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- Module 3: Appraise
Evidence Based Medicine: Module 3: Appraise
Critically Appraising the Evidence
In the critical appraisal process, you are seeking to determine what accounts for a study's results. Specifically, you are looking to determine whether a study's results are most likely due to bias, chance, confounding, or truth.1
The questions needed to critically appraise a specific study will depend on the study design but broadly speaking, when appraising a study, you are looking to determine:
- Validity: Are the study results valid? Was an appropriate research method used and did the researchers attempt to minimize bias and confounding?
- Significance: What are the results and are they statistically significant? What is the clinical importance of the findings?
- Generalizability: Are the results of the study generalizable beyond the study setting? Can the results be applied to your patients and/or in your practice setting?
The ability to critically appraisal a study requires an understanding of epidemiological and biostatistical concepts, particularly clinical study design, biases and confounders in clinical research, basic biostatistics, and common measures of association in biomedical studies.
1. Fletcher GS, Fletcher RH. Clinical epidemiology : the essentials . 6th ed. Philadelphia: Lippincott Williams & Wilkins/Wolters Kluwer; 2021. Chapter 12, Cause; p.204-218
Pre-Appraised Resources
- AAP Grand RoundsNewsletter of structured abstracts and expert commentary of recent advances in pediatrics. From the American Academy of Pediatrics
- ACP Journal ClubACP Journal Club summarizes the best new evidence for internal medicine from over 120 clinical journals. Research staff and clinical editors rigorously assess the scientific merit of the medical literature as it is published and a worldwide panel of over 5000 physicians assesses the clinical relevance and newsworthiness of rigorous studies.
- BMJ Evidence-Based MedicineBMJ Evidence-Based Medicine searches international medical journals and applies strict criteria to identify and appraise relevant research. Each article includes a succinct commentary and an 'EBM Verdict' which focuses on the paper’s key findings and implications for clinical practice.
- BMJ Evidence Based NursingEvidence-Based Nursing (EBN) publishes critical commentaries and summaries of the most valid research in nursing, from other international healthcare journals.
- Cochrane Library This link opens in a new window
The Cochrane Library is a collection of databases from The Cochrane Collaboration, an international network that prepares, promotes and disseminates systematic reviews of health care interventions. Includes six databases: The Cochrane Database of Systematic Reviews (CDSR; Cochrane Reviews); The Database of Abstracts of Reviews of Effectiveness (DARE; Other Reviews); The Cochrane Central Register of Controlled Trials (CENTRAL, Clinical Trials); The Cochrane Methodology Register (CMR); The Health Technology Assessment database; The National Health Service (NHS) Economic Evaluation Database.
The Rational Clinical Examination by ISBN: 9780071590303Publication Date: 2008-09-15The Rational Clinical Examination serves as a guide to the evidence-based clinical encounter. The Evidence to Support the Update section available in most entries consists of a summary and concise assessment of study strength.
