Critical Appraisal of Research

A Resource Toolkit

What is Critical Appraisal?

Critical appraisal is an essential step within the five steps of Evidence-Based Medicine:

Developing an answerable research question.
Identifying the best evidence with which to answer that question.
Critically appraising the evidence for validity.
Integrating the critical appraisal with clinical expertise.
Evaluating effectiveness and efficiency in executing steps 1-4.

One must carefully and critically evaluate the research of others to judge its trustworthiness, value, and relevance.

(Sackett, David L. Evidence-Based Medicine: How to Practice and Teach EBM. Edinburgh: Churchill Livingstone, 2003.)

For more information on Critical Appraisal, see:

Why is Critical Appraisal Important?

In an age of information overload, it is essential that healthcare professionals can judge the quality of an article or study and decide whether to incorporate it into practice.

Critical Appraisal Checklists and Toolkits

Though there are many existing critical appraisal tools, these are a few of my favorites.

Center for Evidence-Based Management Critically Appraised Topic (CAT) - available online and as an app, this tool takes the user through a prompt of questions to evaluate cause and effect and methodological appropriateness
Centre for Evidence-Based Medicine Critical Appraisal Worksheets - a series of worksheets in multiple languages focused on the evaluation of systematic reviews, diagnosis and prognosis, and randomized controlled trials
Critical Appraisal Skills Programme - a series of checklists designed to help the user evaluate everything from RCTs and systematic reviews to qualitative research
Dartmouth Biomedical Library Evidence-Based Medicine Worksheets - use the critical appraisal worksheets to appraise clinical trials, practice guidelines, qualitative research, and more
GRADE - the GRADE Working Group makes recommendations on the Grading of Recommendations, Assessment, Development, and Evaluation for researchers involved in guidelines or systematic reviews
Joanna Briggs Institute Critical Appraisal Tools - a series of checklists with questions used to evaluate all types of clinical research
Johns Hopkins Nursing Evidence-Based Practice Research Evidence Appraisal Tool - part of a larger evidence-based practice model, this worksheet asks a number of questions that will allow the user to grade the evidence
Understanding Health Research - this online questionnaire helps users understand the basic principles of clinical research

Evidence-Based Medicine Pyramid

You are responsible for judging the quality of the evidence that you find. Though research quality can generally be organized into an evidence pyramid like the one below, not all research is good research. You will need to ask the right questions to guide your decision making.