CRITICAL APPRAISAL OF THE TOPICS

SCREEN FOR INITIAL VALIDITY AND

RELEVANCE

The article is from a peer-reviewed journal

Object of the study is limited to animal, which is need more research to
make it applicable in human.
The study was not sponsored by any organization that might influence the
study design or results
SCREEN FOR INITIAL VALIDITY AND RELEVANCE

The results, if valid, need more research for our practice, due to this journal
belongs to animal research
This information will have a direct impact on the health of our patients & something
they will care about, until it can be proven safely in human being.
This information, if valid and proven safely in human, will require us to change our
current practice
DETERMINE THE INTENT OF THE ARTICLE
To compare the outcome of the use silver sulfadiazine
(SSD) and olive oil in partial thickness burn
Clinical category Description Preferred Study Design

Therapy Tests the effectiveness of a treatment, Randomized, double-

such as a drug, surgical procedure, or blinded, placebo-
other intervention controlled trial

Diagnosis Measures the validity (is it Cross-sectional survey

dependable?) and reliability (will the (comparing the new test
same results be obtained every time?) with a reference standard)
of a diagnostic test, or evaluates the
effectiveness of a test in detecting
disease at a pre symptomatic stage
when applied to a large population

Causation Assesses whether a substance is related

Cohort or case-control
to the development of an illness or
condition
Prognosis
Determines the outcome of a disease Longitudinal cohort study
LEVEL 1 OF EVIDENCE
Level Therapy/Prevention, Prognosis Diagnosis
Aetiology/Harm
1a SR (with homogeneity*) of SR (with homogeneity*) SR (with homogeneity*) of
RCTs of inception cohort Level 1 diagnostic
studies; CDR studies; CDR with 1b
validated in studies from different
different clinical centres
populations

1b Individual RCT (with Individual inception Validating** cohort study

narrow Confidence cohort study with > with good reference
Interval) 80% follow-up; standards; or CDR
CDR validated in a tested within one clinical
single population centre

1c All or none All or none case-series Absolute SpPins and

SnNouts
LEVEL 2 EVIDENCE
Level Therapy/Prevention, Prognosis Diagnosis
Aetiology/Harm

2a SR (with homogeneity* ) of SR (with homogeneity*) of SR (with homogeneity*) of Level

cohort studies either retrospective cohort >2 diagnostic studies
studies or untreated control
groups in RCTs

2b Individual cohort study (including
low quality RCT; e.g., <80%
follow-up)
Retrospective cohort study or Exploratory** cohort study with
follow-up of untreated goodreference standards;
control patients in an RCT; CDR after derivation, or
Derivation of CDR or validated only on split-sample
validated on split-sample or databases
only

2c "Outcomes" Research; Ecological "Outcomes" Research

studies
 Level 3,4,5 of Evidence
Level Therapy/Prevention, Prognosis Diagnosis
Aetiology/Harm
3a SR (with homogeneity*) of case- SR (with homogeneity*) of 3b and
control studies better studies
3b Individual Case-Control Study Non-consecutive study; or without
consistently applied reference
standards

4 Case-series (and poor quality Case-series (and poor quality
cohort and case-control prognostic cohort studies***)
studies )
5 Expert opinion without explicit Expert opinion without
critical appraisal, or based on explicit critical appraisal, or
physiology, bench research or based on physiology, bench
"first principles" research or "first principles"
Case-control study, poor or non-
independent reference standard
Expert opinion without explicit
critical appraisal, or based on
physiology, bench research or
"first principles"
GRADES OF RECOMMENDATION
A consistent level 1 studies

B consistent level 2 or 3 studies or extrapolations

from level 1 studies
C level 4 studies or extrapolations from level 2 or 3
studies
D level 5 evidence or troublingly inconsistent or
inconclusive studies of any level
THANK YOU