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Methodological assessment of studies vary depending on the type of research being reported on. The questions to ask of an article reporting on a randomised controlled trial, for example, would differ from the questions that would be applied when reading a systematic review or a case-control study.

Using checklists can help you to evaluate the evidence and make a decision about whether to use any given piece of research to support your practice.

The tools and resources listed below are intended to provide support in understanding the key principles of critical appraisal, and the steps involved in applying critical appraisal to your reading.

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Training on critical appraisal

St George’s library hosts regular training sessions introducing users to the key concepts of critical appraisal. The session discusses the skills required to appraise and evaluate research literature, helping to guide the process of judging whether research is trustworthy, relevant and of value. The course also gives an overview of the tools and techniques which can be used to support the critical appraisal of scientific evidence.

Critical appraisal tools and resources

CASP checklists

The checklists created by the Critical Appraisals Skills Programme (CASP) are designed to help you critically appraise articles of a variety of types of research, including systematic reviews, randomised controlled trials (RCTs), qualitative research and cohort studies, among others. The CASP appraisal tools were developed from guides produced by the Evidence-Based Medicine Working Group published in the Journal of the American Medical Association.

SIGN critical appraisal notes and checklists

The Scottish Intercollegiate Guidance Network (SIGN), part of Healthcare Improvement Scotland, also have a range of checklists to support the critical appraisal of different types of research papers. Each checklist is accompanied by a set of notes to guide you through the checklist questions.

CEBM appraisal tools and checklists

The Centre for Evidence-Based Medicine (CEBM) is part of the Nuffield Department of Primary Care Health Sciences at the University of Oxford. They have produced a set of critical appraisal worksheets on systematic reviews, diagnostic and prognostic studies, as well as randomised controlled trials, each of which have been translated into a number of different languages, including Chinese and Spanish.

CEBM Levels of Evidence

The Centre for Evidence-Based Medicine (CEBM) also produced Levels of Evidence, which is designed to be used to help rank the available evidence and support decision making. It offers a hierarchy of the likely best evidence.

NCCMT Learning Centre

Canada’s National Collaborating Centre for Methods and Tools offers a series of online modules on evidence-informed public health, which include a number of guides to critical appraisal of different types of evidence, including systematic reviews and qualitative studies.
Critical appraisal books

Gosall, N. (2015) The Doctor’s Guide to Critical Appraisal: a comprehensive guide to the skills and knowledge that can help you to critically appraise research literature.

Greenhalgh, T. (2014) How to Read a Paper: How to Read a Paper demystifies evidence-based medicine and explains how to critically appraise published research and also put the findings into practice.

The BMJ published a series of articles based on excerpts from the above title, which can be accessed using the following links:

Kaura, A. (2015). Evidence-based medicine: reading and writing medical papers. This book covers evidence-based medicine, statistics, critical appraisal and audit, giving the reader a contextual knowledge base.

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