How to critically appraise a paper
How to review a paper
Checklist for a qualitative research paper
Checklist for material provided by a pharmaceutical company representative
4 Checklist for a paper that claims to validate a diagnostic or screening test
4 Checklist for a set of clinical guidelines
Checklist for a systematic review or meta-analysis
Checklist for an economic analysis
Checklist for health care organisations working towards an evidence based culture for clinical and purchasing decisions
5 Checklist for searching Medline or the Cochrane library
How to review a paper
Determine what a paper is about
• Why was the study done (what clinical question did it examine)? • Is there a clear description of the problem
• Is the study useful and relevant to General Practice • If the study is conducted in a hospital environment, can the results be interpreted in a general practice situation • Was the study design appropriate to the broad field of research examined (therapy, diagnosis, screening, prognosis, causation)? • What type of study was done?
- Primary research (experiment, randomised controlled trial, other controlled clinical trial, cohort study, case-control study, cross sectional survey, longitudinal survey, case report, or case series)? - Secondary research (simple overview, systematic review, meta-analysis, decision analysis, guideline development, economic analysis)? • Was the study ethical?
- Are there are any ethical objections to the design or reporting of the study • Is there a review of the literature
• Is the writing style easily understood
• Is the paper was well laid out and easy to follow
• The design of the study is consistent with the aims
- Observational studies - qualitative, by interviewing - Observational studies - quantitative, obtain baseline values - Retrospective studies - information from past events - Prospective studies - following events as they happen - Experimental Studies – e.g. randomized control trial • Was the design of the study sensible?
• Was the study original?
• Who is the study about?
• The sample of the study is representative of the population as a whole • How were subjects recruited?
• Are controls needed in the study
- If a cohort, case-control, or other non-randomised comparative study were the controls appropriate? • Who was included in and who was excluded from the study? • The methods of selecting cases and controls is defined well • Were the subjects studied in “real life” circumstances? • What intervention or other manoeuvre was being considered? • Details of the study such as numbers, time intervals, statistical test used are clear and appropriate • The questionnaire and proformas are appropriate and relevant to the study • Was the study adequately controlled?
• If a “randomised trial” was randomisation truly random? • Were the groups comparable in all important aspects except for the variable being studied? • What outcome(s) were measured and how?
• Was assessment of outcome (or, in a case-control study, allocation of caseness) “blind”? • Are there sources of bias in the setting of the subjects • Have confounding influences and multiple influences been removed • Was the study large enough and continued for long enough, and was follow up complete enough, to make the results credible?
Statistical aspects of a paper
• Have the authors set the scene correctly?
❖ Have they determined whether their groups are comparable and, if necessary, adjusted for baseline differences? ❖ What sort of data have they got and have they used appropriate statistical tests? ❖ If the statistical tests in the paper are obscure why have the authors chosen to use them? ❖ Have the data been...
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