CRITICAL APPRAISAL

A METHOD

THE TIMRAD CASCADE

T...TITLE What?

I...INTRODUCTION Why?

M...METHOD How?

R...RESULTS What?

A...ANALYSIS So what?

D...DISCUSSION Where next?

TITLE

WHAT IS IT ABOUT?

IS IT IMPORTANT?

IS IT RELEVANT TO YOU/YOUR PATIENTS?

IS IT ORIGINAL?

INTRODUCTION

WHY DID THEY START THE STUDY?

WHAT IS THE EXACT RESEARCH QUESTION/HYPOTHESIS?

IS IT IMPORTANT AND IN WHAT DIMENSIONS?

IS THE BACKGROUND LITERATURE SENSIBLE AND BALANCED?

WHO FUNDED THE RESEARCH?

IS THE STUDY ETHICAL?

METHOD

WHAT STUDY DESIGN WAS USED?

HOW WERE THE SUBJECTS SELECTED? RANDOMISED?

WERE THE CONTROLS MATCHED AND BLINDED?

WHAT WERE THE INCLUSION/EXCLUSION CRITERIA?

WAS THE RESEARCH INSTRUMENT USED ACCEPTABLE VALID AND RELIABLE?

WAS THE SAMPLE SIZE ADEQUATE?

WHAT OUTCOME MEASURES WERE USED AND WERE THEY CLEARLY DEFINED?

WHAT IS THE STUDY SETTING?

WHAT TYPES OF BIAS CAN YOU IDENTIFY?

RESULTS

ARE THE FINDINGS CLEARLY/OBJECTIVELY PRESENTED?

WAS THE RESPONSE RATE ADEQUATE? (OVER 70%)

ARE ALL SUBJECTS ACCOUNTED FOR BY THE END OF THE STUDY? ANALYSIS PERFORMED USING INTENTION-TO-TREAT?

ARE THE STATISTICAL METHODS USED APPROPRIATE?

ANALYSIS

HAVE THE INITIAL RESEARCH OBJECTIVES BEEN ACHIEVED?

HAS THE DATA BEEN INTERPRETED OBJECTIVELY?

ARE THE CONCLUSIONS JUSTIFIED BY THE RESULTS?

ARE ANY RESULTS NOT DISCUSSED?

ARE THE RESULTS CLINICALLY IMPORTANT?

DISCUSSION

IN VIEW OF ALL THE CRITICISMS YOU HAVE RAISED INCLUDING:

BIAS?

CONFOUNDING VARIABLES?

CHANCE?

DO YOU BELIEVE THE FINDINGS?

CAN THE RESEARCH FINDINGS BE GENERALISED TO YOUR OWN PRACTICE?

IS IT GOING TO CHANGE WHAT YOU DO IN PRACTICE?

Course Organisers 

web designed by Chris Wilkinson, North Worcestershire VTS