Critical Appraisal Overview

Is this paper relevant, valid, clinically useful?

Does this research/information change my clinical practice?
Do I know enough to pass my exams?!?
www.casp-uk.net
CASP Checklists/Toolkits

www.equator-network.org/
The Equator Network

training.cochrane.org/handbook
Mark Kerr
The Cochrane Handbook
Clinical Librarian
2022
 Who was the research carried out by
(organisation/individuals)? Seniority, reputation,
experience?
 Which journal was the research published by? Impact
factor? Reputation?
 When was the research carried out and when was it
published?
 Where is the research based? (setting)
 1. PICO – if relevant, then read it
 2. Difference due to chance? Due to bias?
 If not then likely to be due to intervention
 3. Is difference big enough to be clinically useful?
 And is it ‘real’ (patient-oriented) or surrogate outcome?
 4. Does it change/inform knowledge or practice?
 Can I apply this to my patient?

1. SCREEN 2. APPRAISE 3. ASSESS 4. APPLY

IRRELEVANCE PICO

BIAS RAMMBO

CHANCE Sample size, P value, 95% CI

FUTILITY Effect Size, Clinical Significance

REPRODUCABILITY Similar studies,

meta-analysis

ACCEPTABILITY Social, regulatory &

clinical approval

AFFORDABILITY Cost-effectiveness studies

GENERALISABILITY Are they sufficiently

like us?
Evidenced by:
Internal or external validity

Internal
 Low risk of bias, ‘good’ p value in results, apparently
‘successful’ study

External
 Patients like ‘ours’? Treatment we use? Setting we
recognise? Generalisability? Applicability?