JM2010 CE: Understanding Healthcare Literature/Critical Appraisal
Posted on January 28, 2010 by ebrennan | 1 Comment
By Evonda Copeland, Supervisor of Library Services, Scottsdale Healthcare, Scottsdale, AZ
The CE “Understanding Healthcare Literature: Advanced Critical Appraisal” by Ann McKibbon, opened with a lively, attendee-initiated discussion about the reliability of results that are reported in published studies and the importance of looking at external factors that could influence that reporting. Author’s affiliations, sponsor’s corporate interests, financial disclosures and conflicts of interest can all shed light on the way in which data is presented. Bottom line: be aware of these factors when analyzing outcomes of studies.
We spent time in hands-on critical appraisal of published studies, including a cluster randomized trial, a population-based study, a systematic review, a randomized control trial, and a randomized screening trial for prostate cancer. We started by identifying where to find key components of the research within the article itself. Where is the most reliable place to look for study question, setting, population, interventions, and outcomes? Is it in the abstract? The methodology section? The results or discussion sections? Some people view the abstract as an “advertising ploy” instead of a reliable source of study details. Discussion sections can often be convoluted, making it difficult to clearly identify study components. Typically, the last paragraph of the introduction section is the best place to find a clearly stated study question. Reliable information about the population is found in the methodology section, as is interventions and setting. You can find definitive information about population in the first paragraph of the results section or in “table 1” of the article.
Our instructor gave us a critical analysis worksheet based on GATE (Graphic Appraisal Tool for Epidemiology, from the EPIQ Group, University of Auckland-New Zealand. Visually mapping study components (setting, population, exposure and control groups, and outcomes over time) into a flowchart-style format can be a great tool for better understanding a study and its outcomes. There’s another resource – Equator Network – that offers further assistance with mapping studies based on the type of study (for instance, a map for a diagnostic accuracy study would look different from a map for a randomized control trial).
We also enjoyed a round of late afternoon statistics! P-values and CI (confidence intervals) proved to be challenging topics, but we hung in there & found our way through it. We may not be expert biostatisticians, but I think it’s safe to say we do have a much better familiarity now with statistical significance and levels of confidence in study outcomes.
Overall, a great deal of sharing occurred among attendees and instructor. I believe we all came away with added knowledge, and also a set of new, more educated questions to carry with us as we move forward in critical appraisal of healthcare literature.
For another perspective on this CE, read this blog post.
Posted 1/28/10
Tags: CE (Continuing Education) > evidence based practice > JM2010
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February 2nd, 2010 @ 1:20 pm
[…] For another perspective on this class, visit this blog post. […]