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Health (Nursing, Medicine, Allied Health): Critical Appraisal

Guide to locating health evidence. View the EBP "pyramid" and link to tools for locating relevant research.

Critical Appraisal Resources

Ranking and Appraising the Evidence

  • Appraising an article, a report, a protocol, a printed recommendation, etc. begins as you look at the document and evaluate the methodology and source of the research.  Start by asking the following questions:
    • Who is the author?
    • Was it published by a credible source?  (a scholarly journal?  a popular periodical, e.g, newspaper or magazine?  an association? an organization?)
    • Is the source a book?  A journal article? (Usually a journal name will be in italics.)  Use a library catalog like Bobcat, to find a book in Bobst Library.
    • What is the date of publication?
    • What is the data or research based on?  If it is a scholarly article, is there a "Methods" section?
    • Is there a reference list at the end of the document?  From the reference list, you can assess currency of the information, credibility of the sources, level of evidence of the source material.

  • Tips for determining the "level of evidence" for an article.
    1. Use the evidence pyramid or scheme supplied by your professor.
      • One approach to levels of evidence is linked here at the Centre for Evidence Based Medicine.
    2. To track down a journal citation, select an article database (PubMed, CINAHL, PsycINFO etc.) using the author, article title, OR journal title.
    3. Consult database tutorials for help with #2.
    4. Other tools for tracking down a citation not easily found in databases:  scholar.google.com OR google.com   Googling may provide a path to a more obscure document or report.
    5. Within the article database, notice the "Publication Type" field for an individual citation.  There is often an indication that a citation is a "randomized controlled trial,"  a "case report," a "Review" article, etc. 
    6. Caution, a "review" is not necessarily a "systematic review."  Even if the title or abstract says "systematic review," carefully evaluate whether it is a true systematic review or merely a literature/narrative review.
    7. Look at the article Abstract.  Often an abstract will indicate the research design or methodology.  This can indicate the level of evidence.
    8. Link to the Full Text of an article; then look for the Methods section to review how the research was conducted.
    9. Use critical appraisal tools (CASP, PRISMA, etc.)  to fully appraise article evidence.
    10. If you have difficulty tracking down a citation in a reference list  using the above tips, consider this a potential indication of the quality of the original document.  Perhaps a typo or mistake is the result of careless information.  What does that tell you about the quality of the evidence?

  • More Helpful Links

How to Read a Paper (by Trisha Greenhalgh)

 

How to Read a Paper: The Basics of Evidence Based Medicine was originally published as a series of 10 articles introducing non-experts to finding medical articles and assessing their value.  It is available in hard copy, as an electronic book, and as an online article series:

 



Online links to original article series: How to Read a Paper

Research Design

Understanding Research Study Designs (from the University of Minnesota)

Case Series and Case Reports
Case Control Studies
Cohort Studies
Randomized Controlled Studies
Double Blind Method
Meta Analyses
Systematic Reviews

 

PRISMA Statement Website

PRISMA stands for Preferred Reporting Items for Systematic Reviews and Meta-Analyses. It is an evidence-based minimum set of items for reporting in systematic reviews and meta-analyses.