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REVIEW
http://www.nature.com/clinicalpractice/gasthep
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How to critically appraise an article
Jane M Young* and Michael J Solomon
SUMMARY
Critical appraisal is a systematic process used to identify the strengthsand weaknesses of a research article in order to assess the usefulness and validity of research findings. The most important components of a critical appraisal are an evaluation of the appropriateness of the study design for the research question and a careful assessment of the key methodological features of this design. Other factors that also should be considered include the suitability of the statistical methods used and their subsequent interpretation, potential conflicts of interest and the relevance of the research to ones own practice. This Review presents a 10-step guide to critical appraisal that aims to assist clinicians to identify the most relevant high-quality studies available to guide their clinical practice.
KEYWORDS bias, conflict of interest, critical appraisal, study design
REVIEW CRITERIAMEDLINE and Google Scholar were searched in October 2008 for English language articles published between 1996 and 2008. The keywords critical appraisal were combined with the following keywords skills, medical literature, research, randomized trial, cohort, cross-sectional, case series, diagnostic test, systematic review, meta-analysis, economic, validity, bias, generalizability. Additional searches were conducting using the terms methodological quality, conflict of interest and responsible conduct. Relevant review articles and original articles were retrieved and their reference lists searched for additional articles. Critical-appraisal tools and checklists were accessed from the web pages of organizations identified in the search. Textbooks on clinical epidemiology were referred to for definitions.
INTRODUCTIONTo practice evidence-based medicine, clinicians need to apply the findings of scientific research to the circumstances of individual patients as part of their clinical decision-making process. Clinicians, therefore, must be able to select and appraise scientific literature that is relevant to their field, understand the implications of research findings for individual patients, elicit patients own preferences and develop an appropriate management plan based on the combination of this information. Each of these tasks presents its own challenges, but the sheer volume of medical literature means that the first step (that of selecting and appraising scientific evidence) can be daunting. The number of new medical research articles published each year continually increases, and more than 12,000 new articles, including papers on in...