Research involves gathering data, then collating and analysing it to produce meaningful information. However, not all research is good quality, and many studies are biased and their results untrue. This can lead us to draw false conclusions.
So, how can we tell whether a piece of research has been done properly and that the information it reports is reliable and trustworthy? How can we decide what to believe when research on the same topic comes to contradictory conclusions? This is where Critical Appraisal helps.
If healthcare professionals and patients are going to make the best decisions, they need to be able to:
Aetiology: what caused this illness?
Diagnosis: what does this test result mean in this patient?
Prognosis: what is likely to happen to this patient?
Harm: is having been exposed to this substance likely to do harm, and, if so, what?
Effectiveness: is this treatment likely to help patients with this illness?
Qualitative: what are the outcomes that are most important to patients with this condition?
Type of question | Study design |
---|---|
Etiology and risk factors | Cohort and case–control studies |
Incidence and prevalence | Cohort or cross-sectional |
Harm | Cohort and case–control studies |
Prognosis | Cohort/survival studies |
Value for money | Economic evaluation (e.g. cost-effectiveness study or cost–benefit study) |
Effectiveness | Randomized controlled trial |
Diagnosis | Diagnostic test study (or randomized controlled trial) |
Patient experience (e.g. of illness, treatment or service) | Qualitative studies, e.g. questionnaires, focus groups, or interviews |
Different questions require different study designs for critical appraisal; first, because you need to choose a paper with the right type of study design for the question that you are seeking to answer and, second, because different study designs are prone to different biases.
Thus, when critically appraising a piece of research it is important to first ask: did the researchers use the right sort of study design for their question? It is then necessary to check that the researchers tried to minimise the biases (that is, threats to internal validity) associated with any particular study design; these differ between studies.
The Critical Appraisal Skills Programme (CASP) aims to help people develop the skills they need to make sense of scientific evidence. CASP has produced simple critical appraisal checklists for the key study designs.
These are not meant to replace considered thought and judgement when reading a paper but are for use as a guide and aide memoire.
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