Critical Appraisal : The Librarian’s Role
Andrew Booth and Louise Falzon
What is critical appraisal?Weighing up evidence to assess:
• its validity (closeness to the truth)• its usefulness (clinical
applicability).Sackett and Haynes, 1995
FIND APPRAISE ACT
Can librarians get involved?
• Resource provider• Evidence locator• Appraiser• Digest Producer• Appraisal Tutor
Some familiar roles
• Resource provider– Critical appraisal tools– Critically appraised resources
• Evidence locator– Search skills– Search filters
• Appraiser? Digest producer?
Appraisal continuum
Searching
filtering
digests
appraising
teaching appraisal
Why should librarians get involved?• Extends and demonstrates
existing skills.• Other information sectors do it.• Area of research expertise• Value-added service• Improved profile/prestige
How are we getting involved today...
...Producing an evidence digest
Critically appraised resources• Systematic reviews
– telling the full story– e.g. Cochrane Library, NHS CRD, NHS HTA
• Guidelines– implementing the full story– SIGN, DEC, AHRQ, NIH
• Digests of evidence– giving a pointer in the right direction
Evidence-Based Digests
Study based
• NHS CRD DARE• NHS CRD NHS
EED• EB Journals• Best Evidence
Topic based
• ARIF• Clinical Evidence• Jnl of Clinical
Excellence• Evidence Matters
Aims
• To define a clinically relevant topic• To draw together a body of
relevant evidence• To identify key messages from the
best available evidence
Key messages
• Structured format• Indicative title• One line summaries• Levels of evidence and grades of
recommendation
This afternoon’s workshop• Producing a JCE style topic-based
digest
• Format and content• Techniques• Over to you!
Format
• Why important?– Relevance of topic, ‘burden of disease’
(to health service, society, individual), incidence and prevalence, key issues
• What is required?– Nature of the intervention
• Cost– Cost consequences of implementation
Format (cont.)
• Who is involved– Identification of interested parties
• Evidence– Key messages– Quality
• References– Of all sources consulted
Techniques
• Match evidence to message– Background = stats, official publications– Effectiveness = RCTs, systematic
reviews
• Authorise messages– Consider context– Keep wording from original source– Refer to source
Techniques (cont.)
• Keep it brief– Use ‘bullet points’– Break down complex ideas
• Make a start– Statements can be developed - or
replaced by better statements!
Over to you...
Support for Breastfeeding mothers
• Why important?• What is required?• Cost consequences• Interested parties• Evidence of effectiveness• References (Author, year, study type)
You have to help you...• Search results• Examples of JCE digests• Facilitators• Pens, paper, overheads• Time!
ResourcesforProducing Digests
Matching the evidence
• Background• Clinical effectiveness• Cost effectiveness
Background
• Official publications– Government and professional bodies
• Statistics– StatBase, WHO
• ‘Burden of disease’ to individual, health service and society– Cohort studies
Clinical Effectiveness
• Sources of systematic reviews, guidelines and digests
• TRIP database• SumSearch• PubMed Clinical queries• Medline filters
Cost effectiveness
• NHS CRD NHS EED and HTA• INAHTA Clearing House• Health Economics research units
– University of York CHE links page
• Medline filter
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