Intro
Reading a medical journal article or paper can seem like a complex task, but breaking the process down into steps should enable you to build up the skills to do this well:
- Skimming the article in the first instance to look for the author's main points and conclusions
- Being familiar with the way that many journal articles are structured (abstract, method, results, discussion etc)
- Reflecting on and being critical of what you are reading. A checklist or toolkit such as the ones below, can guide you through this process in a structured way.
Regular sign-up sessions for staff at GSTT and KCH are available. These introductory sessions aim to increase your confidence in your critical appraisal skills. Narrated slide decks are available on both qualitative and quantitative methods and groups of staff can request a session building on the material in these.
On this page you will find links to resources providing guidance on critical appraisal, quantitative research and statistics and qualitative research. If you have any suggestions for other resources please contact library@kcl.ac.uk.
Critically Appraising the Evidence Base:e-learning
- Critically Appraising the Evidence BaseIf you want the skills to know what good evidence looks like, then you need to understand the basics of critical appraisal. Take a look at these 8 e-learning sessions (30 mins each) to understand and apply the basics of critical appraisal.
Critical appraisal resources
New books are published regularly on critical appraisal - check Library Search to see what is available.
A Beginner's Guide to Evidence-Based Practice in Health and Social Care by
This book provides a step by step guide to what we mean by evidence based practice and how to apply it.
ISBN: 9780335227099Publication Date: Oct 2017
Understanding Clinical Papers by
For two decades, Understanding Clinical Papers has been helping students and professionals understand the research that supports evidence-based practice. Now in its fourth edition, this popular introductory textbook covers every major aspect of reading and evaluating clinical research literature, from identifying the aims and objectives of a paper to analysing the data with different multivariable methods. Numerous excerpts from actual clinical research papers make learning real and immediate, supported by a unique visual approach that reinforces key points and connects examples with the chapter material. The fourth edition includes extensively revised content throughout, including four brand-new chapters covering qualitative studies, Poisson regression, studies of complex interventions, and research using previously collected data. New and updated material discusses the difference between clinical and statistical significance, the consequences of multiple testing and methods of correction, how topic guides are used to explore and explain participants' experiences, standardised guidelines for writing trials and reviews, and much more. Offering clear explanations of important research-related topics, this reader-friendly resource: Offers a clear, concise, and accessible approach to learning how to read and analyse clinical research literature Features new coverage of qualitative research, including descriptive studies, sampling and populations, and identifying, summarising, and measuring qualitative characteristics Provides new material on missing data, sub-group analysis, feasibility and pilot studies, cluster randomised trials, and adaptive trial designs Includes new tables, abstracts, and excerpts from recent clinical research literature Understanding Clinical Papers is essential reading for all healthcare professionals and students, particularly those involved in clinical work and medical research, as well as general readers wanting to improve their understanding of research literature.
ISBN: 9781119573142Publication Date: 2020-11-26
How to Read a Paper by Publication Date: 2019-04-05Now in its sixth edition, this informative text includes new and expanded discussions of study bias, political interference in published reports, medical statistics, big data and more.
Research Methods for Nursing and Healthcare by
Research Methods for Nursing and Healthcare is an essential introductory text for all nursing and healthcare students coming to research methods for the first time or those nurses and healthcare staff wishing to improve their skills in this area. The book includes comprehensive coverage of the main research methods topics, and provides guidance on how to understand and apply research techniques. Everyday nursing examples are used throughout to explain research methods concepts and their relevance to practice. Simple self-assessment tasks are included at the end of chapters; the tests can be undertaken individually, or within groups, to assess the student's understanding of the concepts and skills being learnt. Research Methods for Nursing and Healthcare takes the fear out of research methods for all nursing and healthcare professionals. Excellent introductory text that brings interest to research methods for student nurses. Dr Aimee Aubeeluck, Deputy Director: Graduate Entry Nursing, School of Nursing, Midwifery and Physiotherapy University of Nottingham "I think this is one of the most readable books on research I have read. Not the most scholarly, but that was not the intention. It is certainly the most user friendly book that will make the whole, often scary, subject of research less threatening." Paula Crick, Principal Lecturer, Faculty of Health, Staffordshire University "I do think this is one of the most engaging texts aimed at nursing that I have read in a while... This does seem much more exciting and more importantly. 'real world'" Lucy Land, Senior Academic, Centre for Health and Social Care Research Faculty of Health Birmingham City University "Useful resource for our students dissertation which can be a literature review or a research proposal" Melanie Brooke-Read, Department of Health & Social Studies, University of Bedfordshire "Excellent text book which actually takes away the 'fear' of research within healthcare" Angela Cobbold, Institute of Health & Social Care, Anglia Ruskin University "The text is very comprehensive and I found chapter 7 on action research particularly useful in supporting a student I was supervising. I also like the self assessment exercises which I intend to incorporate in my teaching strategy." Ms. Mulcahy, School of Nursing and Midwifery, University College Cork.
ISBN: 9781317903239Publication Date: 2014-02-04
- BMJ - How to read a paper article seriesby Trisha Greenhalgh. Articles include: 'Getting your bearings (deciding what the paper is about)'; 'Statistics for the non-statistician'; 'Papers that report drug trials' and 'Papers that go beyond numbers (qualitative research).
- Centre for evidence-based medicine (CEBM)From the University of Oxford. Checklists, workshops and other resources.
- Critical Appraisal of Evidence elearningKing's Health Partners staff can access this presentation on the Learning Hub which provides a brief introduction to critical appraisal of evidence and evidence-based practice.
- 'How to read a paper' elearningKing's Health Partners staff and students can access a Learning Hub module on "How to read a paper"
Qualitative Research
The Oxford Handbook of Qualitative Research by
The Oxford Handbook of Qualitative Research, Second Edition presents a comprehensive, interdisciplinary overview of the field of qualitative research. Divided into eight parts, the forty chapters address key topics in the field such as approaches to qualitative research (philosophical perspectives), narrative inquiry, field research, and interview methods, text, arts-based, and internet methods, analysis and interpretation of findings, and representation and evaluation. The handbook is intended for students of all levels, faculty, and researchers across the disciplines, and the contributors represent some of the most influential and innovative researchers as well as emerging scholars. This handbook provides a broad introduction to the field of qualitative research to those with little to no background in the subject, while providing substantive contributions to the field that will be of interest to even the most experienced researchers. It serves as a user-friendly teaching tool suitable for a range of undergraduate or graduate courses, as well as individuals working on their thesis or other research projects. With a focus on methodological instruction, the incorporation of real-world examples and practical applications, and ample coverage of writing and representation, this volume offers everything readers need to undertake their own qualitative studies.
ISBN: 9780190847388Publication Date: 2020-08-21
Qualitative Research in Health Care by
Provides the essential information that health care researchers and health professionals need to understand the basics of qualitative research Now in its fourth edition, this concise, accessible, and authoritative introduction to conducting and interpreting qualitative research in the health care field has been fully revised and updated. Continuing to introduce the core qualitative methods for data collection and analysis, this new edition also features chapters covering newer methods which are becoming more widely used in the health research field; examining the role of theory, the analysis of virtual and digital data, and advances in participatory approaches to research. Qualitative Research in Health Care, 4th Edition looks at the interface between qualitative and quantitative research in primary mixed method studies, case study research, and secondary analysis and evidence synthesis. The book further offers chapters covering: different research designs, ethical issues in qualitative research; interview, focus group and observational methods; and documentary and conversation analysis. A succinct, and practical guide quickly conveying the essentials of qualitative research Updated with chapters on new and increasingly used methods of data collection including digital and web research Features new examples and up-to-date references and further reading The fourth edition of Qualitative Research in Health Care is relevant to health care professionals, researchers and students in health and related disciplines.
ISBN: 9781119410836Publication Date: 2020-02-03
Tools/evaluation checklists
- Critical Appraisal Skills Programme (CASP)- eight critical appraisal tools to be used when reading research.
- tools for Systematic Reviews, Randomised Controlled Trials, Cohort Studies, Case Control Studies, Economic Evaluations, Diagnostic Studies, Qualitative studies and Clinical Prediction Rule. - JBI’s critical appraisal toolsJBI’s critical appraisal tools assist in assessing the trustworthiness, relevance and results of published papers. They provide checklists for Analytical Cross Sectional Studies; Case Control Studies; Case Reports; Case Series; Cohort Studies; Diagnostic Test Accuracy Studies; Economic Evaluations; Prevalence Studies; Qualitative Research; Quasi-Experimental Studies; Randomized Controlled Trials; Systematic Reviews and Text and Opinion.
- Mixed Methods Appraisal Tool (MMAT)Appraisal tool used for qualitative, quantitative, and/or mixed methods studies. Helpful for those working on a Mixed Methods Review.
- EQUATOR NetworkThe EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network is an international initiative that seeks to improve the reliability and value of published health research literature. It contains reporting guidelines for the main study types, including COREQ for qualitative research.
- CONSORT Statement- set of recommendations for reporting Randomised Controlled Trials, providing a minimum set of items to be included.
- Use the checklist to help you check for any gaps in an RCT paper you are reading.
- please note this is not designed explicitly to be a critical appraisal tool as it focuses on the minimum to be expected - PRISMA Statement- aims to help authors improve the reporting of systematic reviews and meta-analyses by providing a minimum set of items to be included.
- use the checklist to help you check for any gaps.in a review you are reading
- please note this is not designed explicitly to be a critical appraisal tool as it focuses on the minimum to be expected
Quantitative Research
- BlindingBandolier information on blinding
Qualitative Research
Statistics
Medical Statistics from Scratch by Publication Date: 2014An accessible introduction, or a friendly refresher, to the fundamentals of medical statistics.
Medical Statistics at a Glance by
Now in its fourth edition, Medical Statistics at a Glance is a concise and accessible introduction to this complex subject. It provides clear instruction on how to apply commonly used statistical procedures in an easy-to-read, comprehensive and relevant volume. This new edition continues to be the ideal introductory manual and reference guide to medical statistics, an invaluable companion for statistics lectures and a very useful revision aid. This new edition of Medical Statistics at a Glance: Offers guidance on the practical application of statistical methods in conducting research and presenting results Explains the underlying concepts of medical statistics and presents the key facts without being unduly mathematical Contains succinct self-contained chapters, each with one or more examples, many of them new, to illustrate the use of the methodology described in the chapter. Now provides templates for critical appraisal, checklists for the reporting of randomized controlled trials and observational studies and references to the EQUATOR guidelines for the presentation of study results for many other types of study Includes extensive cross-referencing, flowcharts to aid the choice of appropriate tests, learning objectives for each chapter, a glossary of terms and a glossary of annotated full computer output relevant to the examples in the text Provides cross-referencing to the multiple choice and structured questions in the companion Medical Statistics at a Glance Workbook Medical Statistics at a Glance is a must-have text for undergraduate and post-graduate medical students, medical researchers and biomedical and pharmaceutical professionals.
ISBN: 9781119167839Publication Date: 2019-07-23
Oxford Handbook of Medical Statistics by
A good understanding of medical statistics is essential to evaluate medical research and to choose appropriate ways of implementing findings in clinical practice. The Oxford Handbook of Medical Statistics has been written to provide doctors and medical students with a comprehensive yet concise account of this often difficult subject. Described by readers as a 'statistical Bible', this new edition maintains the accessibility and thoroughness of the original, and includes comprehensive updates including new sections on transitional medicine, cluster designs, and modern statistical packages. The Handbook promotes understanding and interpretation of statistical methods across a wide range of topics, from study design and sample size considerations, through t- and chi-squared tests, to complex multifactorial analyses, all using examples from published research. References and further reading are included, to allow deeper understanding on specific topics. Featuring a new chapter on how to use this book in different medical contexts, the Oxford Handbook of Medical Statistics helps readers to conduct their own research and critically appraise others' work.
ISBN: 9780198743583Publication Date: 2020-08-11
- Medical Statistics: An A-Z Companion
Pereira-Maxwell F. Medical Statistics : An A-Z Companion. [E-Book]. Second edition. CRC Press; 2018. - Medical Statistics: understanding clinical trial results. [e-Book]
Kay R. Medical Statistics: understanding clinical trial results. Fast Facts. [e-Book]. Karger; 2020. - p-values and confidence intervalsBandolier guide
- Unit for Medical StatisticsThe Unit for Medical Statistics (UMS) is a group of medical statisticians with a broad range of collective expertise who undertake research, consultancy, training and teaching at King’s and beyond. The Unit
provides 1-hr consultation appointments to KCL and GSTT staff.
Please note that this service is not available free to KCH staff (unless they are affiliated with KCL). However short, paid pieces of statistics work and involvement in grant applications are open to all KHP. - IoPPN Biostatistics and Health Informatics Advisory ServiceThis service is intended to provide advice to staff and students from IoPPN departments on statistical aspects of a research project including PhD thesis and MSc dissertations, technical support with informatics related projects and qualitative research advice. Note This is only available to staff and students based at the Institute of Psychiatry, Psychology and Neuroscience KCL.
- Introduction to interpreting results for critical appraisalNHS England e-learning module. This session aims to cover common outcome measures and measures of statistical significance reported in clinical papers. Find out more about odds ratio, risk, relative risk, probability, RR, ARR, absolute risk reduction, NNT, p-value, confidence interval, meta-analysis. Anticipated 30 mins to complete.
- KCH Research and DevelopmentFor KCH staff. If you are seeking advice on study set up, feasibility, funding, end of study, amendments and archiving. The R&D team may be able to advise on other aspects of research including where to locate statistical support.
Trustworthiness assessment
Abstract
Background
There is increasing concern that a significant proportion of randomized controlled trials (RCTs) included in Cochrane reviews may not be trustworthy. Applying the Cochrane Pregnancy and Childbirth Trustworthiness Screening Tool (CPC-TST) has already had a clinically important effect on several reviews published by the Cochrane Pregnancy and Childbirth Group.
Objectives
We wanted to assess the impact of removing untrustworthy RCTs from already-published Cochrane reviews on a defined clinical area (antenatal and postnatal nutritional interventions).
Methods
We applied the tool to 18 Cochrane reviews (374 RCTs). The tool had four domains: (i) is the research governance trustworthy; (ii) are the baseline characteristics trustworthy; (iii) is the study feasible; (iv) are the results plausible? When additional information was needed, authors were contacted using a standard template. At least two attempts were made to contact the authors. At the end of the evaluation process each study was classified as: (i) included (YES to all questions); (ii) excluded (retracted study); or (iii) awaiting classification (any NO to the questions).
Results
Ninety-three out of 374 included studies (25%) were reclassified as “excluded” or “awaiting classification.” The number of included RCTs was reduced in 14 out of 18 reviews. Six reviews (33%) were judged to require updating because of important differences in the Summary of Findings tables (direction and size of effects and/or GRADE ratings), conclusions, implication for practice, and/or implication for research.
Conclusions
Formal assessment of trustworthiness, and inclusion only of studies that satisfy prespecified criteria for trustworthiness, affect conclusions in a relatively large number of Cochrane reviews, with potentially important clinical implications for practice and research.
Weeks J, Cuthbert A, Alfirevic Z. Trustworthiness assessment as an inclusion criterion for systematic reviews—What is the impact on results? Cochrane Ev Synth. 2023;e12037. doi:10.1002/cesm.12037