Tutorial 8

Critical Appraisal of Epidemiological

Study
Overview
In this session we will learn a systematic approach that is used to
identify the strength and weakness of a research paper with aimed to
assess the validity and usefulness of the findings.
The main
components if a critical appraisal are an evaluation of the
appropriateness of the study design to the research question and a
careful assessment of the methodological aspect of the design. This
session will introduce you to steps, which will guide you to critically
appraise an article in aimed to identify the most relevant high-quality
studies available to guide a public health practice.
Learning objective
After working through this session, students were expected to be able
to:
Critically appraise a research article including identify the strength
and the weakness of the study
Determined the usefulness of the research finding for a clinical or
public health practices
Use available checklist appropriately to appraise a research article

Critical Appraisal
Critical appraisal is a carefully and systematically process in examining
research to judge its trustworthiness, and its value and relevance in
particular context (Burls,2009). Critical appraisal is an important
element of evidence-based medicine, which included public health
practices.
Critical appraisal is essential to combat information
overload, identify papers that are relevant, and as continuing
professional development.
Examples:
Bad
services/library)

science

(www.ucl.ac.uk/ich/support

The spate of deaths among young people in Britains suicide capital could be linked
to radio waves from dozens of mobile phone transmitter masts near the victims
homes. Dr Roger Coghill, who sits on a Government advisory committee on mobile
radiation, has discovered that all 22 youngsters who have killed themselves in
Bridgend, South Wales, over the past 18 months lived far closer than average to a
mast. (Johnston 2008).

Ben Goldacre, a medical doctor and author of the weekly Bad Science column in the
Guardian, investigated the claim made by the Sunday Express article and found out
the following: I contacted Dr Coghill, since his work is now a matter of great public
concern, and it is vital his evidence can be properly assessed. He was unable to give
me the data. No paper has been published. He himself would not describe the work
as a study. There are no statistics presented on it, and I cannot see the raw figures.
In fact Dr Coghill tells me he has lost the figures. Despite its potentially massive
public health importance, Dr Coghill is sadly unable to make his material assessable.
(Goldacre 2008)

Critical Appraisal of Different Study Design

To critically appraise a journal article, you would have to start by
assessing the research methods used in the study. The following
checklist are commonly use:

CASP http://www.casp-uk.net/#!casp-tools-checklists/c18f8
SIGN guideline developers handbook
http://www.sign.ac.uk/methodology/checklists.html
CEBMH http://www.cebm.net/critical-appraisal/

Activity 1
Read the attached article; answer the question below and
discussed with your tutor regarding your answer and
explanation;
1. Are the studys results valid?
2. What are the results?
3. Do you think the result will help the doctor in improving patient
care?
Article: The International Early Lung Cancer Action Program Investigators;
Survival of Patients with Stage I Lung Cancer Detected on CT Screening, N
Engl J Med 2006(17);355:1763-71;
http://www.nejm.org/doi/full/10.1056/NEJMoa060476#t=article

Assignment (deadline submission: within 2 weeks)

Conduct an critical appraisal for this research paper, which
titled: Pilot evaluation of the text4baby mobile health program, you
may download it at:
http://bmcpublichealth.biomedcentral.com/articles/10.1186/14712458-12-1031