosis and Prognosis papers Users Guides to Evidence based Practice Originally published in JAMA, covers all research methodologies University of Glasgow checklists Checklists for appraising the main types of research article Best Evidence Topics Checklists for main types of research from Manchester Royal Infirmary An EBM glossary from Bandolier Covers wide range of terminology used in appraisal and EBM Cochrane Reviewer’s Glossary Guide to terminology for those taking part in Cochrane Reviews

Statistics explained BMJ Statistics for non statistician part 1 Taken from ‘How to read a paper’ by Greenhalgh BMJ Statistics for non statistician part 2 Taken from ‘How to read a paper’ by Greenhalgh The ‘What is?’ series Includes short guides on NNTs, Confidence Intervals, Cox models Centre for Evidence Based Medicine (CEBM), Oxford Interactive tools, explanations and examples of statistical methods

Formal training opportunities Click on the title of the course to find out more information & contact details ‘Understanding evidence’ at University of Glasgow Looks at concepts of ‘evidence’ and appraisal methods Centre for Evidence Based Medicine, Oxford (CEBM) Provide a number of workshops and training days on evidence based practice and critical appraisal CASP (Critical Appraisal Skills Programme) CASP workshops can be tailored to individual's/organisation’s needs and cover three key themes; finding the evidence, appraising the evidence and acting on the evidence SIGN (Scottish Intercollegiate Guidelines Network) Offers courses in critical appraisal at two different levels; introduction to critical appraisal and interpreting evidence SCHARR (School of Health and Related Research, Sheffield) Provides a range of training sessions including EBM and critical appraisal UK Clinical Research Network: critical appraisal skills One day course providing an introduction to critical appraisal and evidence based practice

Further Information If you require any further information about critical appraisal please contact Kirsty Coltart Kirsty Coltart, Beatson Librarian Fran Schofield, Fran Schofield, NHSGGC Nursing Librarian