The document discusses critical analysis of research articles. It provides guidelines for analyzing different aspects of a research paper, including the journal, abstract, introduction, methods, results, discussion, and funding/conflicts of interest. As an example of critical analysis, the document analyzes a research article on ectodermal dysplasia. Key points analyzed include the objectives, methodology, results presented, and limitations. The document emphasizes the importance of systematically evaluating the strengths and weaknesses of studies.

1. Dr Ebin Roshan Paul
Assistant Professor & Clinical Geneticist
PK DAS Institute of Medical Sciences, Ottapalam, Kerala

2.  Journal club : an educational meeting where an article
is read, evaluated and discussed.
 Meeting where “critical analysis” of research journal
done

3. Critical analysis
 Critical analysis: “systematic process” through which
the strength and weakness of a study revealed.
 “putting the research in to practice”

4. Why we need critical analysis ?
 Common misconceptions about research articles
 1) article published in a scientific journal is always
correct
 2) presence of “paid journals” in scientific community

5. Critical analysis
 Not based on negative intentions.
 quality of the study
 based pre specified set of criteria
 whether the findings are trustworthy and useful
 balanced: alternative suggestions provided to
strengthen and avoid weakness

7. Types of study
Epidemiology (Greek word)
Epi: on
Demos: population
Logos: study

9. Guidelines for reporting studies
 CONSORT : RCT
 PRISMA: Systematic reviews and Meta analysis
 STROBE: Observational studies (Descriptive)
 Based on EQUATOR recommendations

10. EQUATOR Network
 Enhancing the Quality and Transparency Of health
Research.
 international initiative that aims to improve the
quality of research publications.
 provides a comprehensive list of reporting guidelines
https://www.equator-network.org/

12. STROBE checklist
 Strengthening The Reporting of OBservational
studies in Epidemiology.
 22 item checklist
 18 items are common - Cohort, CC and CS study
 6/12/14/15 varies with each design.
https://www.equator-network.org/

14. Our article for critical analysis

15. 1. Overview of paper
 Journal and Year
 Article Title – key objectives
 Authors and Institution
 Corresponding author
https://www.equator-network.org/

16. Journal – Indexed or not ?
 “Scientific quality” of article
 Scientific review process by a trusted/reputed
indexer/institution
 “Index Medicus” from 1879 onwards
 Other – MedLine, Pubmed, EMBASE, SCOPUS, EBSCO,
SCIRUS......

18. SCOPUS indexed journal

19. Critical analysis
a. Journal indexed /
b. Year 
c. Article title 
d. Authors and Correspondence 
No Objective description

20. 2. Abstract (summary) (1)
 Why? Quick way of knowing the article.
 Aims & Objective, Intervention, Methodology, Results,
Conclusions.
 Informative and “balanced summary of what was done
and what was found”
 “never contain data not included in manuscript”
https://www.equator-network.org/

21. a. AIM
b. Materials & Methods
c. Results
d. Conclusions

22. Inclusion/exclusion ??
Severity score /grade ??
Secondary objective ??
??

23. Critical analysis
a. Intelligible 
b. Aims & Objectives 
c. Methodology /
d. Results /
e. Other data present 
f. Conclusion clearly answer QOI 
No criteria, no scoring
No secondary objective

24. 3. Introduction and
Background (2&3)
 Good background information with
adequate references
a. Clinical importance of condition
b. Limitations of available knowledge
c. Why this study relevant ?
d. How this will changes previous concept ?

26. Critical analysis
a. Good background information 
b. Clinical importance 
c. Limitation of current information 
d. Why this study relevant 
e. How this will change the previous concept 
https://www.equator-network.org/

28. 4. Materials and Methods (4-12)
 Precise information  (4) Study design and Methodology
(5) Study settings & Location
(6) Population (PICOT)
(7) Variables
(8) Interventions (if used) & source &
tools of measurements (if used)
(9) Bias
(10) Sample size and calculations
(12) Statistical analysis used, CI, p value
confounding and missing data
Limitations of methodology

29. ?
Outcome ?

30. Critical analysis
 Study design and Methodology 
 Population (PICOT) 
 Study settings & Location 
 Inclusion and exclusion criteria  ( not clearly defined )
 Sample size and calculations  (not done )
 Interventions (if used) & source 
 Tools of measurements (if used) / (severity of CL/CP)
 Statistical analysis used, CI, p value / ( comparison group+)
 Confounding and missing data 
 Limitations of methodology 

31. 5. Result (13-17)
 Whether the Aims and Objectives covered/not?
 (13) In depth description of study population with descriptive and
analytical results done/not?
 (14) Descriptive data: Tables/Diagrams/Charts/Graphs used ?
 (16)What are the main results, are they statistically significant &
valid ?
 (17) Other analysis done in subgroups https://www.equator-network.org/

32. 
Primary
Secondary 12/24/170/5902
24/170
24/5902
Other analysis
Associations
9/24
5/11/24/170/5902

33. Outcome of management ?
Follow up ?
Correction score ? PWSS ?
Immediate events

34. Critical analysis
Demographic 
1◦ objective  (prevalence & characteristics)
2◦ objective  (severity? and outcome ?)
Statistical analysis 
Tables/chart/diagrams 
Self explanatory 
Descriptive data 
Analytical data 
Other analysis  ( Syndromes, Association, Genetics )

35. 6. Discussion (18-21)
 Absolute comparison between published literature Vs
newly established result.
 Whether objectives of study met/not?
 If not: any explanations?
 Statistically significant results are clinically applicable?
 Limitations & Bias
 Recommendations for further studies ?
Validate the present study
Associations established
https://www.equator-network.org/

36. Primary objective
21 years
Scoring ?
Why delayed ?
5/11/24/170
3/24
22% Vs 67%

37. <50% (11/24)
? Secondary objective
? Outcome
? Success
? Follow up
? Scoring / Scale PWSS
9/24
1/24
1/24

38. ? Severity assessment
? Follow up
? Outcome of Mx

39. Critical analysis
Absolute comparison 
Objectives of study /
Statistical analysis 
Generalizability 
Bias 
Limitations 
New associations 
Further studies 
Secondary objective

40. 7. Funding and COI (22)
 Source of funding ?
 Role of funders in present study ?
 Any COI: Author, Authorship, Research, Funder,
Publisher.
https://www.equator-network.org/

41. 


Other information

42. Summary
 Overview: article title add key objectives
 Abstract: secondary objective and conclusion
 Introduction & Background: clinical importance of ED and relevance
of study
 Materials & Methods: inclusion/exclusion criteria, severity scoring,
sample size calculation, statistical analysis, limitations, bias
 Results: Outcome of 2◦ objective
 Discussion: statistical analysis, bias, generalizability, future studies

44. Dr Ebin Roshan Paul

46. Severe

48. Tp 63 gene
 3q28  p63 protein ( TF )  gene regulation
 Structural homology p53
 15 exons and many isoforms
 various region and type of mutation  GOF, abnormal
p63, altered ability to “turn on/off” target gene.
P 40
P51
P63
p73L

50.  AD trait
 Various syndromes 
EEC 3
AEC/RHS
LMS
ADULT
SHFM
OF cleft 8

53. EEC 3 syndrome
 9/24 article cases
 AD variability and penetrance
 Limbs: “lobster claw”
 Ectodermal: sparse hair, peg teeth, dysplastic nails, scaly skin
 Exocrine: hypohidrosis
 IQ normal

55. AEC syndrome / RHS
 Ankyloblepheron- Ectodermal defect- Cleft lip/palate
 1/24 article cases
 Extra features: Skin erosions scalp
“Ankyloblepheron filiforme adnatum”
AEC and RHS are allelic disorders

57. ADULT syndrome
 Acro Dermato Ungual Lacrimal Tooth syndrome
 AD trait
 Tp 63 gene

58.  EEC features ( without clefting) + Dermatological
(freckling, xerosis) + Lacrimal (NL duct obstruction) +
Teeth (hypodontia)

59. Limb mammary syndrome
 Tp63 exon 13 and 14
 Limb defect + “Hypo/aplasia of breast and nipple”
 ED – teeth and nail +/- cleft lip/palate

60. Focal Dermal Hypoplasia (FDH)
 XLD, 1/24 article cases
 PORCN gene (Xp11.23)  WNT proteins not released
 90% females
 Skin: Cutis aplasia, fat nodules, papillomas, telengiectasia.
 Abnormal dentition, sparse hair, dysplastic nails, limb defects, eye
anomalies

62. Blepharocheilodontic syndrome
BCDS
 AD trait
 3/24 article cases
 CDH1 gene (I) and CTNND1 gene (II) associated with E
cadherin and p120-catenin
 Craniofacial development and Ectodermal structures

63.  Blepharo – ectropion, euryblepharon, lagopthalmia,
distichiasis.
 Cheilo- cleft lip/palate
 Dontic- oligodontia, cone shaped teeth
 Others: flat face, high forehead, hair and nail changes,
syndactyly, clinodactyly.