Critical appraisal is integral to the process of Evidence Based Practice. Critical appraisal aims to identify potential threats to the validity of the research findings from the literature and provide consumers of research evidence the opportunity to make informed decisions about the quality of research evidence.
Critical appraisal can occur through a non-structured approach where you critically read the study as you read it, or through a structured approach through the use of a Critical Appraisal Tool (CAT). CAT’s are structured checklists that allow you to check the methodological quality of a study against a set of criteria. An advantage of using a CAT is that you can apply a level of consistency when reviewing a number of studies. However a potential disadvantage is that they may not ask about a potential source of bias that is important for the specific research questions being asked.
Below is a list of CATs, linked to the websites where they were developed. We have also included some information about developing your own CATs.
The following tutorials provide some information on how to critically appraise the literature
- Montgomery M, Critical Appraisal of the Literature https://www.youtube.com/watch?v=ikuVmCtBvF0
Please choose a type of study
- Randomised Controlled Trial (RCT)
- Cohort
- Diagnostic
- Case Control Studies
- Cross Sectional Studies
- Economic Studies
- Other Quantitative
- Qualitative
- Mixed Methods
- Systematic Reviews
Randomised Controlled Trial (RCT)
CASP: Randomised Controlled Trial Appraisal Tool
https://casp-uk.net/casp-tools-checklists/
Summary: Critical Appraisal Skills Program (CASP): RCT CAT is a methodological checklist which provides key criteria relevant to randomised controlled trials.
Authors: Public Health Resource Unit, NHS, England
PDF: CASP RCT CAT
PEDro Scale
Summary: PEDro (Physiotherapy Evidence Database) Scale is an excellent webpage which provides access to a range of appraisal resources including a tutorial and appraisal tool.
Authors: The Centre of Evidence-Based Physiotherapy (CEBP), Sydney, Australia
PDF: PEDro Scale
The JADAD Score
http://onlinelibrary.wiley.com/doi/10.1002/9780470988343.app1/pdf
Summary: The Jadad scale assesses the quality of published clinical trials based methods relevant to random assignment, double blinding, and the flow of patients. There are 7 items in the scale, scored with a yes scoring 1 and a no scoring zero. The last 2 questions attract a negative score, which means that the range of possible scores is 0 (bad) to 5 (good).
Authors: Jadad AR, Moore RA, Carroll D.
PDF: JADAD Scale
GATE CAT: Intervention RCT/Cohort Studies
Summary: This CAT developed by the University of Auckland presents a comprehensive study review process focused on the 5 steps of Evidence Based Practice. Steps you through the process of asking, accessing, appraising (using the RAMboMAN tool), applying and auditing.
Authors: The University of Auckland, New Zealand
PDF: GATE CAT – Intervention RCT Studies
Scottish Intercollegiate Guidelines Network (SIGN) Methodology Checklist: Randomised Controlled Trials
https://www.sign.ac.uk/what-we-do/methodology/checklists/
Summary: This CAT developed by the Scottish Intercollegiate Guidelines Network (SIGN), scores the RCT over 10 questions and provides an overall assessment of the studies effort to reduce bias. Whislt developed to be used for the development of clinical guidelines they are excellent CATs for single study appraisals
Authors: Scottish Intercollegiate Guidelines Network
PDF: SIGN checklist RCT
Centre for Evidence Based Medicine, Oxford University
https://www.cebm.net/2014/06/critical-appraisal/
Summary: This CAT presented by the CEBM, scores the RCT over 5 questions. Many of the questions are present in the CASP CAT
Authors: Centre for Evidence Based Medicine, Oxford University
PDF: CEBM - RCT
JBI checklist for Randomised Controlled Trials
Summary: JBI Critical appraisal tools have been developed by the JBI and collaborators and approved by the JBI Scientific Committee following extensive peer review. Although designed for use in systematic reviews, JBI critical appraisal tools can also be used when creating Critically Appraised Topics in journal clubs and as an educational tool.
Authors: Joanna Briggs Institute, Adelaide, Australia
Specialist Unit for Review Evidence (SURE) 2016: RCTs and Other Experimental Studies
http://www.cardiff.ac.uk/specialist-unit-for-review-evidence/resources/critical-appraisal-checklists
Summary: This CAT presents questions to assist with the critical appraisal of randomised controlled trials and other experimental studies. It has been adapted and updated from the former Health Evidence Bulletins Wales (HEBW) checklist (http://www.cardiff.ac.uk/insrv/libraries/sure/doc/Project%20Methodology%205.pdf) with reference to the NICE Public Health Methods Manual (2012) and previous versions of the Critical Appraisal Skills Programme (CASP) checklists, with reference to the CONSORT statement.
Authors: Cardiff University
RoB 2.0. A revised tool to assess risk of bias in randomized trials
http://www.bristol.ac.uk/population-health-sciences/centres/cresyda/barr/riskofbias/rob2-0/
Summary: This CAT from the Centre for Research Synthesis and Decision Analysis, presents tools supported by guidance notes for different RCT designs.
Authors: Higgins et al.
PDF: Individually-randomized, parallel-group trials - CAT Guidance sheet
Cluster-randomized, parallel-group trials - CAT Guidance Sheet
Individually-randomized, cross-over trials - CAT Guidance Sheet
CAT for RCTs: Roever and Oliveira (2015)
Summary: This CAT is based on a combination of other CATs
Authors: Roever & Oliveira
PDF: CAT for RCTs
Cohort Studies
CASP: Cohort Studies
https://casp-uk.net/casp-tools-checklists/
Summary: Critical Appraisal Skills Program (CASP): Cohort Studies is a methodological checklist which provides key criteria relevant to cohort studies.
Authors: Public Health Resource Unit, NHS, England
PDF: CASP Cohort
GATE CAT – Intervention Cohort Studies
Summary: This CAT developed by the University of Auckland presents a comprehensive study review process focused on the 5 steps of Evidence Based Practice. Steps you through the process of asking, accessing, appraising (using the RAMboMAN tool), applying and auditing.
Authors: The University of Auckland, New Zealand
PDF: GATE CAT – Intervention Studies
Scottish Intercollegiate Guidelines Network (SIGN) Methodology Checklist 3: Cohort studies
https://www.sign.ac.uk/what-we-do/methodology/checklists/
Summary: This CAT developed by the Scottish Intercollegiate Guidelines Network (SIGN), scores the cohort study over 10 questions and provides an overall assessment of the studies effort to reduce bias. Whilst developed to be used for the development of clinical guidelines they are excellent CATs for single study appraisals
Authors: Scottish Intercollegiate Guidelines Network
PDF: SIGN Checklist 3: Cohort studies
JBI checklist for Cohort Studies
Summary: JBI Critical appraisal tools have been developed by the JBI and collaborators and approved by the JBI Scientific Committee following extensive peer review. Although designed for use in systematic reviews, JBI critical appraisal tools can also be used when creating Critically Appraised Topics in journal clubs and as an educational tool.
Authors: Joanna Briggs Institute, Adelaide, Australia
PDF: JBI checklist for Cohort studies
Diagnostic
CASP Diagnostic CAT
https://casp-uk.net/casp-tools-checklists/
Summary: Critical Appraisal Skills Program (CASP): Cohort Studies is a methodological checklist which provides key criteria relevant to diagnostic studies.
Authors: Public Health Resource Unit, NHS, England
PDF: CASP Diagnostic CAT
GATE CAT for Diagnostic Test Accuracy Studies:
Summary: This CAT developed by the University of Auckland presents a comprehensive study review process focused on the 5 steps of Evidence Based Practice. Steps you through the process of asking, accessing, appraising (using the RAMboMAN tool), applying and auditing.
Authors: The University of Auckland, New Zealand
PDF: GATE CAT for Diagnostic Test Accuracy Studies
Scottish Intercollegiate Guidelines Network (SIGN) Methodology Checklist 5: Diagnostic studies
https://www.sign.ac.uk/what-we-do/methodology/checklists/
Summary: This CAT developed by the Scottish Intercollegiate Guidelines Network (SIGN), scores the diagnostic study over 10 questions and provides an overall assessment of the studies effort to reduce bias. Whilst developed to be used for the development of clinical guidelines they are excellent CATs for single study appraisals
Authors: Scottish Intercollegiate Guidelines Network
PDF: SIGN Checklist 5: Diagnostic studies
JBI checklist for Diagnostic Accuracy Studies
Summary: JBI Critical appraisal tools have been developed by the JBI and collaborators and approved by the JBI Scientific Committee following extensive peer review. Although designed for use in systematic reviews, JBI critical appraisal tools can also be used when creating Critically Appraised Topics in journal clubs and as an educational tool.
Authors: Joanna Briggs Institute, Adelaide, Australia
PDF: JBI checklist for Diagnostic studies
CAT for an Article on Diagnosis or Screening
https://www.gla.ac.uk/media/media_64046_en.pdf
Summary: This 12 question CAT developed by the Dept. of General Practice, University of Glasgow can be used for diagnostic or screening studies, and is accompanied by a great jargon buster.
Authors: Dept. of General Practice, University of Glasgow
PDF: CAT for an Article on Diagnosis or Screening
CAT for Diagnostic Studies: Roever (2016)
https://www.researchgate.net/publication/292612112_Critical_Appraisal_of_a_Diagnostic_Test_Study
Summary: This CAT is based on a combination of other CATs
PDF: Roever 2016
Case Control Studies
CASP: Case Control Studies
https://casp-uk.net/casp-tools-checklists/
Summary: Critical Appraisal Skills Program (CASP): Cohort Studies is a methodological checklist which provides key criteria relevant to Case control studies.
Authors: Public Health Resource Unit, NHS, England
PDF: CASP: Case Control Studies
GATE CAT – Case control Studies
Summary: This CAT developed by the University of Auckland presents a comprehensive study review process focused on the 5 steps of Evidence Based Practice. Steps you through the process of asking, accessing, appraising (using the RAMboMAN tool), applying and auditing.
Authors: The University of Auckland, New Zealand
PDF: GATE CAT – Case control Studies
Scottish Intercollegiate Guidelines Network (SIGN) Methodology Checklist 4: Case control studies
https://www.sign.ac.uk/what-we-do/methodology/checklists/
Summary: This CAT developed by the Scottish Intercollegiate Guidelines Network (SIGN), scores the case control study over 10 questions and provides an overall assessment of the studies effort to reduce bias. Whilst developed to be used for the development of clinical guidelines they are excellent CATs for single study appraisals
Authors: Scottish Intercollegiate Guidelines Network
PDF: SIGN Checklist 4: Case control studies
JBI checklist for Case Control Studies
Summary: JBI Critical appraisal tools have been developed by the JBI and collaborators and approved by the JBI Scientific Committee following extensive peer review. Although designed for use in systematic reviews, JBI critical appraisal tools can also be used when creating Critically Appraised Topics in journal clubs and as an educational tool.
Authors: Joanna Briggs Institute, Adelaide, Australia
PDF: JBI checklist for Case control studies
Centre for Evidence Based Medicine, Oxford University CAT for Case Control Studies
https://www.cebma.org/wp-content/uploads/Critical-Appraisal-Questions-for-a-Case-Control-Study.pdf
Summary: This CAT for Case control Studies has been developed by the Centre for Evidence Based Medicine, Oxford University, and has been adapted from Crombie, The Pocket Guide to Critical Appraisal; the critical appraisal approach used by the Oxford Centre for Evidence Medicine, checklists of the Dutch Cochrane Centre, BMJ editor’s checklists and the checklists of the EPPI Centre.
PDF: CEBM CAT for a Case Control-Study
Cross Sectional Studies
Axis Appraisal Tool for Cross Sectional Studies
https://bmjopen.bmj.com/content/bmjopen/6/12/e011458.full.pdf
Summary: critical appraisal tool that addresses study design and reporting quality as well as the risk of bias in cross-sectional studies, developed via an international Delphi panel of 18 medical and veterinary experts.
PDF: Axis Appraisal Tool for Cross Sectional Studies
JBI checklist for analytical cross sectional studies
PDF: JBI checklist for analytical cross sectional studies
Critical Appraisal Tool for Cross- Sectional Studies (CAT-CSS)
https://pdfs.semanticscholar.org/701a/d0df5ae00403b3bd5709d7a68d91db0c3568.pdf
Summary: A critical appraisal tool that includes the criteria appropriate for criticizing cross-sectional study design developed through a Delphi survey of 15 academics.
PDF: CAT-CSS
Critical appraisal tool for cross-sectional studies using biomarker data (BIOCROSS)
https://link.springer.com/content/pdf/10.1186/s12874-018-0583-x.pdf
Summary: A CAT for evaluation of reporting quality from cross-sectional epidemiological studies employing biomarker data.
PDF: BIOCROSS
CEBM Critical Appraisal of a Cross-Sectional Study (Survey)
PDF: CEBM Critical Appraisal of a Cross-Sectional Study
Critical Appraisal of a Cross-Sectional Study on Environmental Health
http://www.ncceh.ca/sites/default/files/Critical_Appraisal_Cross-Sectional_Studies.pdf
Summary: This CAT from the National Collaborating Centre for Environmental Health focuses on studies investigating effect of environmental issues on public health.
PDF: National Collaborating Centre for Environmental Health checklist
Specialist Unit for Review Evidence (SURE) 2018. Questions to assist with the critical appraisal of cross sectional studies
Summary: A checklist developed by the Specialist Unit for Review Evidence (SURE), Cardiff University for checking cross sectional studies.
PDF: Specialist Unit for Review Evidence (SURE) 2018 checklist
Economic Studies
CASP: Economic Evaluation studies
https://casp-uk.net/casp-tools-checklists/
Summary: Critical Appraisal Skills Program (CASP): Cohort Studies is a methodological checklist which provides key criteria relevant to Case control studies.
Authors: Public Health Resource Unit, NHS, England
PDF: CASP: Economic Evaluation studies
Scottish Intercollegiate Guidelines Network (SIGN) Methodology Checklist 6: Economic studies
https://www.sign.ac.uk/what-we-do/methodology/checklists/
Summary: This CAT developed by the Scottish Intercollegiate Guidelines Network (SIGN), scores the economic study over 10 questions and provides an overall assessment of the studies effort to reduce bias. Whilst developed to be used for the development of clinical guidelines they are excellent CATs for single study appraisals
Authors: Scottish Intercollegiate Guidelines Network
PDF: SIGN Checklist 6: Economic studies
JBI checklist for Economic Evaluations
Summary: JBI Critical appraisal tools have been developed by the JBI and collaborators and approved by the JBI Scientific Committee following extensive peer review. Although designed for use in systematic reviews, JBI critical appraisal tools can also be used when creating Critically Appraised Topics in journal clubs and as an educational tool.
Authors: Joanna Briggs Institute, Adelaide, Australia
PDF: JBI checklist for Economic Evaluations
Other Quantitative
McMaster Critical Review Form - Quantitative Studies
Summary: McMaster Critical Review Form for Qualitative studies contains a generic quantitative appraisal tool, accompanied by detailed guidelines for usage.
Authors: Occupational Therapy Evidence-Based Practice Research Group, McMaster University, Canada
PDF: McMaster Critical Review Form - Quantitative Studies
HCPRDU evaluation tool for quantitative studies
http://usir.salford.ac.uk/12969/
Summary: The Evaluation Tool for Quantitative Studies contains 51 questions in six sub-sections: study evaluative overview; study, setting and sample; ethics; group comparability and outcome measurement; policy and practice implications; and other comments.
Authors: Health Care Practice Research & Development Unit (HCPRDU), School of Nursing, University of Salford, UK CriSTal Checklist
PDF: HCPRDU evaluation tool for quantitative studies
READER Critical Appraisal Tool
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1238789/pdf/brjgenprac00035-0039.pdf
Summary: A tool used to aid critical reading by general practitioners which can also be used to CAT an article
Authors: Macauley D, Queens University, Belfast, Northern Ireland
PDF: READER CAT
GATE CAT – Risk Factor or Prognostic Studies
Summary: This CAT developed by the University of Auckland presents a comprehensive study review process focused on the 5 steps of Evidence Based Practice. Steps you through the process of asking, accessing, appraising (using the RAMboMAN tool), applying and auditing.
Authors: The University of Auckland, New Zealand
PDF: GATE CAT – Risk Factor or Prognostic Studies
Critical Appraisal checklist for a study on educational intervention
https://www.gla.ac.uk/media/media_64040_en.pdf
Summary: This CAT developed through the University of Glasgow involves 13 questions that should be asked when reviewing a study involving educational interventions
Authors: Dept. of General Practice, University of Glasgow, UK
PDF: CAT for educational interventions
MINORS Tool
http://cobe.paginas.ufsc.br/files/2014/10/MINORS.pdf
Summary: MINORS is a valid instrument designed to assess the methodological quality of non-randomized surgical studies, whether comparative or non-comparative.
Authors: Slim et al, Department of General and Digestive Surgery, Hotel-Dieu, France
PDF: MINORS tool
The Single-Case Experimental Design (SCED) Scale
Summary: The SCED scale was developed to assess the methodological quality of single-subject designs. It is a validated scale, that can also be used as a single-subject case study design checklist.
Authors: RL Tate, Mcdonald S, Perdices M, Togher L, Schultz R, Savage S.
PDF: SCED Scale
JBI Other Quantitative Checklists
Summary: JBI Critical appraisal tools have been developed by the JBI and collaborators and approved by the JBI Scientific Committee following extensive peer review. Although designed for use in systematic reviews, JBI critical appraisal tools can also be used when creating Critically Appraised Topics in journal clubs and as an educational tool.
Authors: Joanna Briggs Institute, Adelaide, Australia
JBI checklist for Case Reports
PDF: JBI checklist for Case reports
JBI checklist for Case Series
PDF: JBI checklist for Case Series
JBI checklist for Prevalence Studies
PDF: JBI checklist for Prevalence Studies
JBI checklist for Quasi experimental studies
PDF: JBI checklist for Quasi experimental studies
Qualitative
CASP: Qualitative Research
https://casp-uk.net/casp-tools-checklists/
Summary: Critical Appraisal Skills Program (CASP): Qualitative Research is a methodological checklist which provides key criteria relevant to qualitative research studies.
Authors: Public Health Resource Unit, NHS, England
PDF: CASP: Qualitative Research
McMaster Critical Review Form - Qualitative Studies
Summary: McMaster Critical Review Form for Qualitative studies contains a generic quantitative appraisal tool, accompanied by detailed guidelines for usage.
Authors: Occupational Therapy Evidence-Based Practice Research Group, McMaster University, Canada
PDF: McMaster Critical Review Form - Qualitative Studies
Critical Appraisal Checklist for Qualitative Research Studies
https://link.springer.com/article/10.1007/BF02820685
Summary: A checklist of 10 questions to help critically appraise qualitative research studies
Authors: Carla Treloar , Sharon Champness, Paul L. Simpson, Nick Higginbotham
PDF: Critical Appraisal Checklist for Qualitative Research Studies
JBI checklist for Qualitative Research
Summary: JBI Critical appraisal tools have been developed by the JBI and collaborators and approved by the JBI Scientific Committee following extensive peer review. Although designed for use in systematic reviews, JBI critical appraisal tools can also be used when creating Critically Appraised Topics in journal clubs and as an educational tool.
Authors: Joanna Briggs Institute, Adelaide, Australia
PDF: JBI checklist for Qualitative Research
Mixed Methods
Mixed Methods Appraisal Tool (MMAT) – Version 2011
http://www.nccmt.ca/knowledge-repositories/search/232%20(accessed%20May%202017)
Summary: National Collaborating Centre for Methods and Tools (2015). Appraising qualitative, quantitative and mixed methods studies included in mixed studies reviews: The MMAT. Hamilton, ON: McMaster University.
Authors: National Collaborating Centre for Methods and Tools, McMaster University, Canada
PDF: Mixed Methods Appraisal Tool (MMAT)
Evaluation Tool for Mixed Methods Studies
http://usir.salford.ac.uk/13070/1/Evaluative_Tool_for_Mixed_Method_Studies.pdf
Summary: 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.
Authors: Professor Andrew Long, School of Healthcare, University of Leeds
PDF: Evaluation Tool for Mixed Methods Studies
A Scoring system for Mixed Methods Research and Mixed Studies Reviews
https://www.sciencedirect.com/science/article/pii/S0020748909000145?via%3Dihub
Summary: A new form of literature review has emerged, Mixed Studies Review. These reviews include qualitative, quantitative and mixed methods studies. This scoring system assesses Qualitative, Quantitative experimental, Quantitative observational and Mixed Methods at the one time.
Authors: Pluye et al (2009) International Journal of Nursing Studies, 46: 529-46.
Systematic Reviews
CASP: Systematic Reviews
https://casp-uk.net/casp-tools-checklists/
Summary: Critical Appraisal Skills Program (CASP): Systematic Reviews is a methodological checklist which provides key criteria relevant to systematic reviews.
Authors: Public Health Resource Unit, NHS, England
AMSTAR
https://amstar.ca/Amstar_Checklist.php
Summary: Assessment of Multiple Systematic Reviews (AMSTAR) is a 37-item assessment tool used to assess the methodological quality of systematic reviews.
Authors: EMGO Institute, The Netherlands
Scottish Intercollegiate Guidelines Network (SIGN) Methodology Checklist 1: Systematic Reviews
https://www.sign.ac.uk/what-we-do/methodology/checklists/
Summary: This CAT developed by the Scottish Intercollegiate Guidelines Network (SIGN), scores the economic study over 10 questions and provides an overall assessment of the studies effort to reduce bias. Whilst developed to be used for the development of clinical guidelines they are excellent CATs for single study appraisals
Authors: Scottish Intercollegiate Guidelines Network
PDF:SIGN Checklist 1: Systematic Reviews
JBI checklist for Systematic Reviews
Summary: JBI Critical appraisal tools have been developed by the JBI and collaborators and approved by the JBI Scientific Committee following extensive peer review. Although designed for use in systematic reviews, JBI critical appraisal tools can also be used when creating Critically Appraised Topics in journal clubs and as an educational tool.
Authors: Joanna Briggs Institute, Adelaide, Australia
PDF: JBI Checklist for Systematic Reviews
Centre for Evidence Based Medicine, Oxford University
https://www.cebm.net/2014/06/critical-appraisal/
Summary: This CAT presented by the CEBM, scores the SR over 5 questions. Many of the questions are present in the CASP CAT
Authors: Centre for Evidence Based Medicine, Oxford University
PDF: CEBM SR
