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Critical Appraisal Tools

 

 

Appraising randomised controlled trials

 

Appraising non-randomised controlled trials

 

Appraising other forms of quantitative research

 

Appraising case studies

 

Appraising qualitative research

 

Appraising mixed methods research

 

Appraising systematic reviews

 

Appraising meta-analyses

 

Appraising clinical guidelines

 

Appraising outcome measures

 

Finding your own critical appraisal tools

 

Constructing your own critical appraisal tools

 

Assessing treatment choices

 

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1.     CATmaker (Centre for Evidence Based Medicine, Oxford)

CATmaker is a software tool which helps you create Critically Appraised Topics, or CATs, for the key articles you encounter about Therapy, Diagnosis, Prognosis, Aetiology/Harm and Systematic Reviews of Therapy.
It carries out the following functions:
prompts you for your clinical question, your search strategy and key information about the study you found;
provides on-line critical appraisal guides for assessing the validity and usefulness of the study;
automates the calculation of clinically useful measures (and their 95% confidence intervals);
helps you formulate clinical "Bottom Lines" from what you've read;
creates 1-page summaries (CATs) that are easy to store, print, retrieve, and share (as both text and HTML files);
helps you remember when to update each CAT you create;
helps you to teach others how to practice EBM; and
most importantly, looks groovy.
 

2.     CAT walk

This site provides an overview of critical appraisal process, including tools.

 

3.     Evaluation Tool for Quantitative Research Studies (School of Nursing, University of Salford)

The evaluation tool for quantitative studies contains six sub-sections: study evaluative overview; study, setting and sample; ethics; group comparability and outcome measurement; policy and practice implications; and other comments.

 

4.     Evaluation Tool for Qualitative Studies (School of Nursing, University of Salford)

The qualitative study tool was developed to reflect the uniqueness of the qualitative research paradigm, in particular, its concerns with meaning, context and depth. Particular emphasis lies on the areas of study context and the process of data collection and analysis. The tool has six sub-sections: study evaluative overview; phenomenon studied and context issues; ethics; data collection, analysis and researcher bias; policy and practice implications; and other comments.

 

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5.     Evaluation Tool for Mixed Method Studies (School of Nursing, University of Salford)

The evaluation tool for mixed studies allows appraisal of both the qualitative data collection and analysis component and the wider quantitative research design. It is applicable where the aim of the qualitative component is to draw out the informants understandings and perceptions. The tool has seven sub-sections: study evaluative overview; study and context (setting, sample and outcome measurement); ethics; group comparability; qualitative data collection and analysis; policy and practice implications; and other comments.

 

6.     Evaluation Tool for Critical Assessment of an Economic Evaluation of a Health Intervention (School of Nursing, University of Salford)

This methodological checklist has been developed to enable the assessment of economic research studies. The checklist contains six sub-sections including: study overview; key elements of the study; effectiveness data; economic evaluation; results; and conclusion, critical comment and implications. The checklist was developed as part of a PhD into the economic appraisal of rehabilitation services.

 

7.     Checklist for Reviewing the User Centredness of an Outcome Measure (School of Nursing, University of Salford)

This methodological checklist provides an overview of user centeredness of an outcome measures.

 

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8.     AGREE Instrument

The purpose of the Appraisal of Guidelines Research & Evaluation (AGREE) Instrument is to provide a framework for assessing the quality of clinical practice guidelines.
The AGREE Instrument assesses both the quality of the reporting, and the quality of some aspects of recommendations. It provides an assessment of the predicted validity of a guideline, that is the likelihood that it will achieve its intended outcome. It does not assess the impact of a guideline on patients outcomes.
Most of the criteria contained in the AGREE Instrument are based on theoretical assumptions rather than on empirical evidence. They have been developed through discussions between researchers from several countries who have extensive experience and knowledge of clinical guidelines. Thus, the AGREE Instrument should be perceived as reflecting the current state of knowledge in the field.
The AGREE Instrument is designed to assess guidelines developed by local, regional, national or international
groups or affiliated governmental organisations. These include:
1. New guidelines
2. Existing guidelines
3. Updates of existing guidelines
The AGREE Instrument is generic and can be applied to guidelines in any disease area including those for
diagnosis, health promotion, treatment or interventions. It is suitable for guidelines presented in paper or
electronic format.
 

9.     Diagnosis Worksheet (Centre for Evidence-Based Medicine, University of Toronto)

This methodological checklist provides key criteria relevant to diagnostic studies.

 

10.     Harm Worksheet (Centre for Evidence-Based Medicine, University of Toronto)

This methodological checklist provides key criteria relevant to harm studies.

 

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11.     Prognosis Worksheet (Centre for Evidence-Based Medicine, University of Toronto)

This methodological checklist provides key criteria relevant to prognostic studies.

 

12.     Systematic Review (of therapy) Worksheet (Centre for Evidence-Based Medicine, University of Toronto)

This methodological checklist provides key criteria relevant to systematic reviews.

 

13.     Therapy Worksheet (Centre for Evidence-Based Medicine, University of Toronto)

This methodological checklist provides key criteria relevant to therapy studies.

 

14.     Critical Appraisal Skills Program (CASP): Systematic Reviews (Public Health Resource Unit, NHS)

This methodological checklist provides key criteria relevant to systematic reviews.

 

15.     CASP: Randomised Controlled Trial Appraisal Tool (Public Health Resource Unit, NHS)

This methodological checklist provides key criteria relevant to randomised controlled trials.

 

16.     CASP: Qualitative Research (Public Health Resource Unit, NHS)

This methodological checklist provides key criteria relevant to qualitative research.

 

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17.     CASP: Economic Evaluation Studies (Public Health Resource Unit, NHS)

This methodological checklist provides key criteria relevant to economic studies.

 

18.     CASP: Cohort Studies (Public Health Resource Unit, NHS)

This methodological checklist provides key criteria relevant to cohort studies.

 

19.     CASP: Case Control Studies (Public Health Resource Unit, NHS)

This methodological checklist provides key criteria relevant to case control studies.

 

20.     CASP: Diagnostic Test Studies (Public Health Resource Unit, NHS)

This methodological checklist provides key criteria relevant to diagnostic studies.

 

21.     Dynamed: Critical Appraisal Support System (Health Management & Informatics,

This unique, interactive website provides access to a range of critical appraisal solutions for various research designs. You start by clicking click here to start the dialog and it takes you through a series of steps.

 

22.     Delfini tools

This website provides access to a range of tools relevant evidence based practice, including critical appraisal tools.

 

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23.     DISCERN (Division of Public Health and Primary Health Care, University of Oxford)

DISCERN is a brief questionnaire which provides users with a valid and reliable way of assessing the quality of written information on treatment choices for a health problem. DISCERN can also be used by authors and publishers of information on treatment choices as a guide to the standard which users are entitled to expect.

 

24.     GATE (Graphic Appraisal Tool for Epidemiology) (School of Population Health, The University of Auckland)

GATE is a visual framework that illustrates the generic design of all epidemiologic studies. An alternative link is also available.

 

25.     Resources for Critical Appraisal (School of Health and Related Research , University of Sheffield, UK)

This website provides access to a range of resources relevant to critical appraisals.

 

26.     Standard Quality Assessment Criteria for Evaluating Primary Research Papers (Alberta Heritage Foundation for Medical Research)

This document provides an overview of appraisal of primary research studies. It also includes examples of critical appraisal tools.

 

27.     STROBE Statement (STrengthening the Reporting of OBservational studies in Epidemiology)

This website provides access to a range of critical appraisal tools for a range of research methodologies (cohort, case-control, and cross-sectional studies).

 

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28.     TREND Statement (Transparent Reporting of Evaluations with Nonrandomized Designs)

The TREND statement is a 22-item checklist specifically developed to guide standardized reporting of nonrandomized controlled trials. The TREND statement complements the widely adopted CONsolidated Standards Of Reporting Trials (CONSORT) statement developed for randomized controlled trials. A collective effort in promoting transparent reporting is valuable to improve research synthesis and advance evidence-based recommendations for best practices and policies.

 

29.     Critical Appraisal Tool (Royal College of Psychiatrists, UK)

This document provides the reader with various critical appraisal tools. These include tools for meta-analyses and systematic reviews, randomised controlled trials, clinical guidelines and qualitative research papers.

 

30.     QUOROM Statement Checklist

This document provides a checklist which evaluates the quality of meta-analysis of randomised controlled trials.

 

31.     ARIF (Aggressive Research Intelligence Facility)

This webpage provides a checklist which evaluates the quality of systematic reviews.

 

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32.     Critical Appraisal Resources (TRENT Research and Development Support Unit)

This excellent webpage provides access to a range of resources on all things critical appraisal.

 

33.     OT Seeker (Occupational Therapy Systematic Evaluation of Evidence)

This excellent webpage provides access to a range of appraisal resources.

 

34.     PEDro (Physiotherapy Evidence Database)

This excellent webpage provides access to a range of appraisal resources including a tutorial and appraisal tool.

 

35.     RAPid (Rapid Appraisal Protocol Internet Database) (Joanna Briggs Institute)

This excellent webpage provides access to a range of appraisal resources. However, this webpage requires log in.

 

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36.     What is Critical Appraisal? (Critical Appraisal Skills Programme, Institute of Health Sciences, Oxford)

This document provides an excellent overview of critical appraisal including an explanation of critical appraisal tools.

 

37.     Evidence Direct: Critical Appraisal (The Royal Melbourne Hospital)

This excellent webpage provides access to numerous critical appraisal resources including critical appraisal tools, examples and other reading materials.

 

38.     TOOLKIT: Appraising the Evidence (The University of Newcastle)

This interactive webpage provides access to numerous critical appraisal resources including critical appraisal tools, examples and other reading materials.

 

39.     CriSTAL Checklist (The University of Newcastle)

This webpage provides a checklist which evaluates the quality of various research designs.
Appraising a user study     or     Appraising an information needs analysis

 

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40.     ReLIANT (Readers guide to the Literature on Interventions Addressing the Need for education and training) (Denise Koufogiannakis, Andrew Booth & Alison Brettle)

This innovative tool is aimed at appraising published reports of educational and training interventions. This document provides the developmental process of ReLIANT tool and is an interesting read.

 

41.     EBLIP Critical Appraisal Checklist for Library Research (L Glynn, Memorial University of Newfoundland)

This webpage and document provides details of a critical appraisal tool for library and information research. An alternative link is also available.

 

42.     The CONSORT Statement (Consolidated Standards of Reporting Trials)

This detailed document outlines an explanation and elaboration of the CONSORT statement for reporting randomized controlled trials. It also includes (in table two) the critical appraisal tool.

 

43.     Critical Review Form     and     Guidelines- Quantitative Studies (Occupational Therapy Evidence-Based Practice Research Group, McMaster University)

These documents contain a generic quantitative appraisal tool and guidelines for usage.

 

44.     Critical Review Form and Critical Guidelines- Qualitative Studies (Occupational Therapy Evidence-Based Practice Research Group, McMaster University)

These documents contain a generic qualitative appraisal tool and guidelines for usage.

 

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45.     READER Critical Appraisal Tool (MacAuley et al, 1998)

This document outlines READER method of critical appraisal including the critical appraisal tool.

 

46.     JBI-NOTARI Critical Appraisal Tool (Narrative, Opinion and Text Assessment and Review Instrument) (Joanna Briggs Institute)

Slide 9 of this PowerPoint presentation contains JBI-NOTARI critical appraisal tool. A useful tool to evaluate narrative, opinion and others textual evidence.

 

47.     Systematic Review of Critical Appraisal Tools for clinical guidelines (Vlayen et al)

This publication is a systematic review of appraisal tools for clinical guidelines. While there is no access to critical appraisal tools directly from this publication, it does provide an interesting and informative overview of appraisal tools for clinical guidelines.

 

48.     University of Kent

This excellent resource contains plethora of information of critical appraisal, including numerous critical appraisal tools for various primary and secondary research publications.

 

If you require any further information about CAT or this webpage, please contact Dr Saravana Kumar.

 

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