Find out more about critical appraisal and how you can make it an essential part of your skill set.
Critical appraisal is a skill. 'Learning to read an article critically and apply its results is a fundamental skill that all clinicians must have' (1).
It is assumed that you have found a publication that you think might be relevant to your clinical practice, professional education, CPD or your research, having read the title and perhaps the abstract.
Why should I do Critical Appraisal?
The amount of published information is growing rapidly and many clinical practitioners have reached the point of information overload. How do you decide which is worth reading and which is worth acting upon?
What is Critical Appraisal?
'Critical appraisal is the process of carefully and systematically examining research to judge its trustworthiness, and its value and relevance in a particular context.' (2)
It is a systematic framework to assist you to interpret the quality and relevance of research.
'Critical Appraisal asks: '(3)
- Is the study question relevant?
- Does the study add anything new?
- What type of research question is being asked?
- Was the study design appropriate for the research question?
- Did the study methods address the most important potential sources of bias?
- Was the study performed according to the original protocol?
- Does the study test a stated hypothesis?
- Were the statistical analyses performed correctly?
- Do the data justify the conclusions?
- Are there any conflicts of interest?
Research may be undertaken to answer a wide range of questions and there are a myriad of ways to conduct research.
It is important that the methodology chosen is appropriate to the question and that the methodology has been appropriately applied.
Ideally the research has no bias in the methodology that may skew the results. If there is a perceived bias, have the researchers done all that they can to minimise the impact of that bias?
What are the results?
How was the data collected and was the data analysis appropriate? The author should clearly state how the data was collected and analysed. Are the results statistically significant or might they have occurred by chance?
How can this knowledge assist me in clinical practice?
- were the results found amongst a population similar to one of my patient group?
- are there any significant differences and how might they be handled?
- were there any adverse effects that should be considered?
- do I have the professional competences to undertake these changes to my practice?
Learn more about critical appraisal
There are number of tools to help you undertake critical appraisal. The most used is the Critical Appraisal Skills Programme (CASP). This website contains a great deal of useful information about the CASP approach including checklists and details of workshops.
The CSP Online Library Catalogue lists a number of resources about critical appraisal.
The following websites include information on critical appraisal. The University of Kent website includes links to high quality, recommended resources for qualitative and quantitative research; social services; economic evaluation studies; case or cohort studies and more.
- Critical appraisal at The University of Kent
- Critical appraisal tools at the International Centre for Allied Health Evidence
- Critical appraisal frameworks: Health Knowledge
- Notes and checklists: SIGN critical appraisal
- Williams R. Linking research to practice. In: Williams R, Baker L, Marshall J, (Editors) Information searching in healthcare. New York: Slack; 1992.
- Burls A. What is critical appraisal? Newmarket: Hayward Medical Communications; 2009: http://www.bandolier.org.uk/booth/glossary/Critapp.html
- Young J M, Solomon M J. How to critically appraise an article. Nat Clin Pract Gastroenterol Hepatol. 2009;6(2):82-9/. https://www.medscape.com/viewarticle/706399_1