Tutorial 10

Critical Appraisal of Epidemiological Study

Overview
In this session we will learn a systematic approach that is used to identify the strength
and weakness of a research paper with aimed to assess the validity and usefulness of
the findings. The main components if a critical appraisal are an evaluation of the
appropriateness of the study design to the research question and a careful assessment
of the methodological aspect of the design. This session will introduce you to steps,
which will guide you to critically appraise an article in aimed to identify the most
relevant high-quality studies available to guide a public health practice.

Learning objective
After working through this session, students were expected to be able to:
 Critically appraise a research article including identify the strength and the weakness
of the study
 Determined the usefulness of the research finding for a clinical or public health
practices
 Use available checklist appropriately to appraise a research article

Critical Appraisal
Critical appraisal is a carefully and systematically process in examining research to judge
its trustworthiness, and its value and relevance in particular context (Burls,2009). Critical
appraisal is an important element of evidence-based medicine, which included public
health practices. Critical appraisal is essential to combat information overload, identify
papers that are relevant, and as continuing professional development.

Examples: Bad science (www.ucl.ac.uk/ich/support services/library)

The spate of deaths among young people in Britain’s suicide capital could be linked to radio waves from
dozens of mobile phone transmitter masts nea r the victims’ ho mes. Dr Roger Coghill, who sits on a
Government adviso ry committee on mobile radiation, has discovered that all 22 youngsters who have
killed themselves in Bridgend, South Wales, over th e past 18 months lived far closer than average to a
mast. (Johnston 2008).
Ben Goldacre, a medical doctor and author of the weekly Bad Science column in the Guardian,
investigated the claim made by the Sunday Express article and found out the following: I contacted Dr
Coghill, since his work is now a matter of gr eat public concern, and it is vital his evidence can be properly
assessed. He was unable to give me the data. No paper has been published. He himself would not
describe the work as a “study”. There are no statistics presented on it, and I cannot see the raw figures. In
fact Dr Coghill tells me he has lost the figures. Despite its potentially massive public health importance, Dr
Coghill is sadly unable to make his material assessable. (Goldacre 2008)
Critical Appraisal of Different Study Design
To critically appraise a journal article, you would have to start by assessing the research
methods used in the study. The following checklist are commonly use:
 CASP http://www.casp-uk.net/#!casp-tools-checklists/c18f8
 SIGN guideline developer’s handbook http://www.sign.ac.uk/methodology/checklists.html
 CEBMH http://www.cebm.net/critical-appraisal/

Activity 1
Read the attached article; answer the question below and discussed with your tutor
regarding your answer and explanation;
1. Are the study’s results valid?
2. What are the results?
3. Do you think the result will help the doctor in improving patient care?

Article: Pilot evaluation of the text4baby mobile health program

http://www.biomedcentral.com/1471-2458/12/1031

Assignment (deadline submission: within 2 weeks)

Conduct an critical appraisal for this research paper, which titled: Comparison of
cardiovascular risk factors and dietary intakes among Javanese Surinamese and South-
Asian Surinamese in the Netherlands. The HELIUS study, you may download it at:
https://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-016-2352-4
Or you may download it at GAMEL