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Once you have located the evidence, the next step in the evidence-based practice process is critical appraisal. Critical appraisal is the process of examining a research article to determine its validity and applicability to your clinical question. Critical appraisal is important because is ensures that you have a holistic view of the research article - including any strengths, weaknesses, or biases. Having a comprehensive understanding of the research articles you are reviewing will make you better able to apply this information in your practice.
Be prepared - critical appraisal can be time intensive. It requires that you read the entire article, not just skim, so that you are able to properly evaluate it. The University of Warwick's Evidence-Based Medicine Tutorial suggests that you begin by asking yourself the following questions for each article:
1. Who wrote the article. Are they a reconized author? Are they affiliated to a recognized institution?
2. Why was the article written? What were the aims and objectives of the author?
3. Has the right research methodology been used?
4. Is it recent or seminal research?
5. Has it been published in a recognized or peer reviewed journal?
6. Do the results seem valid?
7. Does the statistical evidence seem valid?
8. Is there any obvious bias or conflict of interests?
9. Do the conclusions stack up?
There are ways to approach critical appraisal for each of the types of questions. The following links provide examples of the criticial appraisal process for each of the categories:
Diagnosis |
Therapy |
Prognosis |
Etiology |