MSK Library Guides: MSK Advanced Practice Providers Resources: Critical Appraisal

Critical Appraisal Resources

PRISMA
PRISMA is an evidence-based minimum set of items for reporting in systematic reviews and meta-analyses. PRISMA focuses on the reporting of reviews evaluating randomized trials, but can also be used as a basis for reporting systematic reviews of other types of research, particularly evaluations of interventions.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009) Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(7): e1000097. doi:10.1371/journal.pmed.1000097
AGREE
The Appraisal of Guidelines for Research and Evaluation (AGREE) Instrument evaluates the process of practice guideline development and the quality of reporting.
GRADE Working Group
The GRADE working group began in the year 2000 as an informal collaboration of people with an interest in addressing the shortcomings of present grading systems in health care. Our aim is to develop a common, sensible approach to grading quality of evidence and strength of recommendation.
How to read a paper series
Articles in the BMJ that explain how to read and interpret different kinds of research papers.

Critical Appraisal Tools

OCEBM Critical Appraisal Tools
Worksheets to help you appraise the reliability, importance and applicability of clinical evidence.

PRISMA Checklist
The PRISMA Statement consists of a 27-item checklist and a four-phase flow diagram. The aim of the PRISMA Statement is to help authors improve the reporting of systematic reviews and meta-analyses.
PRISMA Flow Diagram
From: Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(7): e1000097. doi:10.1371/journal.pmed1000097
Therapy/RCT Critical Appraisal Sheet
Use this worksheet to help guide you through appraising a therapy study. It will walk you through the questions to ask yourself about the study design and results to appraise the quality.
Diagnostic Study Critical Appraisal Sheet
Use this worksheet to help guide you through appraising a diagnostic accuracy study. It will walk you through the questions to ask yourself about the study design and results to appraise the quality.
Prognostic Study Critical Appraisal Sheet
Use this worksheet to help guide you through appraising a prognostic study. It will walk you through the questions to ask yourself about the study design and results to appraise the quality.
Systematic Review Appraisal Sheet
Use this worksheet to help guide you through appraising a systematic review. It will walk you through the questions to ask yourself about the study design and results to appraise the quality.
Appraising a PICO Question
Use this worksheet to help guide you through your PICO question in terms of number needed to treat (NNT), appraisal of the study design and the outcomes. This worksheet also allows you to enter in your clinical bottom line and further actions.

Statistical Analyses

Number Needed to Treat (NNT)
The Number Needed to Treat (NNT) is the number of patients you need to treat to prevent one additional bad outcome (death, stroke, etc.).
Likelihood Ratios
The Likelihood Ratio (LR) is the likelihood that a given test result would be expected in a patient with the target disorder compared to the likelihood that that same result would be expected in a patient without the target disorder.
SpPin and SnNout
To understand what is meant by the terms SpPin and SnNout, we need to understand the notions of sensitivity and specificity.
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OCEBM

Risk of Bias

RoB 2: A revised Cochrane risk-of-bias tool for randomized trials
Version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2) is the recommended tool to assess the risk of bias in randomized trials included in Cochrane Reviews
Risk Of Bias In Non-Randomized Studies - of Interventions (ROBINS-I)
The ROBINS-I is a tool developed to assess risk of bias in the results of non-randomized studies that compare health effects of two or more interventions.
Risk Of Bias due to Missing Evidence in a synthesis (ROB-ME)
The ROB-ME tool is intended for authors of systematic reviews to assess risk of bias due to missing evidence in meta-analyses of the effects of interventions, in any other type of pairwise synthesis that yields a point estimate of an intervention effect (e.g. calculation of the median effect across studies when meta-analysis is not possible or appropriate), or in syntheses consisting of only one study with available results.
Catalog of Bias
A collaborative project mapping all the biases that affect health evidence

Data Extraction (Meta-Analyses)

Data extraction in meta-analysis
The aim of this resource is to provide a series of useful tips on data extraction, to shed light on, and raise awareness of the different methods and equations that are available to convert data into what you need for meta-analysis. I’ll also try to demystify the maths by giving worked examples and only offering the derivation of the equations as an optional extra.