Critical appraisal in clinical practice: sometimes irrelevant, occasionally invalid

J R Soc Med. 2001 Nov;94(11):573-7. doi: 10.1177/014107680109401105.

Abstract

A core activity of evidence-based practice is the search for and appraisal of evidence on specific clinical issues. Clinicians vary in their competence in this process; we therefore developed a 16-item checklist for quality of content (relevance and validity) and presentation (useability, attribution, currency and contact details). This was applied to a set of 55 consecutive appraisals conducted by clinicians and posted at a web-based medical journal club site. Questions were well formulated in 51/55 (92%) of the appraisals. However, 22% of appraisals missed the most relevant articles to answer the clinical question. Validity of articles was well appraised, with methodological information and data accurately extracted in 84% and accurate conversion to clinically meaningful summary statistics in 87%. The appraisals were presented in a useable way with appropriate and clear bottom-lines stated in 95%. The weakest link in production of good-quality critical appraisals was identification of relevant articles. This should be a focus for evidence-based medicine and critical appraisal skills.

Publication types

  • Evaluation Study

MeSH terms

  • Evidence-Based Medicine / standards*
  • Humans
  • Information Storage and Retrieval / standards*
  • Internet / standards*
  • Professional Competence
  • Quality Assurance, Health Care*
  • Reproducibility of Results