CRITICAL APPRAISAL

Joko Mulyanto
Department of Public Health & Community Medicine
Faculty of Medicine, Universitas Jenderal Soedirman
Learning objective
• Explain the critical appraisal technique
• Apply the critical appraisal technique in general
• Specifically apply STROBE and CONSORT checklist to critically appraise
journal article
What is critical appraisal?
• Critical appraisal is the process of carefully and systematically
examining research to judge its trustworthiness, and its value and
relevance in a particular context
• Use specific methods/technique with certain procedure
• Strength and weakness
• Internal validity
• External validity
Purpose of critical appraisal
• Eliminating irrelevant/weak studies
• Identify relevant papers
• Distinguish evidence from opinion and assumption
• Assess the validity of the study
• Assess the applicability of the study
• Recognize any potential bias
Initial approach
Scientifically interesting & important aim
• Interesting: raise particular concern
• Important: added value, novelty
Clinically significant
• Beyond statistical significant
• Differences in the real practice that may useful in clinical setting
Well-designed methodology
• Appropriate study design
• Adequate sample size
• Proper sampling methods
• Valid and reliable measurement
• Correct statistical analysis
Evaluation of primary outcome
• Valid measurement
• Instruments
• Procedure
• Data collector
Sample size
• Sample size estimation
• Loss to follow up, attrition, non response
• Missing value analysis
Validity threat
• Chance
• Bias
• Confounding
Detail assessment
• Introduction
• Methods
• Results
• Discussion and conclusion
Critical appraisal tools
• CASP: Critical Appraisal Skill program
• Joana Briggs Institute
• EQUATOR Network
STROBE
The Strengthening the Reporting of Observational Studies in
Epidemiology (STROBE) Statement
CONSORT
Concluding remarks
• Critical appraisal is a method to asses the validity of scientific article
• Provide the most useful scientific evidence for our purpose
• Using critical appraisal tools
• Each study design has particular tools
• Depend on user experience, practice make perfect
THANK YOU
joko.mulyanto@unsoed.ac.id