Critical appraisal is reviewing the evidence to determine the validity, reliability, and applicability of evidence to our practice.

We're asking ourselves, is this article logical/factual, trustworthy, and relatable? 

Simply finding the evidence is not the end of the process.

Think back to our step by step guide of EBP:

When first learning, it's best to use a checklist.

To choose a checklist, first identify the type of evidence you have -- that's the type of study you're evaluating: RCT, systematic review, cohort study, case study, etc. Then, choose a checklist (see the list on the left) designed to critique that type of study design.

Like any skill, it takes practice, but gets easier over time. The goal is to think critically about whether or not the article makes sense, is trustworthy, and can be related to your patient population. While reading, ask yourself:

• Why was study done and did they answer their original questions?
• What is the sample size and how might that affect the results and conclusions?
• Did they look at the right measures of their desired outcomes?
• Are the statistical tests appropriate to the study design?
• Are the conclusions drawn backed up by the data and how might any limitations change your view of the conclusions?

Title: should be clear, concise and convey the main concepts, hypotheses, methods and variables involved in the study.  Usually 12-15 words or a certain number of characters. 

Abstract: is the next most frequently read part of the article and will determine if a reader decides to read the entire article.  Usually 100-250 words that includes the purpose or aims, hypotheses, sample, methods and summary of results. 

Introduction: orients the reader to the subject and provides background (problem, evidence from other studies) on why this study is important.  Includes the aim and hypotheses for the study.  Where you may find the framework used to conduct the study. 

Methods: section describes how the study was done and provide enough information for a reader to replicate the study.  This section is key to determining the validity of the study.  Should describe the sample population and variables, instruments used to measure variables and their reliability and validity,  materials used, the study design, procedures and statistical tests to be used. 

Results: section provides all relevant statistical results including results that don’t support the hypotheses.  Usually will find tables and graphs that are meant to summarize findings and those also should be analyzed and critiqued. 

Discussion section analyzes the results in relation to the research question(s) and/or hypotheses.  Should make it clear if the hypotheses were supported.  If hypotheses are not supported what is a possible explanation for the unexpected results?  Should also discuss limitations of the study and recommendations for future study. 

References are listed and formatted according to the journal protocol.  Few scientific journals use APA.  All references listed in the body of the article must be included in the reference list.

Not sure where to start with p values and confidence intervals? Watch this video: https://www.youtube.com/watch?v=1tWhe4fWp-o. 

Don't hesitate to reach out with any questions. Unpacking statistical and clinical significance just takes some math and common sense.