A primer on critically appraising health literature

1. Critical appraisal of health
literature – an overview Dr. S. A. Rizwan, M.D.
Public Health Specialist
SBCM, Joint Program – Riyadh
Ministry of Health, Kingdom of Saudi Arabia

2. Learning objectives
Critical appraisal of health literature SBCM, Joint Program – Riyadh
• Describe the process of critical appraisal
• Describe the importance of critical appraisal
• Differentiate between pre-appraised and
unapprised literature
• Understand the role of critical appraisal in
health research consumption
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3. What this course contains?
Critical appraisal of health literature SBCM, Joint Program – Riyadh
• Appraisal of the methodology
• Observational studies
• Descriptive
• Analytical
• Experimental studies
• Diagnostic studies
• Prognostic studies
• Systematic reviews and meta-analysis
• Appraisal of results
• Overview, diseases frequency, association
• Bias, chance, confounding
• Statistics, validity, reliability, accuracy
• Appraisal other aspects of an article
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4. Introduction
Critical appraisal of health literature SBCM, Joint Program – Riyadh
• What is critical appraisal?
• Being able to look at a piece of research
in a very objective and structured way in
order to decide how valid it is compared
to other research
• Skills to help you interpret research and
make decisions about the quality of an
information source
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5. Why is it important?
Critical appraisal of health literature SBCM, Joint Program – Riyadh
• Review of more than 4200 published medical reports
in 30 journals showed that only 20% met the validity
criteria
• Much of Critical Appraisal is common sense!
• If we are going to buy a car - do you just read the
brochure from the car manufacturer?
• If practised properly, CA enables you to exclude
research studies that are too poorly designed to
inform practice
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6. Why is it important?
Critical appraisal of health literature SBCM, Joint Program – Riyadh 6
A Comprehensive Survey of Retracted Articles from the Scholarly Literature, Michael L. Grieneisen, Minghua Zhang

7. Practical utility of CA
Critical appraisal of health literature SBCM, Joint Program – Riyadh
• Imagine you have read in the newspaper about
this amazing new program which has a 95%
success rate in helping participants to give up
smoking. It involves a mixture of behaviour
modification, support and a wonderful new drug
and you wonder whether you should introduce it
into your area.
• You do a quick literature search and find an article
that describes the research.
• What questions might you ask about this paper?
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8. Common sense questions in CA
Critical appraisal of health literature SBCM, Joint Program – Riyadh
1. Who wrote the paper?
2. Did they come from a reputable research
organisation? (university, NGO, govt. agency)
3. Who funded the research? (e.g., was it the drug
company that developed the wonderful new drug?)
4. How many people were involved in the research?
5. What country did they come from?
6. Has there been any other research in this area?
7. Is one study enough for you to commit resources?
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9. Linking with EBM
Critical appraisal of health literature SBCM, Joint Program – Riyadh
• Appraising the paper for the things discussed above, tells
us whether the research is useful and appropriate for the
purposes we are looking at it for
• If however, we want to use the paper as “evidence” - we
need to be able to assess the validity of the research
which has been done
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10. Pre-appraised literature
Critical appraisal of health literature SBCM, Joint Program – Riyadh
• In some areas, the critical appraisal has already
been done for us
• For e.g., Systematic reviews, The Cochrane
Collaboration, EBM journals, guidelines from
societies, clinical decision support systems,
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11. Unapprised literature
Critical appraisal of health literature SBCM, Joint Program – Riyadh
• There’s a lot of unapprised literature in public
health
• It is up to the consumer of such research to
critically appraise each studies before applying
those results to specific situations
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12. Take home messages
Critical appraisal of health literature SBCM, Joint Program – Riyadh
• Critical appraisal is a skill that improves with
practice
• It is a corner stone of evidence based
medicine/practice
• All public health professionals must acquire
basic proficiency in this skill
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13. Thank you!
Email your queries to sarizwan1986@outlook.com