Evidence Based Practice

This guide is designed to provide information on what Evidence Based Practice is and how to find evidence.

What is critical appraisal?

Critical appraisal is "the process of assessing and interpreting evidence by systematically considering its validity, results and relevance" (Bandolier, 2007, para. 1).

Critical appraisal uses intrinsic (research design etc) not extrinsic (author, journal, institution) factors which is more commonly used in evaluating web sites.

When appraising an article, it needs to meet the following three requirements:

Quality (the methodology should include trials that are randomised and double blind to avoid selection and observer bias)
Validity (trials need to mimic clinical practice, or used in clinical practice, with outcomes that make sense)
Reliability (trials are credible and repeatable)

Another aspect to consider when appraising evidence is: "How does this inform my practice?"

References
Bandolier. (2007). Critical appraisal.
http://www.bandolier.org.uk/booth/glossary/Critapp.html

Burls, A. (2009). What is critical appraisal?
http://www.bandolier.org.uk/painres/download/whatis/What_is_critical_appraisal.pdf

These videos will provide an introduction to the concept of critical appraisal.

Introduction to Critical Appraisal (Video, Duration 9min.)
This is the first in a series of seven videos developed by Cochrane Common Mental Disorders in collaboration with York University, Northumberland, Tyne and Wear NHS Foundation Trust (NTW), UK and Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV), UK.
Systematic reviews and meta analysis (Video, Duration: 29min.)
This is the second in a series of seven videos developed by Cochrane Common Mental Disorders in collaboration with York University, Northumberland, Tyne and Wear NHS Foundation Trust (NTW), UK and Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV), UK.

Critical appraisal tools

There are a number of checklists / tools available on the Internet to assist you in undertaking critical appraisal of evidence. Some examples are listed below.

Appraisal Tools - Critical Appraisal Skills Programme(UK)
These tools were developed by the Critical Appraisal Skills Programme (CASP) to help with the process of critically appraising articles. Please note this site has problems when opened with Internet Explorer, try Mozilla Firefox or another web browser.
CEBM > EBM Tools > Critical Appraisal (UK)
This site provides access to a number of critical appraisal sheets, CATmaker (a computer-assisted critical appraisal tool) as well as other tools.
EBM Practice Guidelines: Appraisal Guide (Canada)
A practice guideline is a systematically developed statement designed to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances.
How to use the Evidence (Australian National Health and Medical Research Council)
This handbook focuses on how to evaluate and use the evidence gathered from a systematic literature review to inform the development of evidence-based clinical guidelines. Scroll to the bottom of the page to download the handbook.
A systematic review of the content of critical appraisal tools (article)
This article, published in 2004, summarizes the content, intent, construction and psychometric properties of published, currently available critical appraisal tools to identify common elements and their relevance to allied health research.
Systematic Reviews & Other Review Types - Tools for Critical Appraisal
Guide created by Temple University.
Systematic Reviews & Other Review Types - What is a Systematic Review?
Guide created by Temple University.