Appraise the evidence: Difference between revisions
No edit summary |
No edit summary |
||
| Line 6: | Line 6: | ||
== The Appraisal == | == The Appraisal == | ||
The third step of evidence based practice, critical appraisal is the systematic evaluation of clinical research papers in order to establish: | The third step of evidence based practice, critical appraisal is the systematic evaluation of clinical research papers in order to establish: | ||
#Does this study address a clearly focused question? | #Does this study address a clearly focused question? | ||
#Did the study use valid methods to address this question? | #Did the study use valid methods to address this question? | ||
#Are the valid results of this study important? | #Are the valid results of this study important? | ||
#Are these valid, important results applicable to my patient or population? | #Are these valid, important results applicable to my patient or population? | ||
If the answer to any of these questions is “no”, you can save yourself the trouble of reading the rest of it. | If the answer to any of these questions is “no”, you can save yourself the trouble of reading the rest of it. | ||
The following questions are appropriate to appraise the literature: | The following questions are appropriate to appraise the literature: | ||
| Line 32: | Line 32: | ||
*Aside from the experimental intervention, were the groups treated equally? | *Aside from the experimental intervention, were the groups treated equally? | ||
'''What were the results?<br>''' | '''What were the results?<br>''' | ||
* | *How large was the treatment effect? | ||
How large was the treatment effect? | |||
*How precise was the estimate of the treatment effect?<br> | *How precise was the estimate of the treatment effect?<br> | ||
| Line 45: | Line 44: | ||
*Are the likely treatment benefits worth the potential harms and costs?<br><br> | *Are the likely treatment benefits worth the potential harms and costs?<br><br> | ||
[http://www.pedro.org.au/scale_item.html The PEDro scale] is a valid measure of the methodological quality of clinical trials. DeMorton (2009) suggests it is valid to sum PEDro scale item scores to obtain a total score that can be treated as interval level measurement and subjected to parametric statistical analysis<ref>de Morton NA (2009). [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;db=PubMed&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;cmd=Retrieve&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;list_uids=19463084&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;dopt=Abstract The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study], Australian Journal Physiotherapy, 55(2), 129-133</ref>.<br> | [http://www.pedro.org.au/scale_item.html The PEDro scale] is a valid measure of the methodological quality of clinical trials. DeMorton (2009) suggests it is valid to sum PEDro scale item scores to obtain a total score that can be treated as interval level measurement and subjected to parametric statistical analysis<ref>de Morton NA (2009). [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;db=PubMed&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;cmd=Retrieve&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;list_uids=19463084&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;dopt=Abstract The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study], Australian Journal Physiotherapy, 55(2), 129-133</ref>.<br> | ||
Critical Appraisal Worksheets | |||
These critical appraisal worksheets from the centre for evidence based medicine are very useful: | |||
*[http://www.cebm.net/wp-content/uploads/2014/04/SR_Appraisal_sheet_2005_English.doc Systematic Review] Critical Appraisal Sheet | |||
*[http://www.cebm.net/wp-content/uploads/2014/04/diagnostic-study-appraisal-worksheet.pdf Diagnosis] Critical Appraisal Sheet | |||
*[http://www.cebm.net/wp-content/uploads/2014/04/cebm-prognosis-worksheet.pdf Prognosis] Critical Appraisal Sheet | |||
*[http://www.cebm.net/wp-content/uploads/2014/04/RCT_Appraisal_sheets_2005_English.doc Therapy / RCT] Critical Appraisal Sheet | |||
== Resources<br> == | == Resources<br> == | ||
| Line 53: | Line 59: | ||
[http://www.pedro.org.au/tutorial.html The Pedro Tutorial] is designed to help readers of clinical trials differentiate those trials which are likely to be valid from those that might not be. It also looks briefly at how therapists might use the findings of properly performed studies to make clinical decisions. | [http://www.pedro.org.au/tutorial.html The Pedro Tutorial] is designed to help readers of clinical trials differentiate those trials which are likely to be valid from those that might not be. It also looks briefly at how therapists might use the findings of properly performed studies to make clinical decisions. | ||
Understand [[ | Understand [[Grades and Levels of Evidence|Levels and Grades of evidence]] with our related page | ||
Understand simple statistics with our [[Test Diagnostics|Test Diagnostics]] page | Understand simple statistics with our [[Test Diagnostics|Test Diagnostics]] page | ||
Revision as of 10:28, 24 March 2015
Original Editor - Your name will be added here if you created the original content for this page.
Top Contributors - Admin, Rachael Lowe, 127.0.0.1, Tony Lowe, Evan Thomas, George Prudden, WikiSysop, Alex Benham, Grace Barla and Angeliki Chorti
The Appraisal[edit | edit source]
The third step of evidence based practice, critical appraisal is the systematic evaluation of clinical research papers in order to establish:
- Does this study address a clearly focused question?
- Did the study use valid methods to address this question?
- Are the valid results of this study important?
- Are these valid, important results applicable to my patient or population?
If the answer to any of these questions is “no”, you can save yourself the trouble of reading the rest of it.
The following questions are appropriate to appraise the literature:
Are the results of the study valid?
Primary Guides:
- Was the assignment of patients to treatments randomized?
- Were all patients who entered the trial properly accounted for and attributed at its conclusion?
- Was follow up complete?
- Were patients analyzed in the groups to which they were randomized?
Secondary Guides:
- Were patients, health workers, and study personnel "blind" to treatment?
- Were the groups similar at the start of the trial?
- Aside from the experimental intervention, were the groups treated equally?
What were the results?
- How large was the treatment effect?
- How precise was the estimate of the treatment effect?
Will the results help me in caring for my patients?
- Can the results be applied to my patient care?
- Were all clinically important outcomes considered?
- Are the likely treatment benefits worth the potential harms and costs?
The PEDro scale is a valid measure of the methodological quality of clinical trials. DeMorton (2009) suggests it is valid to sum PEDro scale item scores to obtain a total score that can be treated as interval level measurement and subjected to parametric statistical analysis[1].
Critical Appraisal Worksheets
These critical appraisal worksheets from the centre for evidence based medicine are very useful:
- Systematic Review Critical Appraisal Sheet
- Diagnosis Critical Appraisal Sheet
- Prognosis Critical Appraisal Sheet
- Therapy / RCT Critical Appraisal Sheet
Resources
[edit | edit source]
The Pedro Tutorial is designed to help readers of clinical trials differentiate those trials which are likely to be valid from those that might not be. It also looks briefly at how therapists might use the findings of properly performed studies to make clinical decisions.
Understand Levels and Grades of evidence with our related page
Understand simple statistics with our Test Diagnostics page
Recent Related Research (from Pubmed)[edit | edit source]
Extension:RSS -- Error: Not a valid URL: Feed goes here!!|charset=UTF-8|short|max=10
References[edit | edit source]
References will automatically be added here, see adding references tutorial.
- ↑ de Morton NA (2009). The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study, Australian Journal Physiotherapy, 55(2), 129-133
