This document provides an overview of evidence-informed decision making and critical appraisal for nursing practice. It defines evidence-informed decision making and its importance for nursing. It also outlines the steps of evidence-informed decision making including formulating a focused, answerable question using PICO/PICOT, searching for and collecting the best evidence, and critically appraising the literature. Criteria for critically appraising different study designs are discussed, including intervention studies. The importance of critical appraisal for nursing practice, policy, and research is emphasized.
This document provides an introduction and overview of systematic reviews. It defines systematic reviews and their key characteristics, including having a clearly defined question and methodology for systematically searching, appraising, and synthesizing the available evidence to answer a specific question. It contrasts systematic reviews with other types of literature reviews and outlines the main steps in planning and conducting a systematic review, including developing a protocol and search strategy.
Critical Appraisal of systematic review and meta analysis articlesDr. Majdi Al Jasim
Critique of systematic review and meta analysis articles
This presentation is made to educate health care provide rs on how to do critical appraisal of systematic review and meta analysis articles
This document provides an introduction to critical appraisal of research evidence. It discusses the importance of critically appraising research in order to determine the validity, relevance and applicability of findings to clinical practice. Both quantitative and qualitative research methodologies are covered. Key steps in critically appraising systematic reviews, randomized controlled trials and qualitative research studies are outlined. These include assessing the appropriateness of the research question, methodology, analysis and applicability of results. Conducting effective critical appraisal workshops is also addressed.
This document discusses critical appraisal of published medical research. It notes that thousands of new medical articles are published daily, making it difficult for clinicians to keep up-to-date. Critical appraisal involves assessing the validity, reliability, and applicability of a study rather than just dismissing it or looking only at the results. Key aspects of critical appraisal include describing the evidence, assessing internal validity by examining potential biases and confounding factors, evaluating external validity and whether results can apply to other populations, and comparing results to other evidence. The document provides guidance on how to critically appraise studies and lists resources for further information.
This document provides guidance on appraising a systematic review using a checklist. It addresses key questions like whether the systematic review had a clear research question, performed a comprehensive literature search, explicitly stated inclusion/exclusion criteria, assessed study quality, stated how results were combined statistically, reported absolute numbers and summary statistics, and discussed clinical relevance. The document notes that important details on these aspects can typically be found in sections like the Methods, Results, and Conclusion sections of a systematic review. It aims to help reviewers appraise important methodological aspects of a systematic review.
Critical appraisal presentation by mohamed taha 2Cairo University
This document discusses how to critically appraise a research article. It provides 10 questions to ask when appraising an article, including whether the study question is relevant, if the study design was appropriate, and if the data supports the conclusions. As an example, it summarizes a study that examined the relationship between serum cholesterol levels and exposure to violence in suicide attempters. The study addressed relevant questions, utilized an appropriate cohort study design, and its conclusions were reasonably supported by the collected data.
The document discusses various frameworks for rating the level of evidence in studies, including the NHMRC, GRADE, Oxford Centre for Evidence-Based Medicine, and Sackett scales. It outlines the different levels in each scale, with the highest levels reserved for systematic reviews and randomized controlled trials. The lowest levels include case series, case reports, and expert opinion without critical analysis. It also provides guidance on selecting the appropriate study design based on different types of clinical questions regarding therapy, diagnosis, etiology, prognosis, prevention, or costs.
This document provides an introduction and overview of systematic reviews. It defines systematic reviews and their key characteristics, including having a clearly defined question and methodology for systematically searching, appraising, and synthesizing the available evidence to answer a specific question. It contrasts systematic reviews with other types of literature reviews and outlines the main steps in planning and conducting a systematic review, including developing a protocol and search strategy.
Critical Appraisal of systematic review and meta analysis articlesDr. Majdi Al Jasim
Critique of systematic review and meta analysis articles
This presentation is made to educate health care provide rs on how to do critical appraisal of systematic review and meta analysis articles
This document provides an introduction to critical appraisal of research evidence. It discusses the importance of critically appraising research in order to determine the validity, relevance and applicability of findings to clinical practice. Both quantitative and qualitative research methodologies are covered. Key steps in critically appraising systematic reviews, randomized controlled trials and qualitative research studies are outlined. These include assessing the appropriateness of the research question, methodology, analysis and applicability of results. Conducting effective critical appraisal workshops is also addressed.
This document discusses critical appraisal of published medical research. It notes that thousands of new medical articles are published daily, making it difficult for clinicians to keep up-to-date. Critical appraisal involves assessing the validity, reliability, and applicability of a study rather than just dismissing it or looking only at the results. Key aspects of critical appraisal include describing the evidence, assessing internal validity by examining potential biases and confounding factors, evaluating external validity and whether results can apply to other populations, and comparing results to other evidence. The document provides guidance on how to critically appraise studies and lists resources for further information.
This document provides guidance on appraising a systematic review using a checklist. It addresses key questions like whether the systematic review had a clear research question, performed a comprehensive literature search, explicitly stated inclusion/exclusion criteria, assessed study quality, stated how results were combined statistically, reported absolute numbers and summary statistics, and discussed clinical relevance. The document notes that important details on these aspects can typically be found in sections like the Methods, Results, and Conclusion sections of a systematic review. It aims to help reviewers appraise important methodological aspects of a systematic review.
Critical appraisal presentation by mohamed taha 2Cairo University
This document discusses how to critically appraise a research article. It provides 10 questions to ask when appraising an article, including whether the study question is relevant, if the study design was appropriate, and if the data supports the conclusions. As an example, it summarizes a study that examined the relationship between serum cholesterol levels and exposure to violence in suicide attempters. The study addressed relevant questions, utilized an appropriate cohort study design, and its conclusions were reasonably supported by the collected data.
The document discusses various frameworks for rating the level of evidence in studies, including the NHMRC, GRADE, Oxford Centre for Evidence-Based Medicine, and Sackett scales. It outlines the different levels in each scale, with the highest levels reserved for systematic reviews and randomized controlled trials. The lowest levels include case series, case reports, and expert opinion without critical analysis. It also provides guidance on selecting the appropriate study design based on different types of clinical questions regarding therapy, diagnosis, etiology, prognosis, prevention, or costs.
Quick introduction to critical appraisal of quantitative researchAlan Fricker
1) The document provides an introduction to critically appraising quantitative research for healthcare. It discusses key concepts such as levels of evidence, validity, reliability, and transferability.
2) Critical appraisal involves assessing a study's validity, rigor, and relevance through a structured process using checklists to evaluate aspects like research design, sample size, randomization, and potential for bias.
3) Statistical measures like p-values, confidence intervals, and effect sizes are important to consider, but clinical significance is also key when determining if results can be applied to practice.
The document provides guidance on how to critically appraise research studies and articles. It discusses evaluating key aspects of research such as the problem statement, objectives, hypotheses, conceptual framework, literature review, research design, sampling, data collection methods, and ethical considerations. Criteria are provided to assess each component, such as whether the problem is clearly defined, objectives are measurable, sampling and data collection methods are appropriate, and participant rights are protected. Recommended sources on nursing research and critiques are also listed.
Critical appraisal is the process of carefully examining research to judge its validity, relevance, and applicability. It is important to ensure research findings are valid and applicable to one's own population before incorporating them into clinical practice. While research is peer-reviewed, critical appraisal is still needed to avoid misinterpreting results. When critically appraising research, one should examine aspects like the research question, methodology, results, discussion and conclusions to determine the overall quality and implications. Checklists exist to standardize the critical appraisal of different study designs.
This presentation, presented to senior thesis students at UC Berkeley, reviews the uses of qualitative research methods such as ethnography in public health, walking students through methods, sampling, ensuring rigor, and analysis with CAQDAS software such as Atlas.ti
A systematic review is a rigorous analysis of published research on a focused question that collects and summarizes the evidence. It contrasts with an overview, which may include non-research articles and be influenced by other evidence. Meta-analysis uses statistical methods to combine results from multiple studies. To ensure validity, meta-analyses must have a well-defined methodology, including comprehensive searches and duplicate screening and data extraction to reduce bias. Important factors include assessing whether all relevant studies were found and the sources searched, as well as controlling for biases such as from selective data extraction or funding influences.
This document discusses various topics related to health research including:
- Definitions of research and health research.
- Key attributes of good research include planning, accurate data collection, and proper unbiased interpretation.
- Health research serves to identify health challenges and provide solutions to improve health systems.
- Both quantitative and qualitative research methods are useful for understanding health issues.
This document describes a cross-sectional study and its methodology. A cross-sectional study involves collecting data on exposure and outcome variables from a population at a single point in time. The document discusses the differences between descriptive and analytical cross-sectional studies. Descriptive studies measure prevalence, while analytical studies test associations between exposures and outcomes. The document provides examples of cross-sectional study design, biases, advantages, and guidelines for evaluating validity.
Critical appraisal of a journal articleDrSahilKumar
This document provides guidance on critically appraising journal articles. It defines critical appraisal as systematically identifying the strengths and weaknesses of research to assess validity and usefulness. Key aspects to evaluate include relevance of the research question, appropriateness of study design, addressing biases, adherence to original protocol, statistical analyses, and conflicts of interest. Checklists like CASP, CONSORT, and STROBE provide frameworks to appraise study methodologies like randomized trials, systematic reviews, and observational studies. The goal of critical appraisal is for clinicians to identify high-quality evidence to inform clinical practice.
Critical appraisal is the process of carefully and systematically analyze the research paper to judge its trustworthiness, its value and relevance in a particular context. (Amanda Burls 2009)
A critical review must identify the strengths and limitations in a research paper and this should be carried out in a systematic manner.
The Critical Appraisal helps in developing the necessary skills to make sense of scientific evidence, based on validity, results and relevance.
Epidemiologi Lanjut : Penelitian Case ControlFachri Latif
Studi kasus kontrol merupakan penelitian analitik observasional yang membandingkan kelompok kasus dan kontrol untuk mempelajari hubungan antara paparan dan penyakit. Metode ini murah dan mudah tetapi rawan bias. Terdapat berbagai varian desain seperti nested case-control yang menyarangkan pada studi kohort untuk mengurangi bias.
A systematic review is a comprehensive literature review designed to answer a specific clinical question using a pre-defined protocol. It requires at least 12 months to conduct due to extensive searches of published and unpublished studies, validity assessments of included studies, data collection, analysis, and keeping the review up-to-date. In contrast, a traditional literature review does not follow a pre-specified protocol or aim to be comprehensive. Systematic reviews also publish detailed search strategies to allow replication and apply statistical methods like meta-analysis to synthesized data from included studies.
1) A systematic review follows a strict methodology to identify and analyze relevant research on a focused question.
2) The process involves developing a protocol, searching multiple databases, screening studies, assessing bias, and synthesizing data.
3) Reporting guidelines like PRISMA ensure transparency and consistency in reporting systematic reviews.
Case Report Pansitopenia susp Multiple MyelomaKharima SD
Kasus seorang wanita 38 tahun dengan keluhan diare berdarah, lemas, dan penurunan berat badan yang didiagnosis dengan pansitopenia dan kecurigaan mieloma ganda. Pemeriksaan darah rutin menunjukkan anemia, leukopenia, dan trombositopenia berulang.
Critical appraisal of scientific articles overviewDrsnehas2
This document provides an overview of critical appraisal of scientific articles. It explains that critical appraisal is a systematic process to evaluate the strengths and weaknesses of research to assess its validity and usefulness. The document outlines the aims of critical appraisal as updating knowledge, supporting evidence-based practice, and informing health policies. It then describes how to critically appraise articles by following the structure and evaluating different sections like the title, abstract, methodology, results, and conflicts of interest. Finally, it lists different guidelines for appraising different study designs.
This document discusses developing PICO questions to help formulate clinical questions. It provides background on distinguishing background and foreground questions. The PICO framework is introduced as a method to structure clinical questions into four components: P (patient/population), I (intervention), C (comparison), and O (outcome). Examples are provided to demonstrate how to formulate a PICO question from a clinical scenario. The question types that can be addressed through PICO questions are also outlined.
Ketiga jenis studi epidemiologi memiliki perbedaan dalam desain, tujuan, dan cara pemilihan subjek. Studi cross sectional mempelajari hubungan penyakit dan paparan pada populasi pada satu waktu, studi kohort mengikuti kelompok terpapar dan tidak terpapar untuk melihat insidensi penyakit, sedangkan studi case control membandingkan kelompok kasus dan kontrol untuk mempelajari faktor risiko penyakit.
This document discusses nested case-control studies, case-cohort studies, and case-crossover studies. It provides examples and discusses the advantages and disadvantages of each study design. Nested case-control studies select controls from within a prospective cohort study. Case-cohort studies select a random subcohort of controls from the entire cohort. Case-crossover studies use individuals as their own controls by comparing exposure during case periods to control periods.
How to form a clinical question. cincinnati childrensCatherineMiller2
This document provides a tutorial on how to form an answerable clinical question in 5 steps: 1) Ask, 2) Acquire, 3) Appraise, 4) Apply, 5) Assess. It discusses using the PICO (Patient, Intervention, Comparison, Outcome) model to develop a well-built clinical question and identifies the type of clinical question and best study design. Clinical scenarios are presented and answered in PICO format to demonstrate how to apply this process. Additional training opportunities in evidence-based care are listed.
This document defines evidence-based nursing and its key components. Evidence-based nursing integrates the best research evidence, clinical expertise, and patient values and preferences. It involves cultivating a spirit of inquiry, asking clinical questions, searching for evidence, critically appraising evidence, integrating evidence with expertise and patient preferences, evaluating outcomes, and disseminating results. Barriers to evidence-based nursing include lack of skills/time and organizational constraints, while supports include leadership, resources, and mentors.
Quick introduction to critical appraisal of quantitative researchAlan Fricker
1) The document provides an introduction to critically appraising quantitative research for healthcare. It discusses key concepts such as levels of evidence, validity, reliability, and transferability.
2) Critical appraisal involves assessing a study's validity, rigor, and relevance through a structured process using checklists to evaluate aspects like research design, sample size, randomization, and potential for bias.
3) Statistical measures like p-values, confidence intervals, and effect sizes are important to consider, but clinical significance is also key when determining if results can be applied to practice.
The document provides guidance on how to critically appraise research studies and articles. It discusses evaluating key aspects of research such as the problem statement, objectives, hypotheses, conceptual framework, literature review, research design, sampling, data collection methods, and ethical considerations. Criteria are provided to assess each component, such as whether the problem is clearly defined, objectives are measurable, sampling and data collection methods are appropriate, and participant rights are protected. Recommended sources on nursing research and critiques are also listed.
Critical appraisal is the process of carefully examining research to judge its validity, relevance, and applicability. It is important to ensure research findings are valid and applicable to one's own population before incorporating them into clinical practice. While research is peer-reviewed, critical appraisal is still needed to avoid misinterpreting results. When critically appraising research, one should examine aspects like the research question, methodology, results, discussion and conclusions to determine the overall quality and implications. Checklists exist to standardize the critical appraisal of different study designs.
This presentation, presented to senior thesis students at UC Berkeley, reviews the uses of qualitative research methods such as ethnography in public health, walking students through methods, sampling, ensuring rigor, and analysis with CAQDAS software such as Atlas.ti
A systematic review is a rigorous analysis of published research on a focused question that collects and summarizes the evidence. It contrasts with an overview, which may include non-research articles and be influenced by other evidence. Meta-analysis uses statistical methods to combine results from multiple studies. To ensure validity, meta-analyses must have a well-defined methodology, including comprehensive searches and duplicate screening and data extraction to reduce bias. Important factors include assessing whether all relevant studies were found and the sources searched, as well as controlling for biases such as from selective data extraction or funding influences.
This document discusses various topics related to health research including:
- Definitions of research and health research.
- Key attributes of good research include planning, accurate data collection, and proper unbiased interpretation.
- Health research serves to identify health challenges and provide solutions to improve health systems.
- Both quantitative and qualitative research methods are useful for understanding health issues.
This document describes a cross-sectional study and its methodology. A cross-sectional study involves collecting data on exposure and outcome variables from a population at a single point in time. The document discusses the differences between descriptive and analytical cross-sectional studies. Descriptive studies measure prevalence, while analytical studies test associations between exposures and outcomes. The document provides examples of cross-sectional study design, biases, advantages, and guidelines for evaluating validity.
Critical appraisal of a journal articleDrSahilKumar
This document provides guidance on critically appraising journal articles. It defines critical appraisal as systematically identifying the strengths and weaknesses of research to assess validity and usefulness. Key aspects to evaluate include relevance of the research question, appropriateness of study design, addressing biases, adherence to original protocol, statistical analyses, and conflicts of interest. Checklists like CASP, CONSORT, and STROBE provide frameworks to appraise study methodologies like randomized trials, systematic reviews, and observational studies. The goal of critical appraisal is for clinicians to identify high-quality evidence to inform clinical practice.
Critical appraisal is the process of carefully and systematically analyze the research paper to judge its trustworthiness, its value and relevance in a particular context. (Amanda Burls 2009)
A critical review must identify the strengths and limitations in a research paper and this should be carried out in a systematic manner.
The Critical Appraisal helps in developing the necessary skills to make sense of scientific evidence, based on validity, results and relevance.
Epidemiologi Lanjut : Penelitian Case ControlFachri Latif
Studi kasus kontrol merupakan penelitian analitik observasional yang membandingkan kelompok kasus dan kontrol untuk mempelajari hubungan antara paparan dan penyakit. Metode ini murah dan mudah tetapi rawan bias. Terdapat berbagai varian desain seperti nested case-control yang menyarangkan pada studi kohort untuk mengurangi bias.
A systematic review is a comprehensive literature review designed to answer a specific clinical question using a pre-defined protocol. It requires at least 12 months to conduct due to extensive searches of published and unpublished studies, validity assessments of included studies, data collection, analysis, and keeping the review up-to-date. In contrast, a traditional literature review does not follow a pre-specified protocol or aim to be comprehensive. Systematic reviews also publish detailed search strategies to allow replication and apply statistical methods like meta-analysis to synthesized data from included studies.
1) A systematic review follows a strict methodology to identify and analyze relevant research on a focused question.
2) The process involves developing a protocol, searching multiple databases, screening studies, assessing bias, and synthesizing data.
3) Reporting guidelines like PRISMA ensure transparency and consistency in reporting systematic reviews.
Case Report Pansitopenia susp Multiple MyelomaKharima SD
Kasus seorang wanita 38 tahun dengan keluhan diare berdarah, lemas, dan penurunan berat badan yang didiagnosis dengan pansitopenia dan kecurigaan mieloma ganda. Pemeriksaan darah rutin menunjukkan anemia, leukopenia, dan trombositopenia berulang.
Critical appraisal of scientific articles overviewDrsnehas2
This document provides an overview of critical appraisal of scientific articles. It explains that critical appraisal is a systematic process to evaluate the strengths and weaknesses of research to assess its validity and usefulness. The document outlines the aims of critical appraisal as updating knowledge, supporting evidence-based practice, and informing health policies. It then describes how to critically appraise articles by following the structure and evaluating different sections like the title, abstract, methodology, results, and conflicts of interest. Finally, it lists different guidelines for appraising different study designs.
This document discusses developing PICO questions to help formulate clinical questions. It provides background on distinguishing background and foreground questions. The PICO framework is introduced as a method to structure clinical questions into four components: P (patient/population), I (intervention), C (comparison), and O (outcome). Examples are provided to demonstrate how to formulate a PICO question from a clinical scenario. The question types that can be addressed through PICO questions are also outlined.
Ketiga jenis studi epidemiologi memiliki perbedaan dalam desain, tujuan, dan cara pemilihan subjek. Studi cross sectional mempelajari hubungan penyakit dan paparan pada populasi pada satu waktu, studi kohort mengikuti kelompok terpapar dan tidak terpapar untuk melihat insidensi penyakit, sedangkan studi case control membandingkan kelompok kasus dan kontrol untuk mempelajari faktor risiko penyakit.
This document discusses nested case-control studies, case-cohort studies, and case-crossover studies. It provides examples and discusses the advantages and disadvantages of each study design. Nested case-control studies select controls from within a prospective cohort study. Case-cohort studies select a random subcohort of controls from the entire cohort. Case-crossover studies use individuals as their own controls by comparing exposure during case periods to control periods.
How to form a clinical question. cincinnati childrensCatherineMiller2
This document provides a tutorial on how to form an answerable clinical question in 5 steps: 1) Ask, 2) Acquire, 3) Appraise, 4) Apply, 5) Assess. It discusses using the PICO (Patient, Intervention, Comparison, Outcome) model to develop a well-built clinical question and identifies the type of clinical question and best study design. Clinical scenarios are presented and answered in PICO format to demonstrate how to apply this process. Additional training opportunities in evidence-based care are listed.
This document defines evidence-based nursing and its key components. Evidence-based nursing integrates the best research evidence, clinical expertise, and patient values and preferences. It involves cultivating a spirit of inquiry, asking clinical questions, searching for evidence, critically appraising evidence, integrating evidence with expertise and patient preferences, evaluating outcomes, and disseminating results. Barriers to evidence-based nursing include lack of skills/time and organizational constraints, while supports include leadership, resources, and mentors.
evidence based practice that hlps in you reasarch and ease you in reaseach practice. in this presentation many things are given which you learn n your research article.
evidence based practice is best for the people working with patients
ebp should be used by the heath care provider.
ebp based upon clinical experties
best research evidence
patient preference and values
This document provides an overview of evidence-based periodontics. It discusses the need for evidence-based decision making to reduce variations in clinical practice. The advantages of an evidence-based approach are that it is objective, scientifically sound, patient-focused, and incorporates clinical expertise. The process of evidence-based decision making involves framing questions, searching for and appraising evidence from various sources and levels, evaluating outcomes, and implementing decisions. Key aspects include assessing evidence critically and avoiding changes to pre-established hypotheses.
This document discusses evidence-based practice in emergency medical services (EMS). It begins with background on EMS developing globally with variations in practice and the need for standardization. It discusses how EMS personnel should base practice on protocols informed by the best available evidence. The document then covers knowledge translation from research to practice and evaluating different types of medical studies. It provides guidance on applying evidence-based practice in EMS through formulating focused clinical questions, acquiring and evaluating relevant evidence, applying results to patients, and assessing impact on EMS protocols, guidelines, algorithms and practice.
The document discusses evidence-based practice (EBP), defining it as the integration of the best available research evidence, clinical expertise, and patient values. It outlines the key components of EBP as research evidence, clinical expertise, and patient values/circumstances. The five steps of EBP are also summarized: formulating a question, finding evidence, critically appraising evidence, applying evidence in practice, and evaluating outcomes. Barriers and advantages of adopting an EBP approach are briefly mentioned.
Evidence based dentistry, public health , Prosthodontics and EBD,
history of ebd steps, evidence based medicine,evidence based practise. steps in ebd. advantages ,disadvantages, limitations.
prosthodontic considerations.
1) The document provides a tutorial on how to form an answerable clinical question using the PICO (TT) model. It explains the components of a well-built clinical question and how to identify the type of clinical question and best study design.
2) Several clinical scenarios are presented and the reader is asked to formulate each scenario as a PICO question, identify the question type, and recommended study design.
3) The document concludes by emphasizing that developing a clear clinical question using PICO helps efficiently find the best evidence to answer the question. It also provides information on additional education available on evidence-based care topics.
This document discusses evidence-based periodontology and decision making. It defines evidence-based periodontology as applying evidence-based healthcare to periodontology by integrating the best available evidence with clinical practice. The document outlines the steps of evidence-based periodontology, including asking questions using the PICO format, searching for and appraising evidence from systematic reviews and clinical practice guidelines, and applying the evidence to clinical decisions. It also discusses tools for critically assessing evidence, such as considering different levels of evidence and ensuring temporality between causes and effects.
Introduction to Evidence Based Medicine (EBM)Elsayed Salih
This document provides an overview of evidence-based medicine (EBM), including its definition, importance, and process. It defines EBM as the conscientious use of the best available evidence in making decisions about patient care. The key steps in EBM are asking a clear clinical question using the PICO framework, acquiring evidence through a literature search, appraising the evidence for validity and applicability, and applying the evidence to the individual patient. Examples of question types and appropriate study designs are also discussed.
This document discusses evidence-based practice and provides examples of how it is implemented in nursing. It begins by defining evidence-based practice as integrating the best research evidence, clinical expertise, and patient values and preferences. It emphasizes using scientific evidence to inform decision-making and eliminate outdated practices. Several examples are then given of evidence-based practices in nursing related to infection control, oxygen use for COPD patients, measuring blood pressure in children, and intravenous catheter size. The document stresses the importance of following evidence-based protocols for patient health and safety.
This document provides an overview of evidence-based medicine (EBM). It defines EBM as integrating the best available research evidence with clinical expertise and patient values. It notes that the amount of medical evidence is increasing exponentially, making it difficult for physicians to keep up-to-date. The document outlines the 5 steps of EBM practice and emphasizes the importance of critically appraising evidence for validity, importance, and applicability to patients. It also discusses assessing the levels, strength, and quality of evidence to determine the strength of recommendations for clinical practice guidelines.
Critical appraisal.docx IMPORTAN TO HEALTH SCIENCE STUDENTSMulugetaAbeneh1
Critical appraisal is the process of systematically examining evidence to assess its validity, results, and relevance before using it to inform decisions. This document discusses tools for critically appraising different types of studies, including systematic reviews, guidelines, and primary studies. It provides examples of appraising systematic reviews using the AMSTAR tool and appraising randomized controlled trials using the JBI critical appraisal checklist. The document concludes that plastic wraps effectively prevent hypothermia in preterm and low birth weight infants compared to standard care, as shown in multiple systematic reviews and randomized trials.
Presentation1.pptx..this important document for health care workers specially...MulugetaAbeneh1
This document provides an overview of a critical appraisal assignment being conducted by four nursing students in Addis Ababa, Ethiopia. It includes an acknowledgement section thanking instructors for their support. The objective is to develop an understanding of critically appraising evidence using checklists. It introduces levels of evidence and describes how to assess the validity, reliability, and applicability of systematic reviews, randomized controlled trials, and other study designs. Rapid critical appraisal checklists are provided for systematic reviews/meta-analyses and randomized controlled trials to guide evaluation of the studies.
The document discusses evidence-based nursing practice. It defines evidence-based practice as integrating the best research evidence, clinical expertise, and patient values and needs. The key steps in evidence-based practice are asking questions, acquiring evidence, appraising the evidence, applying it to a patient, and evaluating outcomes. Barriers to evidence-based nursing include lack of time and resources, as well as difficulties interpreting and applying research. Facilitators include administrative support and accessible, clearly written research. Maximizing evidence-based nursing requires overcoming barriers, incorporating different types of evidence, and accounting for issues beyond measurement like patient preferences.
This document discusses translating research into nursing practice through evidence-based practice. It defines evidence and the EBP process. It describes different types of quantitative and qualitative research methods like randomized controlled trials, cohort studies, case-control studies, systematic reviews, and meta-analyses. It discusses how to find, appraise, and apply evidence to clinical questions. The importance of validity, reliability, and applicability are covered. Overall, the document provides an overview of research translation and evidence-based nursing.
This document outlines the objectives and agenda for a workshop on journal clubs and evidence-based medicine reviews. The workshop will teach participants how to present clinical evidence-based medicine summaries to peers, critically appraise clinical studies, and discuss how to integrate evidence-based findings into clinical practice. Participants will have opportunities to present on their own clinical scenarios and evidence searches.
This document discusses evidence-based practice (EBP) in physiotherapy. It provides several definitions of EBP which emphasize integrating the best research evidence with clinical expertise and patient values. The document notes that clinical practices become outdated if new evidence is not incorporated. It highlights the importance of EBP in improving patient care and outcomes. Examples of research on manual therapy for neck pain, shortwave diathermy for low back pain, and a survey of Malaysian physiotherapists' treatment preferences for low back pain are provided to illustrate EBP. The introduction to research section outlines the importance of clinical research and different types including experimental and non-experimental research.
. Evidence-based dentistry (EBD) is the integration and interpretation of the available current research evidence, combined with personal experience. It allows dentists, as well as academics researchers, to keep update of the new developments and to make decisions that should improve their clinical practice.
Ayat ruqyah syaikh abderraouf ben halimaArgitya Righo
Dokumen ini berisi ringkasan beberapa ayat Al-Quran yang dibacakan oleh Syaikh Abderraouf Ben Halima untuk keperluan ruqyah. Ayat-ayat tersebut diambil dari berbagai surah seperti Al-Baqarah, Ali-Imran, An-Nisa, dan lainnya. Tujuannya adalah membersihkan jin dan setan, menarik perhatian jin, dan mengambil senjata mereka. Dokumen ini diharapkan dapat bermanfaat bag
Filsafat ilmu membahas tiga aspek utama yaitu ontologi, epistemologi, dan aksiologi. Ontologi membahas hakikat ilmu seperti klasifikasi dan batasan ilmu. Epistemologi membahas sumber dan perkembangan pengetahuan ilmu. Aksiologi membahas penerapan ilmu dan dampaknya bagi manusia. Filsafat ilmu kedokteran membahas klasifikasi ilmu kedokteran, sumber dan perkembangan pengetahuan kedokteran
Dokumen tersebut membahas tentang etika penelitian kualitatif dan kuantitatif yang melibatkan manusia. Terdapat 3 prinsip utama etika penelitian yaitu respek terhadap orang, kebajikan, dan keadilan. Dokumen ini juga menjelaskan prosedur pengajuan surat kelayakan etik, prinsip-prinsip penelitian etis internasional, dan penerapan prinsip-prinsip etika penelitian dalam konteks penelitian ke
This systematic review analyzed 5 case-control studies to determine if bicycle helmets reduce head, brain, and facial injuries. The studies found that helmets provide a 63-88% reduction in the risk of head, brain, and severe brain injuries for bicyclists of all ages. Helmets also provide a 65-88% reduction in the risk of facial injuries. The review concludes that bicycle helmets effectively reduce injuries to the head and face for bicyclists involved in crashes or falls.
Dokumen tersebut memberikan panduan singkat tentang cara mencari jurnal ilmiah dan menulis karya tulis ilmiah (KTI) secara etis. Terdapat informasi mengenai sumber pencarian jurnal online seperti portalgaruda.org, doaj.org, dan database jurnal internasional seperti Proquest, Ebsco, dan JStor. Dokumen tersebut juga menjelaskan tips untuk menghindari plagiarisme dalam penulisan KTI seperti membuat catatan ringkas saat membaca referens
The document provides guidance on how to effectively read and understand a scientific article. It discusses conducting a structured reading by first skimming the abstract, introduction, and conclusion to get the overall context and main points. The document outlines the typical structure of a scientific article, including the abstract, introduction, methods, results, and discussion sections. It provides tips for distinguishing the key points in each section and generating questions to guide an active reading. Finally, the document reviews how to identify the claim, evidence, and analysis in paragraphs to fully comprehend the information presented.
The review identified 25 interventions reported in 24 studies that aimed to promote compassionate nursing care. Intervention types included staff training, new care models, and staff support. While most interventions reported improvements in outcomes, the methodological quality of included studies was low. Descriptions of interventions and their theoretical basis were often inadequate. The evidence was insufficient to recommend any intervention for routine implementation. Higher quality research is needed to identify effective approaches to strengthening compassion in nursing care.
Tantangan Pendidikan Berkelanjutan Bagi Perawat Di IndonesiaArgitya Righo
This document discusses challenges in sustainable nursing education in Indonesia. It identifies several issues including unmet standards for competent lecturers and faculty, different regional policies, and varying competency levels among nurses. It emphasizes the need to maintain competency through continuous education and training programs. It also outlines Indonesia's nursing policy goals of improving nursing education, training, placement, and the nursing profession. Finally, it discusses Indonesia's role in harmonizing higher education with the ASEAN community.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
2. Objectives
Define evidence-informed decision-making and describe
its importance to nursing practice
Identify the parts of a relevant, answerable question
Describe the different types of questions relevant to
nursing practice
Define the term critical appraisal and discuss its relevance
to nursing practice, policy and research
Identify criteria appraisal criteria for health care
intervention studies
Develop skill in applying the criteria for critical appraisal of
an intervention study to determine the quality and
applicability of the research.
3. What is evidence-informed decision-
making?
“The conscientious, explicit and judicious use of
the current best evidence in making decisions
about the care of individual patients”
(Sackett et al, 1996)
4. Health care
resources
Patient
preferences
and actions
Research
evidence
Clinical state, setting,
and circumstances
Clinical Expertise
Clinical Decision
A Model for Evidence-Based Clinical Decisions
[Haynes, R.B., Devereaux, P.J., & Guyatt, G.H. (2002). Clinical expertise in the era of evidence-based medicine and
patient choice. ACP J Club, 136, A11-14]
5. Why is evidence-based practice important?
• Demonstrate that nursing actions and decisions
are clinically appropriate and result in positive
outcomes for clients, their families and health care
system as a whole
• Demonstrate professional accountability to clients
• Provide evidence for the cost-effectiveness of
nursing care
6.
7. Steps to Evidence-Informed Decision-
Making:
1. Define: Formulate a focused answerable question from the
practice situation based on your information needs
2. Search: Efficiently search for research
3. Appraise: Critically and efficiently appraise the research sources
4. Synthesize: Interpret/form recommendations for practice based
on the literature
5. Apply: Apply the results to the client/population
6. Implement: Decide whether (and plan how) to implement the
adapted evidence into practice
7. Evaluate: Evaluate the effectiveness of implementation efforts
10. Bagaimanakah pencegahan terhadap kejadian
pressure ulcers dengan teknik “X” jika
dibandingkan dengan pelayanan standar yaitu
diganti posisi setiap 2 jam terhadap munculnya
gejala munculnya pressure ulcers pada pasien
yang dirawat diruang perawatan dalam jangka
panjang dimana pasien mempunyai resiko untuk
pressure ulcers?
KASUS-1 : MOHON
MASUKANNYA
11. Langkah ke-1 Pertanyaan Klinik dengan
PICO/PICOT Format
JENIS-JENIS PERTANYAAN KLINIS (Melnyk & Fineout-Overholt,
2011)
Intervention question
• Meneliti mengenai keefektivan dari
suatu treatment/intervensi
Diagnostic question
• Meneliti mengenai manfaat,
keakuratan, seleksi, atau interpretasi
dari suatu alat/instrumen
Prognostic question
• Meneliti mengenai keadaan pasien
terkait kondisi tertentu atau
mengidentifikasi faktor-faktor yang
mungkin mengubah prognosis pasien
Etiology question
• Meneliti mengenai hubungan sebab
akibat dan sesuatu yang mungkin
merugikan
Meaning question
• Meneliti mengenai makna dari
sesuatu hal
12. Formulate a Focused Answerable Question
• P opulation / Situation
• I ntervention / Exposure
• C omparison /Counter intervention
• O utcome
• T imeframe
13. Population/Situation:
• Client group or clinical scenario of interest
• Single patient or group of patients with a
particular condition or health care problem,
e.g.,:
• A person with a health condition
• People with hypertension (a group of people with a
particular condition
• Primary health care for the elderly (an aspect of health
care delivery)
14. Intervention/Exposure:
• Interventions can be:
• Therapeutic
• Preventive
• Diagnostic
• Organizational
• If exploring the meaning of a phenomena, the
question may involve a situation rather than an
intervention
15. Comparison / Counter Intervention:
• Clinical decisions involve choosing between
alternative courses of action (or no action)
16. Outcome:
• What is the outcome, or the effect we are hoping
to achieve by the using the intervention?
• May be more than one outcome that is important
to the question
17. Time Frame:
• What is the period of time over which the question
occurs?
• What is the optimal time to measure a change in
the outcome(s)?
18. Prognostic
Apakah diet karbohidrat mampu memprediksi pemeliharaan berat badan yang
sehat (BMI< 25) selama lebih dari 6 bulan pada pasien yang mempunyai
riwayat keluarga obesitas (BMI> 30)?
Diagnostic
Apakah d-dimer assay lebih akurat dalam mendiagnosa deep vein thrombosis
jika dibandingkan dengan ultrasound pada pasien suspected deep vein
thrombosis?
Etiology
Apakah wanita kulit putih yang terpapar sinar UV ray berkepanjangan dan
tidak menggunakan protection (>1 jam) meningkatkan resiko terkena
melanoma jika dibandingkan wanita kulit hitam yang tidak terpapar UV ray?
Meaning
Bagaimanakah wanita paruh baya dengan fibromialgia mempersepsikan
kehilanggan motor functions?
TENTUKAN DESIGN PENELITIANNYA
19. Step 1:Formulate a focused answerable question
• Formulating Answerable Clinical Questions (Centre for Evidence-
Based Medicine, Mount Sinai Hospital)
• The Well-Built Clinical Question (Duke University Medical Center
Library and Health Sciences Library, UNC-Chapel Hill)
• Formulating Patient Centered Questions (University Library,
University of Illinois at Chicago)
• Asking Focused Questions (Centre for Evidence-Based Medicine,
Oxford)
20. Types of questions relevant to nursing
practice
• Therapy/Health care interventions: What is the effectiveness of different interventions?
• Causation and harm: What might be causing disease/ill health/adverse effects?
• Diagnosis or assessment: Does a diagnostic test differentiate between people with and
without a condition?
• Prognosis: What are potential future outcomes of a condition?
• Economic evaluation: What is the cost-effectiveness of different interventions?
• Meaning: Describing, exploring and explaining aspects of health and illness.
21. Nursing Graduate Seminar
200921
Different clinical questions require evidence from
different research designs
Type of Question Suggested Best Type of Study Design
Therapy/Health care
intervention
RCT>cohort>case control>case series
Diagnosis Prospective, blind comparison to a gold standard
Prognosis Cohort study>case control>case series
Harm (Causation or
etiology)
RCT>cohort>case control>case series
Economic evaluation Economic analysis
Meaning of illness Qualitative
22. Qualitative Survey
(cross sectional)
(Randomised)
crossover
(Randomised)
Parallel group
Cohort study
Cross-sectional
(analytic)
Case-control study
Q1
Q3
Q2
All studies
Experimental
Analytic
(PICO or PECO)
Descriptive
(PO)
Theoretical
(PS)
Observational
analytic
What type of research design will you use?
[Glasziou, P., & Heneghan, C. (2009). A spotter’s guide to study designs. EBN Notebook, 12, 71-72]
23. Kata kunci untuk mencari bukti-bukti = kata-kata yang ada
dalam PICO/PICOT
Cari kata-kata lain yang mempunyai makna sama seperti
kata-kata yang ada di PICO/PICOT
Setiap jenis pertanyaan mempunyai hierarchy of evidence
yang berbeda
• Database:
• Pubmed
• CINAHL
• Ovid-medline
• National Guideline Clearing house
• Chochrane Databases
Langkah ke-2 Mencari dan Mengumpulkan
Bukti-bukti
26. Step 2: Collect the best evidence:
Hierarchy of Pre-Processed Evidence
[Adapted from Haynes, R.B. (2007). Of studies, summaries, synopses, and systems: The “5S”
evolution of information services for evidence-based healthcare decisions. Evidence-Based Nursing,
10, 6-7]
EXAMPLES:
SYSTEMS:
Computerized decision support
SUMMARIES::
Evidence-Based Guidelines
~ Evidence-Based Texts
SYNOPSES OF SYNTHESES:
DARE ~ Evidence-Based
Abstract Journals
SYNTHESES (Systematic
Reviews): Cochrane Database
of Systematic Reviews
SYNOPSES OF SINGLE
STUDIES:
Evidence-Based Abstract
Journals
SINGLE STUDIES:
Clinical Queries
27. Step 3: Critically appraise the literature for
validity and applicability
What is critical appraisal?
• Critical appraisal is the process of assessing and
interpreting evidence by systematically considering its
validity, results and relevance to an individual's work.
28. Langkah ke-3 Melakukan Critical Appraisal
Terhadap Bukti-bukti
Critical Appraisal menyesuaikan dari jenis/level artikel
Pertanyaan utama dalam Critical Appraisal adalah
• Apakah hasil dari penelitian tersebut valid?
• Apakah penelitian tersebut menggunakan metodologi penelitian
yang baik?
• Apakah hasil dari penelitian tersebut reliable?
• Apakah intervensinya bekerja dengan baik?
• Sebesar apa efek dari intervensi tersebut?
• Apakah hasil penelitian tersebut akan membantu dalam
melakukan perawatan untuk pasien saya?
• Apakah sample penelitiannya mirip dengan pasien saya?
• Apakah keuntungannya lebih besar dari pada resikonya?
• Apakah intervensi tersebut mudah untuk di implementasikan
29. Relevance of Critical Appraisal to Nursing
Practice, Policy and Research
• Use the literature more effectively in answering clinical
questions to guide clinical practice
• Distinguish stronger evidence from weaker evidence –
identify high quality research
• Identify the methodological strengths and limitations,
results and relevance of the studies in answering a
clinical question
30. Three Steps in Using an Article from the
Health Care Literature
1. Are the results valid?
2. What are the results?
3. Are the results applicable (and useful) to
my client care population?
[DiCenso, A., Guyatt, G., & Ciliska, D. (2005). Evidence-
based nursing: A guide to clinical practice]
31. Are the results valid?
• Are the study methods sufficiently rigorous to
ensure that the study results represent an
unbiased estimate of the true effect?
OR
• Are the study methods sufficiently biased to
lead to a false conclusion?
32. Are the results valid?
• Final assessment of validity is never a yes/no
decision
• Validity as a continuum ranging from strong
studies to weak studies
• Evaluation of the validity of a study involves some
subjectivity
33. What are the results?
• Size and precision of the estimate of effect
34. Are the results applicable (and useful) to
my client care population?
• Can you apply the results to patients in your
clinical setting?
• Were all important outcomes considered?
• Are the likely intervention benefits worth the
potential harm and costs?
35. Applying appropriate criteria
• User Guides to Evidence-Based Practice
• 1993-2000: Evidence based medicine working group: “User guides
to the Medical Literature” in JAMA
• 2002: Guyatt et al. “User guides to the medical literature: A manual
for evidence based clinical practice”
• 2005: DiCenso, Guyatt, & Ciliska. “Evidence-based nursing: A
guide to clinical practice”
36. Applying appropriate criteria
• Critical Appraisal Forms:
• Critical Appraisal of Articles on CAUSATION
• Critical Appraisal of Articles on THERAPY/INTERVENTIONS
• Critical Appraisal of SYSTEMATIC REVIEWS
• Critical Appraisal of Articles on PREVALENCE AND INCIDENCE
• Critical Appraisal of QUALITATIVE RESEARCH
• Critical Appraisal of Articles on PROGNOSIS
http://www.cche.net/usersguides/prognosis.asp
• Critical Appraisal of GUIDELINES [AGREE: Appraisal of Guidelines
Research and Evaluation Instrument]
http://www.agreecollaboration.org/pdf/agreeinstrumentfinal.pdf
38. Example: The Effectiveness of a Nurse-Led
Interprofessional Team Approach to Fall Prevention
in Older Home Care Clients at Risk of Falling
Markle-Reid, M., Browne, G., Gafni, A., Roberts, J., Weir, R., Thabane, L., Miles, M., Vaitonis, V.,
Hecimovich, C., Baxter, P., & Henderson, S. (2010). The effects and costs of a multifactorial and
interdisciplinary team approach to fall prevention for older home care clients “at risk” for falling: A
randomized controlled trial. Canadian Journal on Aging, 29(1), 139-161
39. Critical Appraisal Criteria for Health
Care Intervention Studies
Screening Questions:
1. Did the study ask a clearly focused question?
Consider if the question is ‘focused’ in terms of:
• The population studied
• The intervention given
• The outcomes considered
40. Research Question:
• `What is the effectiveness of a 6-month nurse-led interprofessional
team approach to fall prevention compared with usual home care
services in older home care clients “at risk” of falling with respect to
the number of falls and fall risk factors (slip or trip, health-related
quality of life and function, depressive symptoms, nutritional status,
gait and balance, cognitive function, fear of falling)?
• P Frail older adults using home care services at risk for falling
• I Nurse-led interprofessional team approach to fall prevention
• C Usual home care services
• O Number of falls, slip or trip, health-related quality of life
and function, depressive symptoms, nutritional status, gait and
balance, cognitive function, fear of falling
• T 6 months
41. Critical Appraisal Criteria for
Health Care Intervention
Studies
Screening Questions:
2. Was this a randomized controlled trial (RCT) and was it
appropriately so?
Consider:
Why this study was carried out as an RCT
If this was the right research approach for the question being
asked
43. Critical Appraisal Criteria for
Health Care Intervention
Studies
3.How were participants allocated to intervention and control
groups?
Consider:
How participants were allocated to intervention and control
groups. Was the process truly random?
Whether the method of allocation was described
How the randomization schedule was generated
Were the groups comparable at baseline on characteristics
that might explain the outcome?
45. Strengths
• Random allocation of participants to groups
ensures that groups are similar in all respects
except exposure to the outcome;
• Prospective design ensures that exposure to
the intervention precedes the development of
the outcome;
• Greater likelihood that participants, health
care providers, and outcome assessors can
be blinded.
46. Limitations
• May not be ethical or feasible;
• Volunteer bias limits generalizability;
• Problems associated with a longitudinal design:
• Time
• Expense
• Dropouts
• Final results may not be available for several
years.
47. Critical Appraisal Criteria for
Health Care Intervention
Studies
4. Were participants, staff and study personnel
‘blind’ to participants’ study group?
Consider:
• The fact that blinding is not always possible
• If every effort was made to achieve blinding
• If you think this matters to the study
• The fact that we are looking for ‘observer bias’
48. Critical Appraisal Criteria for
Health Care Intervention
Studies
5. Was follow-up complete?
Consider:
• If any intervention-group participants got a control group
option or vice versa
• If all participants were followed up in each study group
• Was there loss to follow-up bias?
• If all of the participants’ outcomes were analysed by the
groups to which they were originally allocated (intention to
treat analysis)
49. Study Flow
R
Eligible Clients
n=267
Informed consent from 40.8% of
eligible applicants
n=109
Refused 141
Unable to Contact 13
Language 4
158
Group 1
n=54
Group 2
n=55
n=5 (9.3%)
n=49 (90.7%)
Interprofessional Falls
Prevention Team
Usual Home Care
Services
n=12 (21.8%)
n=43 (78.2%)
Group Size
Interventions
Dropouts @ 6 month follow-
up: 17 clients (15.6%)
Analyzed @ 6 month follow-
up: 92 clients (84.4%)
50. Critical Appraisal Criteria for
Health Care Intervention
Studies
6. Were participants in both groups followed up and
data collected in the same way?
Consider:
• Was data collected in the same way and at the
same time interval for both groups?
51. Data Collection
• Multiple sources of data:
• In-person interviews
• Data from service provider agencies
• Measurement of Clinical Outcomes: Baseline and
6-months
52. Outcomes
Effects:
Frequency and Context of Falls (Falls Surveillance Report)
Functional Health Status and Quality of Life (SF-36 Health Survey)
Cognitive Status (SMMSE)
Depressive Symptoms (CES-D)
Gait and Balance (POMA)
Nutritional Status (SCREEN II)
Environmental Safety (HOME FAST)
Perceived Self-Efficacy (MFES)
Costs: Health Services Utilization (HSSU and CCAC Utilization Data)
53. Critical Appraisal Criteria for
Health Care Intervention
Studies
7. How are the results presented and what is the main result?
Consider:
• What are the results?
• How large this size of result and how meaningful it is
• How you would sum up the bottom-line result of the trial in
a few sentences
54. Results
• At 6 months, there was no difference in the mean
number of falls between groups;
• Subgroup analyses showed that the intervention was
effective in reducing falls in men, 75-84 years of age,
with a fear of falling, or a negative history of falls;
• Greater reduction in number of slips and trips in the
intervention group;
• Greater improvement in role functioning related to
emotional health in the intervention group;
• No additional cost from a societal perspective, e.g. both
interventions cost the same.
55. Critical Appraisal Criteria for
Health Care Intervention
Studies
8. How precise are these results?
Consider:
• If the result is precise enough to make a decision
• If a confidence interval were reported. Would
your decision about whether or not to use this
intervention be the same at the upper confidence
limit as at the lower confidence limit?
56. Critical Appraisal Criteria for
Health Care Intervention
Studies
9. Were all important outcomes considered so the results
can be applied?
Consider whether:
• How the participants could be different from your
population in ways that would produce different results
• Your local setting differs from that of the trial
• Is the intervention feasible in your setting?
Consider outcomes from the point of view of the:
• Individual
• Policy maker and professional
• Family caregivers
• Wider community
57. Critical Appraisal Criteria for
Health Care Intervention
Studies
9. Were all important outcomes considered so the results
can be applied?
Consider whether:
• Any benefit reported outweighs any harm and/or cost
• Policy or practice should change as a result of the
results of this trial
58. Methodological Strengths
• Study design: randomized controlled trial
• Follow-up period was appropriate
• Follow-up was complete (<20% loss to
follow-up)
• Groups comparable at baseline
59. Methodological Limitations
• Small sample size
• Volunteer bias
• Potential for recall bias related to reporting falls
• Strategies for collecting data regarding the number of
falls
60. Other Resources
• Evidence-Informed Decision-Making Resource Modules posted on Avenue to Learn
• Bandolier Evidence-Based Health Care http://www.medicine.ox.ac.uk/bandolier/
• Tutorials:
• Introduction to Evidence-Based Medicine (Duke University Medical Center Library)
http://www.hsl.unc.edu/services/tutorials/ebm/index.htm
• Directories:
• Evidence Based Medicine (EBM) Tookit (New York University School of Medicine. The
Frederick L. Ehrman Medical Library):
• www.urmc.rochester.edu/hslt/miner/digital_library/evidence_based_resources.cfm
• Resource Guide for Evidence-Based Practice (University of Alberta Libraries)
http://www.library.ualberta.ca/subject/evidence/guide/index.cfm
• McKibbon, A. (1999). PDQ: Evidence-based principles and practice. Hamilton, Ontario: B.C.
Decker Inc.
• Evidence Based Practice Tips http://www.ebmtips.net/risk001.asp