Template for Critical Appraisal

I. Introduction

A. Study objective/purpose

1. Is the purpose of the study clearly stated?

  1. Hypotheses
    1. Is the research question or hypothesis clearly stated?

II. Methodology/Study Design

  1. Design of the experiment/trial

1. Is it a clinical trial, cohort, case-control, cross-sectional, or case-series?

B. Population/sample

1. What are the criteria for inclusion and exclusion of subjects?

2. What limitations result?

C. Treatment allocation

1. How are subjects chosen or recruited?  Randomly?

2. If not:

a. Are they representative of the population?

b. How were patients selected for the study to avoid bias?

c. If historical controls were used, were methods and criteria

the same for the experimental group, and were cases and

controls compared on prognostic factors?

  1.       If there is a control group, how is it chosen?
  2.       How are patients followed up? Who are the dropouts, and how 

many are there? Were the circumstances for patients dropping out  explained by the authors?

  1.       Do the authors explain or give a reference to any unusual method

      used in the study?

D. Outcome measures

1. Are there multiple endpoints?

2. Are subgroup analyses performed and, if so, reported


  1. Statistical analysis
    1. Are the statistical methods used in the study specified in sufficient


    1. Is there a statement about the sample size or power? (Statements

on power are especially critical in a negative study).

    1. Do the statistical tests answer the research questions?  Are all

relevant outcomes reported?

    1. Were repeated measures made over time, and if so, were they

analyzed appropriately?

III. Results

  1. Do the results relate to research questions proposed in the study


  1. Are actual values reported (e.g., means, standard deviations, proportions),

not just the results of statistical tests?

  1. In paired designs, is the magnitude and range of the differences reported?
  2. Are group similar on baseline measures?  If not, were appropriated analyses done to take differences into consideration?
  3. Are appropriate graphics used to present results clearly?

IV.       Study Discussion/Students’ Conclusions

  1. Interpretation of results
    1. Are the questions posed in the study adequately addressed?
    2. Are the conclusions justified from the data?

  1. Does the student reflect on the clinical and statistical significance of

results from the study?

  1. Does the student compare results from the study to those of similar studies


  1. Discuss study limitations
    1. Are shortcomings of the study addressed and constructive

suggestions given for the future research?

  1. Applicability of results

1. Do the authors extrapolate beyond the data?

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