Institute of health science

School of nursing and midwifery

Department of PCHN and Adult health nursing
1. Yomif Desisa
2. Lalesa Tadesse wu/1500325
3. Mitiku Teka wu/1500421
4. Almaz saketa
5. Garoma Tegegn
Outlines
Critical appraisal

Introduction

Summary

Evaluation of the articles

 Explanation of cohort studies critical appraisal

Conclusion

Reference
Objectives
At the ends of presentation the audience will able
to understand
How to criticize and evaluate article of the
researcher
Introduction to Critical appraisal

An article critics is a detail analysis of an article or piece of

writing

This paper will critically examine the article by Habtamu et al.

(2005-2006), “Impact of perinatal and repeated CMD on
educational outcomes of primary school children in rural
Ethiopia: population-based cohort study.

Critical appraisal skill program (CASP),2014 and Readers

guide to critical appraisal of cohort studies by Mamdani et al.
(2015) will be applied in critiquing this article.
Article critique(cohort study)

Introduction
Concepts of article were clearly stated, consistent with
the title, related literature reviewed.

The researcher briefly introduced the topic

But, did not conclusively describe the concepts behind

the study & little information was provided to give the
study credibly.
Cont…

 The purpose of the study were stated concisely

The researcher didn’t clearly state the

hypothesis/justification of the study.

The rationale of the study is also not provided thus the

reader was not understand why the study was important.
summary
The author summarize the content in the paper and
deliver the relevant elements of the article.

The summary of article gives brief overview of the study

Components are:

– Background

– Methods

– Results and Conclusions are included

– Keywords are mentioned.

Evaluation of the articles
Article provide an important information but has
own limitation like did not provide the theoretical
frame work

Study deign was mentioned that is Population based

cohort study but type of cohort study were not
clearly identified.
Evaluation…..

An author uses the data to determine a cause &

effect relation but he didn’t mention un exposed
group & exposed group

power analysis was not clearly stated to estimate

the population size.
1. Similarity and recruitment of population

In this article the two group were similar and recruited from the
same population because the study was done on rural primary
school but , the author didn’t explain the reason why he exclude
1st and 2nd trimester pregnant women.

-He also include only those speak Amharic.

2. Exposure measurement

The authors used WHO 20 item version of SRQ in pregnant

and at all nine post natal time until the child was 8 and half year
to measure exposure in similar for both (exposure & non
exposure).
Cont…

Repeated high maternal mental disorder score were generated

when the women scored >=6, but to be clear for reviewer, it is
better if it has operational definition of this score.

3. Validity and reliability of the exposure measurement

The researcher measure the exposure with WHO 20 item

version of SRQ which has acceptance & valid to identify
exposure (CMD) at the beginning of follow up.

And also the authors uses repetitive measurement to confirm

reliability.
4. Confounding factors identification

Article explained all necessary confounding factors

which deviate the results;

-stressful life events

-socio-economic status

-paternal substance use

-Demographic characteristics

-Child nutritional status

5. strategies to deal with confounding factors

 The researcher carried out two stage of multivariable analysis.

 In the 1st model (Logistic regression) each primary exposure

adjusted for all potential confounder identified & finally ran a
model containing AN, PN & repeated CMD score & then all
potential confounder at the 60 months time points in the same
model.

6. participants free of the outcome at the start of the study

 By default, the study participants were outcome free (educational

outcome of primary school) at the beginning of the study but the
authors did not mentioned in this article.
7. Validity and reliability of the outcome measurement

 The researcher try to measure the outcome of the study but he didn’t

mentioned from where he used standard of measurement(outcome

were measured in relation to academic year rather than birth date) to

make clear about validity & reliability of measurements.

8. Follow up time reporting and time sufficient

 The author reports follow up time which is sufficient study period

for this title compared to similar research conducted on prenatal

mental disorder & post infancy child development in rural Ethiopia.

9. Completeness of follow up and reason of loss of follow up

Almost around 80% followed up until the end of the study.

This is calculated from total of recruited individual (1065) &

the number of drop out by different reason (216) = 20%
Which is insignificant

The reason of loss to follow up was raised;

Still birth

NN death

PN infant mortality

 out-migration

 mothers and children died

10. strategies to address incomplete follow up

The researcher address incomplete follow up due to different problem

raised in question number nine & adjusted to allow for different
length of follow up.

11. statistical analysis used

An appropriate Statistical analysis method were used

 Measure of association= RR & OR

 Statistical analysis= Logistic Regression

Conclusion
In general an article provide necessary and useful
knowledge which is basic for writing article
critique.

Its better if researcher compare his finding with the

same tittle previously conducted at somewhere to
make the reader more clear.
Reference

• Mekonnen, H., Medhin, G., Tomlinson, M., Alem, A.,

Prince, M., & Hanlon, C. (2019). Impact of perinatal and
repeated maternal common mental disorders on educational
outcomes of primary school children in rural Ethiopia:
population-based cohort study. BJPsych Open, 5(6), e87.
doi:10.1192/bjo.2019.69
Thank you!!