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 email@example.com.
New books are published regularly on critical appraisal - check Library Search to see what is available.
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.
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).
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).
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.
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