Critical appraisal is the systematic evaluation of research to determine its trustworthiness and value. It is about applying the same standards to, and asking the same questions of, all comparable research to ensure the strongest evidence is used. It is an important part of research and practice.

Library Services has designed training and web pages to assist you with undertaking critical appraisal, and your NHS Librarian is available to help if you need it.

Library training sessions and one to ones

Our librarians run skills workshops for NHS staff on the wide range of medical, nursing and evidence-based information online. This includes taught sessions on critical appraisal skills as well as practical sessions where participants can work together to appraise an example paper.

Find out more about our skills workshops

At present, teaching sessions are taking place online via Microsoft Teams with some in-person teaching.

To book, please register with the skills and information hub, KnowledgeShare. Once you have registered, select the Skills tab on the KnowledgeShare home page and click on Forthcoming Skills Sessions.

NHS Support Librarians are also available for one to one support to suit your needs as well as ad hoc training tailored to you and your team. Please contact us for more information.

Library Services can also offer support for journal clubs, teaching and events that include critical appraisal.

Checklists and guidance

Checklists to aid in critically appraising and evaluating articles and other sources of medical information have been created by a variety of organisations. The checklists are usually tailored to specific types of article or studies such as RCTs, systematic reviews or qualitative studies.

Critical Appraisal Skills Programme (CASP) (freely available)

Centre for Evidence Based Medicine (CEBM) (freely available)

EQUATOR Network (freely available)
EQUATOR gives access to main types reporting guidelines for research such as CONSORT for RCTs, as well as those for observational, clinical practice, qualitative, quality improvement, economic evaluation studies as well as systematic reviews and more. Knowing reporting guidelines could help you to judge the transparency and accuracy of reporting of study methodologies to decide on reliability and value of material you are appraising.

Critically appraising for anti-racism

Many current critical appraisal tools do not prompt the appraiser to consider issues such as racial bias and its effects on research and its application. In response, a supplementary tool has been developed by information specialist and librarian Ramona Naicker to help those undertaking critical appraisal explicitly address the issue.

Naicker highlights representation and interpretation as two broad categories to consider. A short supplementary checklist of five questions is also provided to be used alongside exisiting tools.

Critically appraising for anti-racism

Key reference texts

A selection of books, e-books and articles to help build knowledge and skills in critically appraising and understanding health research has been collated into a helpful reading list.

Additional resources

Websites

British Heart Foundation: Behind the Headlines (freely available)
The British Heart Foundation offers articles, for use by the public, which assess health claims made in the media.

Understanding Health Research (freely available)
Understanding Health Research will guide you through a series of simple questions to help you easily review and interpret a published health research paper.

Pre-appraised research

BestBETS (freely available)
BETS were developed in the ED of Manchester Royal Infirmary, UK, to provide rapid evidence-based answers to real-life clinical questions, using a systematic approach to reviewing the literature. BETs take into account the shortcomings of much current evidence, allowing physicians to make the best of what there is. Although BETs initially had an emergency medicine focus, there are a significant number of BETs covering cardiothoracics, nursing, primary care and paediatrics.

Calculators

CATmaker (freely available)
CATmaker is downloadable software that is designed to aid critical appraisal. Users can create Critically Appraised Topics (CATs) for diagnosis, prognosis and aetiology or / harm studies as well as systematic reviews and randomized controlled trials. CATmaker calculates useful clinical measures, such as relative risk reduction and number needed to treat, from information entered by the user and helps formulate clinical 'bottom lines'.

Centre for Evidence Based Medicine (freely available)
The Centre for Evidence Based Medicine (CEBM) hosts calculating tools for interpreting the clinical and statistical significance of data reported in clinical research, such as confidence intervals and hazard ratios.

CASP Online Learning (paid access)
CASP provide online learning materials relating to critical appraisal, with access lasting 12 months.