Guidelines for the critical appraisal of a paper
- Who wrote the paper?
- Do they or the institution have a proven academic record?
- Is the paper interesting and relevant?
Introduction
- Did the study introduction address the relevant points?
- Was the study original?
- Were the aims clearly stated?
Methods
- Was an appropriate group of subjects studies?
- How were subjects recruited?
- What were the inclusion criteria?
- What were the exclusion criteria?
- Was the sample size justified?
- Was a power calculation performed?
- Was the study design appropriate?
- Review - systematic or meta-analysis
- Drug treatment - randomised controlled trail
- Prognosis - cohort study
- Causation - case - control study
- Were the study groups comparable?
- Demographics, baseline criteria etc
- Was the assignment of patients to treatments randomised?
- How was the randomisation performed
- Were the groups treated equally other than for the experimental intervention?
- Were the outcome measures stated and relevant?
- Were measurements valid and reliable?
- Were patients and healthcare workers 'blinded' to the treatment given?
- Were all patients entered into the study properly accounted for?
- Is there any missing data?
- Were side effects and adverse outcome documented?
- Was the duration and completeness of follow up appropriate?
Statistics
- Were the statistical methods described?
- Does the tests chosen reflect the type of date
- Parametric versus parametric tests
- Were analyses performed on an intention to treat basis?
- Was systematic bias avoided or minimized?
Results
- How large was the treatment effect?
- How precise was the estimate of the treatment effect?
Discussion
- Were the aims of the study fulfilled?
- Were the sources of error discussed?
- Are the relevant findings justified?
- Are the conclusions of the paper justified?
- Are likely treatment benefits worth the potential harm or costs?
- What is the impact of the paper?
- Can the results be generalised to other populations?
- What do you think of the paper?
Bibliography
Greenhalgh T. The Medline database. Br Med J 1997; 315: 180-183
Greenhalgh T. Getting your bearings (deciding what the paper is about). Br Med J
1997; 315: 243-246
Greenhalgh T. Assessing the methodological quality of published papers. Br Med J
1997; 315: 305-308
Greenhalgh T. Statistics for the non-statistician I: Different types of data need different
statistical tests: Br Med J 1997; 315: 364-366.
Greenhalgh T. Statistics for the non-statistician II: Significant relations and their pitfalls. Br
Med J; 1997: 315; 422-425
Greenhalgh T. Papers that report drug trials. Br Med J 1997; 315: 480-483
Greenhalgh T. Papers that report diagnostic or screening tests. Br Med J 1997;
315: 540-543.
Greenhalgh T. Papers that tell you what things cost (economic analysis). Br Med J
1997; 315: 596-599.
Greenhalgh T. Papers that summarize other papers (systematic reviews and meta-analyses). Br
Med J 1997; 315: 672-675.
Greenhalgh T. Papers that beyond numbers (qualitative research). Br Med J 1997;
315: 740-743.
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