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NSG 325 - Psychosocial Nursing

A course guide to support NSG 325 - Psychosocial Nursing

Importance of Appraisal

Once you figure out what to look for and where, you'll still have to worry about the quality of the material you find. A poorly done systematic review is not better than a well done randomized controlled trial. On this page, you will find resources to help you with appraising the material you find.

Evidence

Critical appraisal is a systematic process of analyzing research to assess methods, validity and usefulness. 



The key questions in critical appraisal are:

Why was the study done?

  • A clearly focused question should address population, intervention and outcomes.

What type of study was done?

  • The study design must match the question asked. Intervention questions are best answered with randomized controlled trials.

What are the study characteristics?

  • Use the PICO question format to help you answer the question. 

What was done to address bias?

  • Was the assignment of patients to treatments randomized?
  • Were patients, health workers and study personnel ‘blind’ to treatment allocation? 
  • Were all of the patients who entered the trial properly accounted for at its conclusion? Look for follow-up tables and whether patients were analyzed in the groups to which they were randomized. 
  • Were the groups similar at the start of the study?
  • Aside from the experimental intervention, were the groups treated equally?

What are the results and are the results valid?

  • Are the outcome measures relevant?
  • How large was the treatment effect?How precise was the estimate of the treatment effect?
  • Look for confidence limits and p values.

What conclusions can you make?

  • Are the results generalizable, that is, can the results be applied to my patients?  Were all clinically important outcomes considered? Are the benefits worth the harms and costs?
  • Are the results relevant to my situation? Patient population / similar definitions/protocols / health system similarities.

 

Adapted from: Voutier, C. (2013). Critical appraisal. Evidence Direct: A Service of the RMH Health Sciences Library. Retrieved 17 December 2015 from: http://library.mh.org.au/index.php?option=com_content&view=article&id=272&Itemid=537