Critical Appraisal

Week 4

Studies, Synthesis, Synopses, Summaries, Systems

List the 5 levels in the 5S approach from bottom to top

synthesis; systematic; PRISMA

____ is the second from bottom level of the 5S approach that includes _____ reviews and follows the _____ guidelines

Studies

the bottom tier of the 5S approach, where it addresses just one aspect of management in which the Clinician has to appraise and integrate multiple studies to guide their clinical decision

synopses; clinical

The third from bottom on the 5S approach are _____, which are quick and dirty summaries of a review or original study that only gives you information you need to support a _____ action

clinically-appraised paper

CAP stands for

declarative title

synopses often use a _______ ____ to make it even easier

ACP journal club, EBM

list two sources for synopses

summaries

the 4th from top on 5S model that integrates the best available evidence from the lower layers to provide a full range of evidence concerning management options for a given health problem

Critically Appraised Topics

in the summaries tier, CAP turns into ______

retrieval

should include details of the _____ process used to find best evidence

explicit; auditable

the appraisal process for rating the quality of evidence should be _____ and ______

clinical evidence, journal of sport rehabilitation

sources for Summaries

increase; decrease

a limitation of the 5S approach is that the ____ in the pyramid will bring a _____ in resources

time; scarce; disagree; diverse

limitations of the 5S approach:

information processing takes ____
reviews of diagnoses, prognoses, and etiology are _____
sometimes synthesis may _____ with each other
lower in the pyramid you get a more _____ range of clinical problems

5S

The ____ model shows us that the best evidence for clinicians is that which has already been appraised

critical appraisal

____ _____ is an evaluation process to decide whether the results are valid and their applicability to your patient

Results, Validity, Applicability

what is involved in the 3 questions of Critical Appraisal

• How large was the treatment effect?

• What was the relative risk reduction?

• What was the absolute risk reduction?

• How precise was the estimate of the treatment effect?

List some things that can be asked in the Results question of critical appraisal

– Were the patients randomized?

– Was the group allocation process concealed?

– Were the patients in each group similar?

– To what extent was the study blinded?

– Was the follow-up complete?

– Were the patients analyzed in the groups to which they were first

allocated?

– Was the trial stopped early?

what types of questions are asked in the Validity question of critical appraisal

– Were the study patients similar to my population of interest?

– Were all clinically important outcomes considered?

– Are the likely treatment benefits worth the potential harm and costs?

what types of questions are asked in the Applicability question of critical appraisal

validity; reliability; applicability

____ assesses whether appropriate research design was used to answer the clinical question, while _____ identifies if the method used in the study is reproducible, and _____ determines if the findings from the study can directly influence clinical decision-making