Critical Appraisal tools
Critical appraisal is the systematic evaluation of clinical research papers in order to establish:
- Does this study address a clearly focused question?
- Did the study use valid methods to address this question?
- Are the valid results of this study important?
- Are these valid, important results applicable to my patient or population?
If the answer to any of these questions is “no”, you can save yourself the trouble of reading the rest of it.
This section contains useful tools and downloads for the critical appraisal of different types of medical evidence. Example appraisal sheets are provided together with several helpful examples.
Critical Appraisal Worksheets
Chinese – Translated by Chung-Han Yang and Shih-Chieh Shao
German – Translated by Johannes Pohl and Martin Sadilek
Lithuanian – Translated by Tumas Beinortas
Portuguese – Translated by Enderson Miranda and Luis Eduardo Fontes
Spanish – Translated by Ana Cristina Castro
Explanations & Examples
Received Date: Nov 19, 2015 / Accepted Date: Nov 26, 2015 / Published Date: Dec 03, 2015
An initial difficulty for the characterization of case studies lies in the fact that different methodologies adopted in the same clinical setting. The case study can be defined as an operating system a limited or a case, obtained by means of a detailed data collection, involving multiple sources of information (history, physical examination, laboratory testing, imaging and treatment). It is a study depth of a unit, group or individual, in its complexity and in its own dynamism, providing relevant information for clinical decision making [1-9]. The Table 1 shows the checklists needed to make a critical analysis of a case study article.
The discussion of clinical cases is an important tool in learning and improvement of clinical reasoning, the use of this critical evaluation of case reported can improve the scientific quality of such article. It is important for readers to recognize the advantages and disadvantages of case series.
|Did the study address a clearly focused question/issue?|
|Is the study design appropriate for answering the research question?|
|Was the study well-defined protocol?|
|Are both the setting and the subject’s representative with regard to the population to which the findings will be referred?|
|Is the researcher’s perspective clearly described and taken into account?|
|Are the methods for collecting data clearly described?|
|Are the methods for analyzing the data likely to be valid and reliable? Are quality control measures used?|
|Was the analysis repeated by more than one researcher to ensure reliability?|
|Are the results credible, and if so, are they relevant for practice? Are results easy to understand?|
|It was clinically relevant outcomes?|
|Are the conclusions drawn justified by the results?|
|Are the findings of the study transferable to other settings?|
Table 1: Critical appraisal of a case report.
- Crombie, The Pocket Guide to Critical Appraisal; the critical appraisal approach used by the Oxford Centre for Evidence Medicine, checklists of the Dutch Cochrane Centre, BMJ editor’s checklists and the checklists of the EPPI Centre.
- Moon SM, Trepper TS(19961996). Case study research. In: Sprenkle DH, Moon SM. Research methods in familiy therapy. New York: Guilford Press 393-410.
- Stake RE (2000) Case studies. In: Denzin NK, Lincoln YS (eds). Handbook of qualitative research. London: Sage436.
- Reis PEO, Roever L, Reis IFO, Rotolo M, Sandri PA, et al. (2015) Surgical Treatment of Traumatic Injury of the Artery and Popliteal Vein - A Case Report. J Clin Case Rep 5:610.
- Ocke Reis PE, Roever L (2015) Endovascular Treatment of Popliteal Artery Aneurism and Occlusive Arterial Disease-A case Report. J Clin Case Rep 5:503.
- Thaler KJ, Morgan LC, Van Noord M, Jonas DE, McDonagh MS, et al. (2013) A case study of pooled-studies publications indicated potential for both valuable information and bias. J ClinEpidemiol 66:1082-1092.
- Stahl S, Santos Stahl A, Lotter O, Pfau M, Perner S, et al. (2012) Palliative surgery for skeletal metastases from melanoma in the scaphoid--a critical case report appraisal. J PlastReconstrAesthetSurg 65:1111-1115.
- Chan K, Bhandari M (2011) Three-minute critical appraisal of a case series article. Indian J Orthop 45: 103-104.