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.

1. CRITICAL APPRAISAL OF
SCIENTIFIC ARTICLES-
OVERVIEW
- DR. SNEHA
- 2ND YR POST GRADUATE
- DEPT OF COMMUNITY MEDICINE
- KMC

2. AIM OF THIS SEMINAR?
• To know what is critical appraisal?
• Why to critically appraise ?
• How to critically appraise a published article?
• What are the different guidelines available to critically appraise
articles?

3. WHAT IS CRITICAL APPRAISAL?
• critical appraisal is a systematic process used to identify the strengths
and weaknesses of a research article in order to assess the usefulness
and validity of research findings.
• Involves both positive and negative criticism.

4. • The most important component is to evaluate the appropriateness of
the study design for the research question and careful assessment of
the key methodological features of this design.
• Also the statistical analysis , results and conflicts of interest are also
evaluated.
• Thereby critical appraisal will give a good quality evidence to practice
medicine.

5. WHY TO CRITICALLY APPRAISE ?
• To update our knowledge for clinical practice
• Forms the basis for evidence based medicine
• To keep updated regarding health care administration, diagnostics
and health policies.
• Before implementing any public health laws/ policies/ health
programs.

6. MISCONCEPTIONS REGARDING ARTICLES.

7. HOW TO CRITICALLY APPRAISE?
• Just follow the structure of a scientific article
 title
Abstract
Introduction
Materials and methods
Results
Discussion
Conclusion
Conflicts of interest

8. TITLE
• Is it informative, interesting ?
• Does it truly reflect the purpose of the study and findings of the
study?
• Not too long
• No abbreviations.
• Does it observe the four basic components (PICO)
• P=population / I= Intervention / C= control / O= outcome.

9. • Simple and clear research question
• PICO components present.
• Study design also mentioned.
• No abbreviations.

10. ABSTRACT ( trailer for your study)
• Should be an informative and balanced summary of what was done
and what was found.
• Provides key information that enables readers to understand a study
and decide whether to red the article .
• Components:
Background: mirror the end of introduction/ clear objectives
Methods
Results
conclusion

11. • In result section better to mention the p value or statistical results in
numerical form rather than statements.
• Abstracts should be structured.
• Should summarize the key details of the findings and only present
information that is provided.

12. • Structured abstract
• Objectives clearly
mentioned
• Numerical values
mentioned in results.

13. • Methodology section not clear
and incomplete
• The actual intent of the study
is not clear
• Vague and incomplete abstract

14. INTRODUCTION
• Should describe why the study was done ( explain the objective)
• Describe what questions and hypotheses it addresses.
• Should allow others to understand the study’s context.
• Overview of what is known and what gaps in current knowledge are
addressed by the study.

15. • Objectives are not clearly
explained: the importance of 3 day
treatment over 5 days Rx is not
mentioned
• Never do or repeat a study to
prove the earlier one.
• Rather do a study that will add
new information.

16. METHODOLOGY (blueprint of your study)
• Study design
• Setting
• Participants: inclusion/exclusion criteria
• Variables: exposure/ outcome/confounders/predictors, etc.
• Data sources/ measurement
• Bias: how it is addressed?
• Sample size

17. • Sampling
• Ethical consideration
• Statistical analysis

19. 1. Double blinding done to reduce bias
2. Study participants clearly mentioned
3. Setting is not proper: should mention either govt
or private hospital.
4. Sample size and sampling mentioned.
5. Randomization done to control confounders
6. Study variables clearly defined and mentioned.
7. Ethical clearance not mentioned.

20. RESULTS
• Factual account of what was found
• Should be free of interpretation and author’s view
• RCT: recruitment of study participants to be mentioned ( using flow
diagram)
• Descriptive statistics
• Appropriate statistical analysis:
Cohort: RR
 RCT: RR
Case control: OR

21. • The aims in the introduction should be addressed in the results.
• Maintain the logical sequence
• Check for the validity of the results
• Appropriate sample size for significant results

22. Before recruiting 2188 children ,
how many were approached and
how many didn’t give consent
should also be mentioned.

23. 1. Males are alone mentioned
2. Females are not mentioned
3. Values are not clear
4. Percentages are missing
5. Data is not complete

24. Table very neat and
clear

25. Usually Relative risk is
preferred in RCT over odds
ratio.

26. DISCUSSION AND CONCLUSION
• Compare with previous studies of related topics.
• If any discrepancies seen, explain why.
• Mention the strengths and limitations of the current study
• State whether the hypothesis was proved or rejected
• Should have a concluding paragraph that summarizes the study.
• Check whether the statistically significant result is actually clinically
significant or not
• Check if too much importance is given for variables that are
statistically significant.

27. CONFLICTS OF INTEREST
• Conflicts of interest occurs when some factors have the potential to
influence professional roles or responsibilities.
• Etc: receiving money from pharmaceutical companies for RCT
• Funding agencies should be stated

28. QUESTIONS TO BE ASKED WHILE CRITICALLY
APPRAISING
• Is the study question relevant?
• Does the study add anything new?
• What type of research question is being asked?
• Was the study design appropriate for the research question?
• Did the study methods address the most important potential sources of
bias?
• Was the study performed according to the original protocol?
• Does the study test a stated hypothesis?
• Were the statistical analyses performed correctly?
• Do the data justify the conclusions?
• Are there any conflicts of interest?

29. KEY POINTS
• Critical appraisal is a systematic process used to identify the strengths
and weaknesses of a research article
• Critical appraisal provides a basis for decisions on whether to use the
results of a study in clinical practice
• Different study designs are prone to various sources of systematic
bias
• Design-specific, critical appraisal checklists are useful tools to help
assess study quality.

30. DIFFERENT GUIDELINES
• RCT: CONSORT
• CASE REPORT: CARE
• OBSERVATIONAL STUDIES: STROBE
• SR AND MA: PRISMA
• DIAGNOSTIC ACCURACY: STARD