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33 Critical Analysis Examples

critical analysis examples and definition, explained below

Critical analysis refers to the ability to examine something in detail in preparation to make an evaluation or judgment.

It will involve exploring underlying assumptions, theories, arguments, evidence, logic, biases, contextual factors, and so forth, that could help shed more light on the topic.

In essay writing, a critical analysis essay will involve using a range of analytical skills to explore a topic, such as:

  • Evaluating sources
  • Exploring strengths and weaknesses
  • Exploring pros and cons
  • Questioning and challenging ideas
  • Comparing and contrasting ideas

If you’re writing an essay, you could also watch my guide on how to write a critical analysis essay below, and don’t forget to grab your worksheets and critical analysis essay plan to save yourself a ton of time:

Grab your Critical Analysis Worksheets and Essay Plan Here

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Critical Analysis Examples

1. exploring strengths and weaknesses.

Perhaps the first and most straightforward method of critical analysis is to create a simple strengths-vs-weaknesses comparison.

Most things have both strengths and weaknesses – you could even do this for yourself! What are your strengths? Maybe you’re kind or good at sports or good with children. What are your weaknesses? Maybe you struggle with essay writing or concentration.

If you can analyze your own strengths and weaknesses, then you understand the concept. What might be the strengths and weaknesses of the idea you’re hoping to critically analyze?

Strengths and weaknesses could include:

  • Does it seem highly ethical (strength) or could it be more ethical (weakness)?
  • Is it clearly explained (strength) or complex and lacking logical structure (weakness)?
  • Does it seem balanced (strength) or biased (weakness)?

You may consider using a SWOT analysis for this step. I’ve provided a SWOT analysis guide here .

2. Evaluating Sources

Evaluation of sources refers to looking at whether a source is reliable or unreliable.

This is a fundamental media literacy skill .

Steps involved in evaluating sources include asking questions like:

  • Who is the author and are they trustworthy?
  • Is this written by an expert?
  • Is this sufficiently reviewed by an expert?
  • Is this published in a trustworthy publication?
  • Are the arguments sound or common sense?

For more on this topic, I’d recommend my detailed guide on digital literacy .

3. Identifying Similarities

Identifying similarities encompasses the act of drawing parallels between elements, concepts, or issues.

In critical analysis, it’s common to compare a given article, idea, or theory to another one. In this way, you can identify areas in which they are alike.

Determining similarities can be a challenge, but it’s an intellectual exercise that fosters a greater understanding of the aspects you’re studying. This step often calls for a careful reading and note-taking to highlight matching information, points of view, arguments or even suggested solutions.

Similarities might be found in:

  • The key themes or topics discussed
  • The theories or principles used
  • The demographic the work is written for or about
  • The solutions or recommendations proposed

Remember, the intention of identifying similarities is not to prove one right or wrong. Rather, it sets the foundation for understanding the larger context of your analysis, anchoring your arguments in a broader spectrum of ideas.

Your critical analysis strengthens when you can see the patterns and connections across different works or topics. It fosters a more comprehensive, insightful perspective. And importantly, it is a stepping stone in your analysis journey towards evaluating differences, which is equally imperative and insightful in any analysis.

4. Identifying Differences

Identifying differences involves pinpointing the unique aspects, viewpoints or solutions introduced by the text you’re analyzing. How does it stand out as different from other texts?

To do this, you’ll need to compare this text to another text.

Differences can be revealed in:

  • The potential applications of each idea
  • The time, context, or place in which the elements were conceived or implemented
  • The available evidence each element uses to support its ideas
  • The perspectives of authors
  • The conclusions reached

Identifying differences helps to reveal the multiplicity of perspectives and approaches on a given topic. Doing so provides a more in-depth, nuanced understanding of the field or issue you’re exploring.

This deeper understanding can greatly enhance your overall critique of the text you’re looking at. As such, learning to identify both similarities and differences is an essential skill for effective critical analysis.

My favorite tool for identifying similarities and differences is a Venn Diagram:

venn diagram

To use a venn diagram, title each circle for two different texts. Then, place similarities in the overlapping area of the circles, while unique characteristics (differences) of each text in the non-overlapping parts.

6. Identifying Oversights

Identifying oversights entails pointing out what the author missed, overlooked, or neglected in their work.

Almost every written work, no matter the expertise or meticulousness of the author, contains oversights. These omissions can be absent-minded mistakes or gaps in the argument, stemming from a lack of knowledge, foresight, or attentiveness.

Such gaps can be found in:

  • Missed opportunities to counter or address opposing views
  • Failure to consider certain relevant aspects or perspectives
  • Incomplete or insufficient data that leaves the argument weak
  • Failing to address potential criticism or counter-arguments

By shining a light on these weaknesses, you increase the depth and breadth of your critical analysis. It helps you to estimate the full worth of the text, understand its limitations, and contextualize it within the broader landscape of related work. Ultimately, noticing these oversights helps to make your analysis more balanced and considerate of the full complexity of the topic at hand.

You may notice here that identifying oversights requires you to already have a broad understanding and knowledge of the topic in the first place – so, study up!

7. Fact Checking

Fact-checking refers to the process of meticulously verifying the truth and accuracy of the data, statements, or claims put forward in a text.

Fact-checking serves as the bulwark against misinformation, bias, and unsubstantiated claims. It demands thorough research, resourcefulness, and a keen eye for detail.

Fact-checking goes beyond surface-level assertions:

  • Examining the validity of the data given
  • Cross-referencing information with other reliable sources
  • Scrutinizing references, citations, and sources utilized in the article
  • Distinguishing between opinion and objectively verifiable truths
  • Checking for outdated, biased, or unbalanced information

If you identify factual errors, it’s vital to highlight them when critically analyzing the text. But remember, you could also (after careful scrutiny) also highlight that the text appears to be factually correct – that, too, is critical analysis.

8. Exploring Counterexamples

Exploring counterexamples involves searching and presenting instances or cases which contradict the arguments or conclusions presented in a text.

Counterexamples are an effective way to challenge the generalizations, assumptions or conclusions made in an article or theory. They can reveal weaknesses or oversights in the logic or validity of the author’s perspective.

Considerations in counterexample analysis are:

  • Identifying generalizations made in the text
  • Seeking examples in academic literature or real-world instances that contradict these generalizations
  • Assessing the impact of these counterexamples on the validity of the text’s argument or conclusion

Exploring counterexamples enriches your critical analysis by injecting an extra layer of scrutiny, and even doubt, in the text.

By presenting counterexamples, you not only test the resilience and validity of the text but also open up new avenues of discussion and investigation that can further your understanding of the topic.

See Also: Counterargument Examples

9. Assessing Methodologies

Assessing methodologies entails examining the techniques, tools, or procedures employed by the author to collect, analyze and present their information.

The accuracy and validity of a text’s conclusions often depend on the credibility and appropriateness of the methodologies used.

Aspects to inspect include:

  • The appropriateness of the research method for the research question
  • The adequacy of the sample size
  • The validity and reliability of data collection instruments
  • The application of statistical tests and evaluations
  • The implementation of controls to prevent bias or mitigate its impact

One strategy you could implement here is to consider a range of other methodologies the author could have used. If the author conducted interviews, consider questioning why they didn’t use broad surveys that could have presented more quantitative findings. If they only interviewed people with one perspective, consider questioning why they didn’t interview a wider variety of people, etc.

See Also: A List of Research Methodologies

10. Exploring Alternative Explanations

Exploring alternative explanations refers to the practice of proposing differing or opposing ideas to those put forward in the text.

An underlying assumption in any analysis is that there may be multiple valid perspectives on a single topic. The text you’re analyzing might provide one perspective, but your job is to bring into the light other reasonable explanations or interpretations.

Cultivating alternative explanations often involves:

  • Formulating hypotheses or theories that differ from those presented in the text
  • Referring to other established ideas or models that offer a differing viewpoint
  • Suggesting a new or unique angle to interpret the data or phenomenon discussed in the text

Searching for alternative explanations challenges the authority of a singular narrative or perspective, fostering an environment ripe for intellectual discourse and critical thinking . It nudges you to examine the topic from multiple angles, enhancing your understanding and appreciation of the complexity inherent in the field.

A Full List of Critical Analysis Skills

  • Exploring Strengths and Weaknesses
  • Evaluating Sources
  • Identifying Similarities
  • Identifying Differences
  • Identifying Biases
  • Hypothesis Testing
  • Fact-Checking
  • Exploring Counterexamples
  • Assessing Methodologies
  • Exploring Alternative Explanations
  • Pointing Out Contradictions
  • Challenging the Significance
  • Cause-And-Effect Analysis
  • Assessing Generalizability
  • Highlighting Inconsistencies
  • Reductio ad Absurdum
  • Comparing to Expert Testimony
  • Comparing to Precedent
  • Reframing the Argument
  • Pointing Out Fallacies
  • Questioning the Ethics
  • Clarifying Definitions
  • Challenging Assumptions
  • Exposing Oversimplifications
  • Highlighting Missing Information
  • Demonstrating Irrelevance
  • Assessing Effectiveness
  • Assessing Trustworthiness
  • Recognizing Patterns
  • Differentiating Facts from Opinions
  • Analyzing Perspectives
  • Prioritization
  • Making Predictions
  • Conducting a SWOT Analysis
  • PESTLE Analysis
  • Asking the Five Whys
  • Correlating Data Points
  • Finding Anomalies Or Outliers
  • Comparing to Expert Literature
  • Drawing Inferences
  • Assessing Validity & Reliability

Analysis and Bloom’s Taxonomy

Benjamin Bloom placed analysis as the third-highest form of thinking on his ladder of cognitive skills called Bloom’s Taxonomy .

This taxonomy starts with the lowest levels of thinking – remembering and understanding. The further we go up the ladder, the more we reach higher-order thinking skills that demonstrate depth of understanding and knowledge, as outlined below:

blooms taxonomy, explained below

Here’s a full outline of the taxonomy in a table format:

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Examples Of Critical Appraisal

INTRODUCTION The purpose of this essay is to conduct a comprehensive critical appraisal of a research paper titled ‘Chloramphenicol treatment for acute infective conjunctivitis in children in primary care’ that was carried out by Rose et al. (2005) in the United Kingdom (UK). The aim of evaluation is to critically concentrate on the strength and limitation of the study. Firstly, a clear definition of critical appraisal and its importance will be highlighted, going on further will be the critical, analysis, discussion and evaluation of the peer reviewed paper contents so as to ascertain the validity and reliability of the study. Therefore, a conclusion will be drawn to learning its significance in public health. BACKGROUND Critical Appraisal …show more content…

According to University College London (UCL) (2011), critical evaluation helps to filter necessary information, identify studies that are applicable clinically and also for continuous professional development (CPD). However, evaluation of an article, is assessed using pre-designed instrument that encourages a more thorough and systematic method; it is designed for different study design and ask specific questions as pertain validity of the study such as: if the study has given an answer to the research question and has met its set aims and objectives, the methodology, analysis and interpretation of findings (Harder, 2014; Burls, 2009; Whiffin and Hasselder, 2013). It could be said that a good critical assessment plays a vital in evidence-based practice. Therefore, a critical appraisal skills programme (CASP, 2009) checklist will be used to evaluate the selected paper for this …show more content…

This would help inform decision making clinically. Nevertheless, the journals or article must have a realistic research question (s) and objectives that would determine the appropriate research design. The study is a randomised control trial (RCT) quantitative study conducted by Rose et al. (2005) with the sole aim of determining the effectiveness of topical chloramphenicol for children presenting with acute infective conjunctivitis in a primary care sector, United Kingdom (UK). Bowling (2009) defines RCT as an experimental method for the evaluation of the effectiveness of health services and interventions in relation to specific conditions. RCT involves the random allocation of participants between experimental groups, whose members receive the treatment or other intervention, and control group whose members receive a standard or placebo treatment. Also, it is a gold standard in testing the efficacy of an intervention (UCL, 2011). To commence the article assessment is the view of the abstract. The heading and abstract of the study was well outlined, concise and focused on the sample population, methodology, data analysis as well as the result of the study. Burns and Grove (2009) state that abstract is a clear, succinct outline of a study, usually between a hundred to two hundred and fifty words count. Also, abstracts are short outline generally

Final Pico Question Paper

Keeping an open mind and being transparent when doing a literature search is key in producing a comprehensive and meaningful literature review. Discussion 5: 1) Read “How to search evidence” PowerPoint, and 2) discuss at least 5 things what you learned about searching evidence. Five points learned from the Power Point include: 1. Using professional databases such as PubMEd, CINAHL, Cochrane, EBSCO, etc. is essential in finding reliable, current and valid data. 2.

Pcp Psychology Case Study Scenarios

Discussion Post Week Six NURS6521, N-11 As a primary care provider (PCP) one will encounter many patients with eye, ear, nose, and throat illnesses. For the purpose of the discussion, I will evaluate a case study for a child with one of the above issues. I will state a primary diagnosis and differential diagnoses. I will indicate the treatment and management of the primary diagnosis and educational strategies for the parents to aid in the reduction of any fears or concerns they may have.

Evidence-Based Psychiatric Practice

RCTs and their logical equivalents (efficacy research) are the standard for drawing causal inferences about the effects of interventions (context of scientific verification). 9. Meta-analysis is a systematic means to synthesize results from multiple studies, test hypotheses, and quantitatively estimate the size of effects. How to practice evidence –based psychiatry There is 5 step in applying evidence base practice (medicine process)

Scientist-Practitioner Model Summary

They also share commonalities in having the best research and clinical skills using scientific-based research to convey assessments and interventions. In order for clients to receive the best treatment we must use empirical science and evaluate treatment data to evaluate and make sure clients are receiving the best treatment possible for their individual needs. Furthermore, scientific approaches can ensure us that the interventions utilize should be the most effective. It is important that scientific practice provides us with the ability to acquire skills to evaluate and formulate hypothesis. The scientific-practitioner model ties into the BCBA guidelines as well.

Nursing Evidence Based Practice Paper

The model outlines specific steps to a practice question, evaluating, and developing recommendations and implementing practice change. It also has a rating scale to determining the value of evidence for research and non-research data. Unlike ACE, it includes both clinician and patient expertise. The critical appraisal component guides the teaching process of evidence review to students. While it is adaptable to clinical settings, is has little emphasis in the organization cultural

Mindfulness Therapy Annotated Bibliography

Proper sample size was used and the trial duration was long enough to capture the characteristics of

Evidence Based Practice Paper

Systematic reviews examine feasibility, appropriateness and

Scientific Biomedical Framework Of Health

The more traditional framework that would have been used would have been the scientific biomedical framework. This framework is a model that does not take into consideration the psychological and social factors which may be contributing to a person’s illness; the illness is simply seen in biological terms. This ideology is far outdated, and one can see this simply by reading the WHO’s most recent definition of health, mentioned in the opening of this paper. This model views medications as the resolution to all illnesses, however we know that in today’s society, medications can often cause further problems- for example the creation of superbugs such as MRSA in the hospital system, bugs that as a result of overexposure to antibiotics have now become immune to the medication’s effects, and can therefore be detrimental to a patient’s health. By choosing to concentrate merely on biological impacts on health, a vast array of other factors, such as the environment, the money invested in public health care systems and many more, are ignored.

Response To Intervention: Annotated Bibliography

Journal Article Review Format You may download this form and insert your information under each requirement. Make sure to put your name in the header. 1. 1 paragraph summary of the section in the textbook pertaining to the topic of the article. Additionally provide the chapter and page number where this content is be found.

Clinical Audit Assignment

For this Audit the author took the following steps in developing questions for the Audit tool as guided by The National Institute for Clinical Excellence

Level I Rcts: A Summary

Base on the type of service that was provided to the patient and the concept of the establishment of the healthcare practice guidelines, the evidence-based practice that was identified was the level I which is the evidence of randomized controlled trials (RCT). The level I RCTs, which is the meta-analysis level and sometime called the hierarchy of evidence of all relevant, are assigned to studies based on the methodological quality of their design, validity, and applicability to patient care which According to the Medical News Today (2014) stated that the randomized controlled trials in the use of clinical intervention and the procedures are the gold standard of scientific testing and in a research study. The purpose of the RCT it is to support

Annotated Bibliography

There are using methods such as narrative analysis of the nature of the interventions, the effective public health practice project quality assessment tool to the quality of studies, calculating effect sizes and a meta-analysis is used for the effectiveness

Evidence-Based Practice

1. Are the results of the study valid? 2. What are the results and are they important? 3.

Access To Care: A Literature Review

A summary of these articles is located in Appendix C. Analysis of literature to support this project range from randomized controlled trials, to surveys, and focus groups. All the study analyses ranked from Level II

Evaluating Clinical Sources

A relevant and reliable research is needed to formulate clinical guidelines. But the next issue that needs to be addressed is which sources are reliable and which ones are not. There are many available research sources out there but one has to know that reliable researches must be relevant, verifiable, and unbiased. It can be difficult to know which information is up to date and most accurate, but choosing the right type of sources is crucial for the development of clinical guidelines. During a team project, the one who is assigned to weed out unacceptable research studies must come up with evaluating criteria.

More about Examples Of Critical Appraisal

How To Write a Critical Appraisal

daily newspaper

A critical appraisal is an academic approach that refers to the systematic identification of strengths and weakness of a research article with the intent of evaluating the usefulness and validity of the work’s research findings. As with all essays, you need to be clear, concise, and logical in your presentation of arguments, analysis, and evaluation. However, in a critical appraisal there are some specific sections which need to be considered which will form the main basis of your work.

Structure of a Critical Appraisal

Introduction.

Your introduction should introduce the work to be appraised, and how you intend to proceed. In other words, you set out how you will be assessing the article and the criteria you will use. Focusing your introduction on these areas will ensure that your readers understand your purpose and are interested to read on. It needs to be clear that you are undertaking a scientific and literary dissection and examination of the indicated work to assess its validity and credibility, expressed in an interesting and motivational way.

Body of the Work

The body of the work should be separated into clear paragraphs that cover each section of the work and sub-sections for each point that is being covered. In all paragraphs your perspectives should be backed up with hard evidence from credible sources (fully cited and referenced at the end), and not be expressed as an opinion or your own personal point of view. Remember this is a critical appraisal and not a presentation of negative parts of the work.

When appraising the introduction of the article, you should ask yourself whether the article answers the main question it poses. Alongside this look at the date of publication, generally you want works to be within the past 5 years, unless they are seminal works which have strongly influenced subsequent developments in the field. Identify whether the journal in which the article was published is peer reviewed and importantly whether a hypothesis has been presented. Be objective, concise, and coherent in your presentation of this information.

Once you have appraised the introduction you can move onto the methods (or the body of the text if the work is not of a scientific or experimental nature). To effectively appraise the methods, you need to examine whether the approaches used to draw conclusions (i.e., the methodology) is appropriate for the research question, or overall topic. If not, indicate why not, in your appraisal, with evidence to back up your reasoning. Examine the sample population (if there is one), or the data gathered and evaluate whether it is appropriate, sufficient, and viable, before considering the data collection methods and survey instruments used. Are they fit for purpose? Do they meet the needs of the paper? Again, your arguments should be backed up by strong, viable sources that have credible foundations and origins.

One of the most significant areas of appraisal is the results and conclusions presented by the authors of the work. In the case of the results, you need to identify whether there are facts and figures presented to confirm findings, assess whether any statistical tests used are viable, reliable, and appropriate to the work conducted. In addition, whether they have been clearly explained and introduced during the work. In regard to the results presented by the authors you need to present evidence that they have been unbiased and objective, and if not, present evidence of how they have been biased. In this section you should also dissect the results and identify whether any statistical significance reported is accurate and whether the results presented and discussed align with any tables or figures presented.

The final element of the body text is the appraisal of the discussion and conclusion sections. In this case there is a need to identify whether the authors have drawn realistic conclusions from their available data, whether they have identified any clear limitations to their work and whether the conclusions they have drawn are the same as those you would have done had you been presented with the findings.

The conclusion of the appraisal should not introduce any new information but should be a concise summing up of the key points identified in the body text. The conclusion should be a condensation (or precis) of all that you have already written. The aim is bringing together the whole paper and state an opinion (based on evaluated evidence) of how valid and reliable the paper being appraised can be considered to be in the subject area. In all cases, you should reference and cite all sources used. To help you achieve a first class critical appraisal we have put together some key phrases that can help lift you work above that of others.

Key Phrases for a Critical Appraisal

  • Whilst the title might suggest
  • The focus of the work appears to be…
  • The author challenges the notion that…
  • The author makes the claim that…
  • The article makes a strong contribution through…
  • The approach provides the opportunity to…
  • The authors consider…
  • The argument is not entirely convincing because…
  • However, whilst it can be agreed that… it should also be noted that…
  • Several crucial questions are left unanswered…
  • It would have been more appropriate to have stated that…
  • This framework extends and increases…
  • The authors correctly conclude that…
  • The authors efforts can be considered as…
  • Less convincing is the generalisation that…
  • This appears to mislead readers indicating that…
  • This research proves to be timely and particularly significant in the light of…

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How to Write A Critical Essay

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Critical Appraisal for Health Students

  • Critical Appraisal of a quantitative paper
  • Critical Appraisal: Help
  • Critical Appraisal of a qualitative paper
  • Useful resources

Appraisal of a Quantitative paper: Top tips

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  • Introduction

Critical appraisal of a quantitative paper (RCT)

This guide, aimed at health students, provides basic level support for appraising quantitative research papers. It's designed for students who have already attended lectures on critical appraisal. One framework for appraising quantitative research (based on reliability, internal and external validity) is provided and there is an opportunity to practise the technique on a sample article.

Please note this framework is for appraising one particular type of quantitative research a Randomised Controlled Trial (RCT) which is defined as 

a trial in which participants are randomly assigned to one of two or more groups: the experimental group or groups receive the intervention or interventions being tested; the comparison group (control group) receive usual care or no treatment or a placebo.  The groups are then followed up to see if there are any differences between the results.  This helps in assessing the effectiveness of the intervention.(CASP, 2020)

Support materials

  • Framework for reading quantitative papers (RCTs)
  • Critical appraisal of a quantitative paper PowerPoint

To practise following this framework for critically appraising a quantitative article, please look at the following article:

Marrero, D.G.  et al  (2016) 'Comparison of commercial and self-initiated weight loss programs in people with prediabetes: a randomized control trial',  AJPH Research , 106(5), pp. 949-956.

Critical Appraisal of a quantitative paper (RCT): practical example

  • Internal Validity
  • External Validity
  • Reliability Measurement Tool

How to use this practical example 

Using the framework, you can have a go at appraising a quantitative paper - we are going to look at the following article:

Marrero, d.g.  et al  (2016) 'comparison of commercial and self-initiated weight loss programs in people with prediabetes: a randomized control trial',  ajph research , 106(5), pp. 949-956.,            step 1.  take a quick look at the article, step 2.  click on the internal validity tab above - there are questions to help you appraise the article, read the questions and look for the answers in the article. , step 3.   click on each question and our answers will appear., step 4.    repeat with the other aspects of external validity and reliability. , questioning the internal validity:, randomisation : how were participants allocated to each group did a randomisation process taken place, comparability of groups: how similar were the groups eg age, sex, ethnicity – is this made clear, blinding (none, single, double or triple): who was not aware of which group a patient was in (eg nobody, only patient, patient and clinician, patient, clinician and researcher) was it feasible for more blinding to have taken place , equal treatment of groups: were both groups treated in the same way , attrition : what percentage of participants dropped out did this adversely affect one group has this been evaluated, overall internal validity: does the research measure what it is supposed to be measuring, questioning the external validity:, attrition: was everyone accounted for at the end of the study was any attempt made to contact drop-outs, sampling approach: how was the sample selected was it based on probability or non-probability what was the approach (eg simple random, convenience) was this an appropriate approach, sample size (power calculation): how many participants was a sample size calculation performed did the study pass, exclusion/ inclusion criteria: were the criteria set out clearly were they based on recognised diagnostic criteria, what is the overall external validity can the results be applied to the wider population, questioning the reliability (measurement tool) internal validity:, internal consistency reliability (cronbach’s alpha). has a cronbach’s alpha score of 0.7 or above been included, test re-test reliability correlation. was the test repeated more than once were the same results received has a correlation coefficient been reported is it above 0.7 , validity of measurement tool. is it an established tool if not what has been done to check if it is reliable pilot study expert panel literature review criterion validity (test against other tools): has a criterion validity comparison been carried out was the score above 0.7, what is the overall reliability how consistent are the measurements , overall validity and reliability:, overall how valid and reliable is the paper.

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example of critical appraisal essay

What Is a Critical Analysis Essay: Definition

example of critical appraisal essay

Have you ever had to read a book or watch a movie for school and then write an essay about it? Well, a critical analysis essay is a type of essay where you do just that! So, when wondering what is a critical analysis essay, know that it's a fancy way of saying that you're going to take a closer look at something and analyze it.

So, let's say you're assigned to read a novel for your literature class. A critical analysis essay would require you to examine the characters, plot, themes, and writing style of the book. You would need to evaluate its strengths and weaknesses and provide your own thoughts and opinions on the text.

Similarly, if you're tasked with writing a critical analysis essay on a scientific article, you would need to analyze the methodology, results, and conclusions presented in the article and evaluate its significance and potential impact on the field.

The key to a successful critical analysis essay is to approach the subject matter with an open mind and a willingness to engage with it on a deeper level. By doing so, you can gain a greater appreciation and understanding of the subject matter and develop your own informed opinions and perspectives. Considering this, we bet you want to learn how to write critical analysis essay easily and efficiently, so keep on reading to find out more!

Meanwhile, if you'd rather have your own sample critical analysis essay crafted by professionals from our custom writings , contact us to buy essays online .

How to Write a Critical Analysis

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Critical Analysis Essay Topics by Category

If you're looking for an interesting and thought-provoking topic for your critical analysis essay, you've come to the right place! Critical analysis essays can cover many subjects and topics, with endless possibilities. To help you get started, we've compiled a list of critical analysis essay topics by category. We've got you covered whether you're interested in literature, science, social issues, or something else. So, grab a notebook and pen, and get ready to dive deep into your chosen topic. In the following sections, we will provide you with various good critical analysis paper topics to choose from, each with its unique angle and approach.

Critical Analysis Essay Topics on Mass Media

From television and radio to social media and advertising, mass media is everywhere, shaping our perceptions of the world around us. As a result, it's no surprise that critical analysis essays on mass media are a popular choice for students and scholars alike. To help you get started, here are ten critical essay example topics on mass media:

  • The Influence of Viral Memes on Pop Culture: An In-Depth Analysis.
  • The Portrayal of Mental Health in Television: Examining Stigmatization and Advocacy.
  • The Power of Satirical News Shows: Analyzing the Impact of Political Commentary.
  • Mass Media and Consumer Behavior: Investigating Advertising and Persuasion Techniques.
  • The Ethics of Deepfake Technology: Implications for Trust and Authenticity in Media.
  • Media Framing and Public Perception: A Critical Analysis of News Coverage.
  • The Role of Social Media in Shaping Political Discourse and Activism.
  • Fake News in the Digital Age: Identifying Disinformation and Its Effects.
  • The Representation of Gender and Diversity in Hollywood Films: A Critical Examination.
  • Media Ownership and Its Impact on Journalism and News Reporting: A Comprehensive Study.

Critical Analysis Essay Topics on Sports

Sports are a ubiquitous aspect of our culture, and they have the power to unite and inspire people from all walks of life. Whether you're an athlete, a fan, or just someone who appreciates the beauty of competition, there's no denying the significance of sports in our society. If you're looking for an engaging and thought-provoking topic for your critical analysis essay, sports offer a wealth of possibilities:

  • The Role of Sports in Diplomacy: Examining International Relations Through Athletic Events.
  • Sports and Identity: How Athletic Success Shapes National and Cultural Pride.
  • The Business of Sports: Analyzing the Economics and Commercialization of Athletics.
  • Athlete Activism: Exploring the Impact of Athletes' Social and Political Engagement.
  • Sports Fandom and Online Communities: The Impact of Social Media on Fan Engagement.
  • The Representation of Athletes in the Media: Gender, Race, and Stereotypes.
  • The Psychology of Sports: Exploring Mental Toughness, Motivation, and Peak Performance.
  • The Evolution of Sports Equipment and Technology: From Innovation to Regulation.
  • The Legacy of Sports Legends: Analyzing Their Impact Beyond Athletic Achievement.
  • Sports and Social Change: How Athletic Movements Shape Societal Attitudes and Policies.

Critical Analysis Essay Topics on Literature and Arts

Literature and arts can inspire, challenge, and transform our perceptions of the world around us. From classic novels to contemporary art, the realm of literature and arts offers many possibilities for critical analysis essays. Here are ten original critic essay example topics on literature and arts:

  • The Use of Symbolism in Contemporary Poetry: Analyzing Hidden Meanings and Significance.
  • The Intersection of Art and Identity: How Self-Expression Shapes Artists' Works.
  • The Role of Nonlinear Narrative in Postmodern Novels: Techniques and Interpretation.
  • The Influence of Jazz on African American Literature: A Comparative Study.
  • The Complexity of Visual Storytelling: Graphic Novels and Their Narrative Power.
  • The Art of Literary Translation: Challenges, Impact, and Interpretation.
  • The Evolution of Music Videos: From Promotional Tools to a Unique Art Form.
  • The Literary Techniques of Magical Realism: Exploring Reality and Fantasy.
  • The Impact of Visual Arts in Advertising: Analyzing the Connection Between Art and Commerce.
  • Art in Times of Crisis: How Artists Respond to Societal and Political Challenges.

Critical Analysis Essay Topics on Culture

Culture is a dynamic and multifaceted aspect of our society, encompassing everything from language and religion to art and music. As a result, there are countless possibilities for critical analysis essays on culture. Whether you're interested in exploring the complexities of globalization or delving into the nuances of cultural identity, there's a wealth of topics to choose from:

  • The Influence of K-Pop on Global Youth Culture: A Comparative Study.
  • Cultural Significance of Street Art in Urban Spaces: Beyond Vandalism.
  • The Role of Mythology in Shaping Indigenous Cultures and Belief Systems.
  • Nollywood: Analyzing the Cultural Impact of Nigerian Cinema on the African Diaspora.
  • The Language of Hip-Hop Lyrics: A Semiotic Analysis of Cultural Expression.
  • Digital Nomads and Cultural Adaptation: Examining the Subculture of Remote Work.
  • The Cultural Significance of Tattooing Among Indigenous Tribes in Oceania.
  • The Art of Culinary Fusion: Analyzing Cross-Cultural Food Trends and Innovation.
  • The Impact of Cultural Festivals on Local Identity and Economy.
  • The Influence of Internet Memes on Language and Cultural Evolution.

How to Write a Critical Analysis: Easy Steps

When wondering how to write a critical analysis essay, remember that it can be a challenging but rewarding process. Crafting a critical analysis example requires a careful and thoughtful examination of a text or artwork to assess its strengths and weaknesses and broader implications. The key to success is to approach the task in a systematic and organized manner, breaking it down into two distinct steps: critical reading and critical writing. Here are some tips for each step of the process to help you write a critical essay.

Step 1: Critical Reading

Here are some tips for critical reading that can help you with your critical analysis paper:

  • Read actively : Don't just read the text passively, but actively engage with it by highlighting or underlining important points, taking notes, and asking questions.
  • Identify the author's main argument: Figure out what the author is trying to say and what evidence they use to support their argument.
  • Evaluate the evidence: Determine whether the evidence is reliable, relevant, and sufficient to support the author's argument.
  • Analyze the author's tone and style: Consider the author's tone and style and how it affects the reader's interpretation of the text.
  • Identify assumptions: Identify any underlying assumptions the author makes and consider whether they are valid or questionable.
  • Consider alternative perspectives: Consider alternative perspectives or interpretations of the text and consider how they might affect the author's argument.
  • Assess the author's credibility : Evaluate the author's credibility by considering their expertise, biases, and motivations.
  • Consider the context: Consider the historical, social, cultural, and political context in which the text was written and how it affects its meaning.
  • Pay attention to language: Pay attention to the author's language, including metaphors, symbolism, and other literary devices.
  • Synthesize your analysis: Use your analysis of the text to develop a well-supported argument in your critical analysis essay.

Step 2: Critical Analysis Writing

Here are some tips for critical analysis writing, with examples:

How to Write a Critical Analysis

  • Start with a strong thesis statement: A strong critical analysis thesis is the foundation of any critical analysis essay. It should clearly state your argument or interpretation of the text. You can also consult us on how to write a thesis statement . Meanwhile, here is a clear example:
  • Weak thesis statement: 'The author of this article is wrong.'
  • Strong thesis statement: 'In this article, the author's argument fails to consider the socio-economic factors that contributed to the issue, rendering their analysis incomplete.'
  • Use evidence to support your argument: Use evidence from the text to support your thesis statement, and make sure to explain how the evidence supports your argument. For example:
  • Weak argument: 'The author of this article is biased.'
  • Strong argument: 'The author's use of emotional language and selective evidence suggests a bias towards one particular viewpoint, as they fail to consider counterarguments and present a balanced analysis.'
  • Analyze the evidence : Analyze the evidence you use by considering its relevance, reliability, and sufficiency. For example:
  • Weak analysis: 'The author mentions statistics in their argument.'
  • Strong analysis: 'The author uses statistics to support their argument, but it is important to note that these statistics are outdated and do not take into account recent developments in the field.'
  • Use quotes and paraphrases effectively: Use quotes and paraphrases to support your argument and properly cite your sources. For example:
  • Weak use of quotes: 'The author said, 'This is important.'
  • Strong use of quotes: 'As the author points out, 'This issue is of utmost importance in shaping our understanding of the problem' (p. 25).'
  • Use clear and concise language: Use clear and concise language to make your argument easy to understand, and avoid jargon or overly complicated language. For example:
  • Weak language: 'The author's rhetorical devices obfuscate the issue.'
  • Strong language: 'The author's use of rhetorical devices such as metaphor and hyperbole obscures the key issues at play.'
  • Address counterarguments: Address potential counterarguments to your argument and explain why your interpretation is more convincing. For example:
  • Weak argument: 'The author is wrong because they did not consider X.'
  • Strong argument: 'While the author's analysis is thorough, it overlooks the role of X in shaping the issue. However, by considering this factor, a more nuanced understanding of the problem emerges.'
  • Consider the audience: Consider your audience during your writing process. Your language and tone should be appropriate for your audience and should reflect the level of knowledge they have about the topic. For example:
  • Weak language: 'As any knowledgeable reader can see, the author's argument is flawed.'
  • Strong language: 'Through a critical analysis of the author's argument, it becomes clear that there are gaps in their analysis that require further consideration.'

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Creating a Detailed Critical Analysis Essay Outline

Creating a detailed outline is essential when writing a critical analysis essay. It helps you organize your thoughts and arguments, ensuring your essay flows logically and coherently. Here is a detailed critical analysis outline from our dissertation writers :

I. Introduction

A. Background information about the text and its author

B. Brief summary of the text

C. Thesis statement that clearly states your argument

II. Analysis of the Text

A. Overview of the text's main themes and ideas

B. Examination of the author's writing style and techniques

C. Analysis of the text's structure and organization

III. Evaluation of the Text

A. Evaluation of the author's argument and evidence

B. Analysis of the author's use of language and rhetorical strategies

C. Assessment of the text's effectiveness and relevance to the topic

IV. Discussion of the Context

A. Exploration of the historical, cultural, and social context of the text

B. Examination of the text's influence on its audience and society

C. Analysis of the text's significance and relevance to the present day

V. Counter Arguments and Responses

A. Identification of potential counterarguments to your argument

B. Refutation of counterarguments and defense of your position

C. Acknowledgement of the limitations and weaknesses of your argument

VI. Conclusion

A. Recap of your argument and main points

B. Evaluation of the text's significance and relevance

C. Final thoughts and recommendations for further research or analysis.

This outline can be adjusted to fit the specific requirements of your essay. Still, it should give you a solid foundation for creating a detailed and well-organized critical analysis essay.

Useful Techniques Used in Literary Criticism

There are several techniques used in literary criticism to analyze and evaluate a work of literature. Here are some of the most common techniques:

How to Write a Critical Analysis

  • Close reading: This technique involves carefully analyzing a text to identify its literary devices, themes, and meanings.
  • Historical and cultural context: This technique involves examining the historical and cultural context of a work of literature to understand the social, political, and cultural influences that shaped it.
  • Structural analysis: This technique involves analyzing the structure of a text, including its plot, characters, and narrative techniques, to identify patterns and themes.
  • Formalism: This technique focuses on the literary elements of a text, such as its language, imagery, and symbolism, to analyze its meaning and significance.
  • Psychological analysis: This technique examines the psychological and emotional aspects of a text, including the motivations and desires of its characters, to understand the deeper meanings and themes.
  • Feminist and gender analysis: This technique focuses on the representation of gender and sexuality in a text, including how gender roles and stereotypes are reinforced or challenged.
  • Marxist and social analysis: This technique examines the social and economic structures portrayed in a text, including issues of class, power, and inequality.

By using these and other techniques, literary critics can offer insightful and nuanced analyses of works of literature, helping readers to understand and appreciate the complexity and richness of the texts.

Sample Critical Analysis Essay

Now that you know how to write a critical analysis, take a look at the critical analysis essay sample provided by our research paper writers and better understand this kind of paper!

Final Words

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example of critical appraisal essay

“The purpose of critical appraisal is to determine the scientific merit of a research report and its applicability to clinical decision making.” 1 Conducting a critical appraisal of a study is imperative to any well executed evidence review, but the process can be time consuming and difficult. 2 The critical appraisal process requires “a methodological approach coupled with the right tools and skills to match these methods is essential for finding meaningful results.” 3 In short, it is a method of differentiating good research from bad research.

Critical Appraisal by Study Design (featured tools)

  • Non-RCTs or Observational Studies
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  • Tool Repository
  • AMSTAR 2 The original AMSTAR was developed to assess the risk of bias in systematic reviews that included only randomized controlled trials. AMSTAR 2 was published in 2017 and allows researchers to “identify high quality systematic reviews, including those based on non-randomised studies of healthcare interventions.” 4 more... less... AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews)
  • ROBIS ROBIS is a tool designed specifically to assess the risk of bias in systematic reviews. “The tool is completed in three phases: (1) assess relevance(optional), (2) identify concerns with the review process, and (3) judge risk of bias in the review. Signaling questions are included to help assess specific concerns about potential biases with the review.” 5 more... less... ROBIS (Risk of Bias in Systematic Reviews)
  • BMJ Framework for Assessing Systematic Reviews This framework provides a checklist that is used to evaluate the quality of a systematic review.
  • CASP Checklist for Systematic Reviews This CASP checklist is not a scoring system, but rather a method of appraising systematic reviews by considering: 1. Are the results of the study valid? 2. What are the results? 3. Will the results help locally? more... less... CASP (Critical Appraisal Skills Programme)
  • CEBM Systematic Reviews Critical Appraisal Sheet The CEBM’s critical appraisal sheets are designed to help you appraise the reliability, importance, and applicability of clinical evidence. more... less... CEBM (Centre for Evidence-Based Medicine)
  • JBI Critical Appraisal Tools, Checklist for Systematic Reviews JBI Critical Appraisal Tools help you assess the methodological quality of a study and to determine the extent to which study has addressed the possibility of bias in its design, conduct and analysis.
  • NHLBI Study Quality Assessment of Systematic Reviews and Meta-Analyses The NHLBI’s quality assessment tools were designed to assist reviewers in focusing on concepts that are key for critical appraisal of the internal validity of a study. more... less... NHLBI (National Heart, Lung, and Blood Institute)
  • RoB 2 RoB 2 “provides a framework for assessing the risk of bias in a single estimate of an intervention effect reported from a randomized trial,” rather than the entire trial. 6 more... less... RoB 2 (revised tool to assess Risk of Bias in randomized trials)
  • CASP Randomised Controlled Trials Checklist This CASP checklist considers various aspects of an RCT that require critical appraisal: 1. Is the basic study design valid for a randomized controlled trial? 2. Was the study methodologically sound? 3. What are the results? 4. Will the results help locally? more... less... CASP (Critical Appraisal Skills Programme)
  • CONSORT Statement The CONSORT checklist includes 25 items to determine the quality of randomized controlled trials. “Critical appraisal of the quality of clinical trials is possible only if the design, conduct, and analysis of RCTs are thoroughly and accurately described in the report.” 7 more... less... CONSORT (Consolidated Standards of Reporting Trials)
  • NHLBI Study Quality Assessment of Controlled Intervention Studies The NHLBI’s quality assessment tools were designed to assist reviewers in focusing on concepts that are key for critical appraisal of the internal validity of a study. more... less... NHLBI (National Heart, Lung, and Blood Institute)
  • JBI Critical Appraisal Tools Checklist for Randomized Controlled Trials JBI Critical Appraisal Tools help you assess the methodological quality of a study and to determine the extent to which study has addressed the possibility of bias in its design, conduct and analysis.
  • ROBINS-I ROBINS-I is a “tool for evaluating risk of bias in estimates of the comparative effectiveness… of interventions from studies that did not use randomization to allocate units… to comparison groups.” 8 more... less... ROBINS-I (Risk Of Bias in Non-randomized Studies – of Interventions)
  • NOS This tool is used primarily to evaluate and appraise case-control or cohort studies. more... less... NOS (Newcastle-Ottawa Scale)
  • AXIS Cross-sectional studies are frequently used as an evidence base for diagnostic testing, risk factors for disease, and prevalence studies. “The AXIS tool focuses mainly on the presented [study] methods and results.” 9 more... less... AXIS (Appraisal tool for Cross-Sectional Studies)
  • NHLBI Study Quality Assessment Tools for Non-Randomized Studies The NHLBI’s quality assessment tools were designed to assist reviewers in focusing on concepts that are key for critical appraisal of the internal validity of a study. • Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies • Quality Assessment of Case-Control Studies • Quality Assessment Tool for Before-After (Pre-Post) Studies With No Control Group • Quality Assessment Tool for Case Series Studies more... less... NHLBI (National Heart, Lung, and Blood Institute)
  • Case Series Studies Quality Appraisal Checklist Developed by the Institute of Health Economics (Canada), the checklist is comprised of 20 questions to assess “the robustness of the evidence of uncontrolled, [case series] studies.” 10
  • Methodological Quality and Synthesis of Case Series and Case Reports In this paper, Dr. Murad and colleagues “present a framework for appraisal, synthesis and application of evidence derived from case reports and case series.” 11
  • MINORS The MINORS instrument contains 12 items and was developed for evaluating the quality of observational or non-randomized studies. 12 This tool may be of particular interest to researchers who would like to critically appraise surgical studies. more... less... MINORS (Methodological Index for Non-Randomized Studies)
  • JBI Critical Appraisal Tools for Non-Randomized Trials JBI Critical Appraisal Tools help you assess the methodological quality of a study and to determine the extent to which study has addressed the possibility of bias in its design, conduct and analysis. • Checklist for Analytical Cross Sectional Studies • Checklist for Case Control Studies • Checklist for Case Reports • Checklist for Case Series • Checklist for Cohort Studies
  • QUADAS-2 The QUADAS-2 tool “is designed to assess the quality of primary diagnostic accuracy studies… [it] consists of 4 key domains that discuss patient selection, index test, reference standard, and flow of patients through the study and timing of the index tests and reference standard.” 13 more... less... QUADAS-2 (a revised tool for the Quality Assessment of Diagnostic Accuracy Studies)
  • JBI Critical Appraisal Tools Checklist for Diagnostic Test Accuracy Studies JBI Critical Appraisal Tools help you assess the methodological quality of a study and to determine the extent to which study has addressed the possibility of bias in its design, conduct and analysis.
  • STARD 2015 The authors of the standards note that “[e]ssential elements of [diagnostic accuracy] study methods are often poorly described and sometimes completely omitted, making both critical appraisal and replication difficult, if not impossible.”10 The Standards for the Reporting of Diagnostic Accuracy Studies was developed “to help… improve completeness and transparency in reporting of diagnostic accuracy studies.” 14 more... less... STARD 2015 (Standards for the Reporting of Diagnostic Accuracy Studies)
  • CASP Diagnostic Study Checklist This CASP checklist considers various aspects of diagnostic test studies including: 1. Are the results of the study valid? 2. What were the results? 3. Will the results help locally? more... less... CASP (Critical Appraisal Skills Programme)
  • CEBM Diagnostic Critical Appraisal Sheet The CEBM’s critical appraisal sheets are designed to help you appraise the reliability, importance, and applicability of clinical evidence. more... less... CEBM (Centre for Evidence-Based Medicine)
  • SYRCLE’s RoB “[I]mplementation of [SYRCLE’s RoB tool] will facilitate and improve critical appraisal of evidence from animal studies. This may… enhance the efficiency of translating animal research into clinical practice and increase awareness of the necessity of improving the methodological quality of animal studies.” 15 more... less... SYRCLE’s RoB (SYstematic Review Center for Laboratory animal Experimentation’s Risk of Bias)
  • ARRIVE 2.0 “The [ARRIVE 2.0] guidelines are a checklist of information to include in a manuscript to ensure that publications [on in vivo animal studies] contain enough information to add to the knowledge base.” 16 more... less... ARRIVE 2.0 (Animal Research: Reporting of In Vivo Experiments)
  • Critical Appraisal of Studies Using Laboratory Animal Models This article provides “an approach to critically appraising papers based on the results of laboratory animal experiments,” and discusses various “bias domains” in the literature that critical appraisal can identify. 17
  • CEBM Critical Appraisal of Qualitative Studies Sheet The CEBM’s critical appraisal sheets are designed to help you appraise the reliability, importance and applicability of clinical evidence. more... less... CEBM (Centre for Evidence-Based Medicine)
  • CASP Qualitative Studies Checklist This CASP checklist considers various aspects of qualitative research studies including: 1. Are the results of the study valid? 2. What were the results? 3. Will the results help locally? more... less... CASP (Critical Appraisal Skills Programme)
  • Quality Assessment and Risk of Bias Tool Repository Created by librarians at Duke University, this extensive listing contains over 100 commonly used risk of bias tools that may be sorted by study type.
  • Latitudes Network A library of risk of bias tools for use in evidence syntheses that provides selection help and training videos.

References & Recommended Reading

1.     Kolaski, K., Logan, L. R., & Ioannidis, J. P. (2024). Guidance to best tools and practices for systematic reviews .  British Journal of Pharmacology ,  181 (1), 180-210

2.    Portney LG.  Foundations of clinical research : applications to evidence-based practice.  Fourth edition. ed. Philadelphia: F A Davis; 2020.

3.     Fowkes FG, Fulton PM.  Critical appraisal of published research: introductory guidelines.   BMJ (Clinical research ed).  1991;302(6785):1136-1140.

4.     Singh S.  Critical appraisal skills programme.   Journal of Pharmacology and Pharmacotherapeutics.  2013;4(1):76-77.

5.     Shea BJ, Reeves BC, Wells G, et al.  AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both.   BMJ (Clinical research ed).  2017;358:j4008.

6.     Whiting P, Savovic J, Higgins JPT, et al.  ROBIS: A new tool to assess risk of bias in systematic reviews was developed.   Journal of clinical epidemiology.  2016;69:225-234.

7.     Sterne JAC, Savovic J, Page MJ, et al.  RoB 2: a revised tool for assessing risk of bias in randomised trials.  BMJ (Clinical research ed).  2019;366:l4898.

8.     Moher D, Hopewell S, Schulz KF, et al.  CONSORT 2010 Explanation and Elaboration: Updated guidelines for reporting parallel group randomised trials.  Journal of clinical epidemiology.  2010;63(8):e1-37.

9.     Sterne JA, Hernan MA, Reeves BC, et al.  ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions.  BMJ (Clinical research ed).  2016;355:i4919.

10.     Downes MJ, Brennan ML, Williams HC, Dean RS.  Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS).   BMJ open.  2016;6(12):e011458.

11.   Guo B, Moga C, Harstall C, Schopflocher D.  A principal component analysis is conducted for a case series quality appraisal checklist.   Journal of clinical epidemiology.  2016;69:199-207.e192.

12.   Murad MH, Sultan S, Haffar S, Bazerbachi F.  Methodological quality and synthesis of case series and case reports.  BMJ evidence-based medicine.  2018;23(2):60-63.

13.   Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J.  Methodological index for non-randomized studies (MINORS): development and validation of a new instrument.   ANZ journal of surgery.  2003;73(9):712-716.

14.   Whiting PF, Rutjes AWS, Westwood ME, et al.  QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies.   Annals of internal medicine.  2011;155(8):529-536.

15.   Bossuyt PM, Reitsma JB, Bruns DE, et al.  STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies.   BMJ (Clinical research ed).  2015;351:h5527.

16.   Hooijmans CR, Rovers MM, de Vries RBM, Leenaars M, Ritskes-Hoitinga M, Langendam MW.  SYRCLE's risk of bias tool for animal studies.   BMC medical research methodology.  2014;14:43.

17.   Percie du Sert N, Ahluwalia A, Alam S, et al.  Reporting animal research: Explanation and elaboration for the ARRIVE guidelines 2.0.  PLoS biology.  2020;18(7):e3000411.

18.   O'Connor AM, Sargeant JM.  Critical appraisal of studies using laboratory animal models.   ILAR journal.  2014;55(3):405-417.

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  • Volume 25, Issue 1
  • Critical appraisal of qualitative research: necessity, partialities and the issue of bias
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  • http://orcid.org/0000-0001-5660-8224 Veronika Williams ,
  • Anne-Marie Boylan ,
  • http://orcid.org/0000-0003-4597-1276 David Nunan
  • Nuffield Department of Primary Care Health Sciences , University of Oxford, Radcliffe Observatory Quarter , Oxford , UK
  • Correspondence to Dr Veronika Williams, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK; veronika.williams{at}phc.ox.ac.uk

https://doi.org/10.1136/bmjebm-2018-111132

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  • qualitative research

Introduction

Qualitative evidence allows researchers to analyse human experience and provides useful exploratory insights into experiential matters and meaning, often explaining the ‘how’ and ‘why’. As we have argued previously 1 , qualitative research has an important place within evidence-based healthcare, contributing to among other things policy on patient safety, 2 prescribing, 3 4 and understanding chronic illness. 5 Equally, it offers additional insight into quantitative studies, explaining contextual factors surrounding a successful intervention or why an intervention might have ‘failed’ or ‘succeeded’ where effect sizes cannot. It is for these reasons that the MRC strongly recommends including qualitative evaluations when developing and evaluating complex interventions. 6

Critical appraisal of qualitative research

Is it necessary.

Although the importance of qualitative research to improve health services and care is now increasingly widely supported (discussed in paper 1), the role of appraising the quality of qualitative health research is still debated. 8 10 Despite a large body of literature focusing on appraisal and rigour, 9 11–15 often referred to as ‘trustworthiness’ 16 in qualitative research, there remains debate about how to —and even whether to—critically appraise qualitative research. 8–10 17–19 However, if we are to make a case for qualitative research as integral to evidence-based healthcare, then any argument to omit a crucial element of evidence-based practice is difficult to justify. That being said, simply applying the standards of rigour used to appraise studies based on the positivist paradigm (Positivism depends on quantifiable observations to test hypotheses and assumes that the researcher is independent of the study. Research situated within a positivist paradigm isbased purely on facts and consider the world to be external and objective and is concerned with validity, reliability and generalisability as measures of rigour.) would be misplaced given the different epistemological underpinnings of the two types of data.

Given its scope and its place within health research, the robust and systematic appraisal of qualitative research to assess its trustworthiness is as paramount to its implementation in clinical practice as any other type of research. It is important to appraise different qualitative studies in relation to the specific methodology used because the methodological approach is linked to the ‘outcome’ of the research (eg, theory development, phenomenological understandings and credibility of findings). Moreover, appraisal needs to go beyond merely describing the specific details of the methods used (eg, how data were collected and analysed), with additional focus needed on the overarching research design and its appropriateness in accordance with the study remit and objectives.

Poorly conducted qualitative research has been described as ‘worthless, becomes fiction and loses its utility’. 20 However, without a deep understanding of concepts of quality in qualitative research or at least an appropriate means to assess its quality, good qualitative research also risks being dismissed, particularly in the context of evidence-based healthcare where end users may not be well versed in this paradigm.

How is appraisal currently performed?

Appraising the quality of qualitative research is not a new concept—there are a number of published appraisal tools, frameworks and checklists in existence. 21–23  An important and often overlooked point is the confusion between tools designed for appraising methodological quality and reporting guidelines designed to assess the quality of methods reporting. An example is the Consolidate Criteria for Reporting Qualitative Research (COREQ) 24 checklist, which was designed to provide standards for authors when reporting qualitative research but is often mistaken for a methods appraisal tool. 10

Broadly speaking there are two types of critical appraisal approaches for qualitative research: checklists and frameworks. Checklists have often been criticised for confusing quality in qualitative research with ‘technical fixes’ 21 25 , resulting in the erroneous prioritisation of particular aspects of methodological processes over others (eg, multiple coding and triangulation). It could be argued that a checklist approach adopts the positivist paradigm, where the focus is on objectively assessing ‘quality’ where the assumptions is that the researcher is independent of the research conducted. This may result in the application of quantitative understandings of bias in order to judge aspects of recruitment, sampling, data collection and analysis in qualitative research papers. One of the most widely used appraisal tools is the Critical Appraisal Skills Programme (CASP) 26 and along with the JBI QARI (Joanna Briggs Institute Qualitative Assessment and Assessment Instrument) 27 presents examples which tend to mimic the quantitative approach to appraisal. The CASP qualitative tool follows that of other CASP appraisal tools for quantitative research designs developed in the 1990s. The similarities are therefore unsurprising given the status of qualitative research at that time.

Frameworks focus on the overarching concepts of quality in qualitative research, including transparency, reflexivity, dependability and transferability (see box 1 ). 11–13 15 16 20 28 However, unless the reader is familiar with these concepts—their meaning and impact, and how to interpret them—they will have difficulty applying them when critically appraising a paper.

The main issue concerning currently available checklist and framework appraisal methods is that they take a broad brush approach to ‘qualitative’ research as whole, with few, if any, sufficiently differentiating between the different methodological approaches (eg, Grounded Theory, Interpretative Phenomenology, Discourse Analysis) nor different methods of data collection (interviewing, focus groups and observations). In this sense, it is akin to taking the entire field of ‘quantitative’ study designs and applying a single method or tool for their quality appraisal. In the case of qualitative research, checklists, therefore, offer only a blunt and arguably ineffective tool and potentially promote an incomplete understanding of good ‘quality’ in qualitative research. Likewise, current framework methods do not take into account how concepts differ in their application across the variety of qualitative approaches and, like checklists, they also do not differentiate between different qualitative methodologies.

On the need for specific appraisal tools

Current approaches to the appraisal of the methodological rigour of the differing types of qualitative research converge towards checklists or frameworks. More importantly, the current tools do not explicitly acknowledge the prejudices that may be present in the different types of qualitative research.

Concepts of rigour or trustworthiness within qualitative research 31

Transferability: the extent to which the presented study allows readers to make connections between the study’s data and wider community settings, ie, transfer conceptual findings to other contexts.

Credibility: extent to which a research account is believable and appropriate, particularly in relation to the stories told by participants and the interpretations made by the researcher.

Reflexivity: refers to the researchers’ engagement of continuous examination and explanation of how they have influenced a research project from choosing a research question to sampling, data collection, analysis and interpretation of data.

Transparency: making explicit the whole research process from sampling strategies, data collection to analysis. The rationale for decisions made is as important as the decisions themselves.

However, we often talk about these concepts in general terms, and it might be helpful to give some explicit examples of how the ‘technical processes’ affect these, for example, partialities related to:

Selection: recruiting participants via gatekeepers, such as healthcare professionals or clinicians, who may select them based on whether they believe them to be ‘good’ participants for interviews/focus groups.

Data collection: poor interview guide with closed questions which encourage yes/no answers and/leading questions.

Reflexivity and transparency: where researchers may focus their analysis on preconceived ideas rather than ground their analysis in the data and do not reflect on the impact of this in a transparent way.

The lack of tailored, method-specific appraisal tools has potentially contributed to the poor uptake and use of qualitative research for informing evidence-based decision making. To improve this situation, we propose the need for more robust quality appraisal tools that explicitly encompass both the core design aspects of all qualitative research (sampling/data collection/analysis) but also considered the specific partialities that can be presented with different methodological approaches. Such tools might draw on the strengths of current frameworks and checklists while providing users with sufficient understanding of concepts of rigour in relation to the different types of qualitative methods. We provide an outline of such tools in the third and final paper in this series.

As qualitative research becomes ever more embedded in health science research, and in order for that research to have better impact on healthcare decisions, we need to rethink critical appraisal and develop tools that allow differentiated evaluations of the myriad of qualitative methodological approaches rather than continuing to treat qualitative research as a single unified approach.

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  • ↵ CASP (Critical Appraisal Skills Programme). date unknown . http://www.phru.nhs.uk/Pages/PHD/CASP.htm .
  • ↵ The Joanna Briggs Institute . JBI QARI Critical appraisal checklist for interpretive & critical research . Adelaide : The Joanna Briggs Institute , 2014 .
  • Stephens J ,

Contributors VW and DN: conceived the idea for this article. VW: wrote the first draft. AMB and DN: contributed to the final draft. All authors approve the submitted article.

Competing interests None declared.

Provenance and peer review Not commissioned; externally peer reviewed.

Correction notice This article has been updated since its original publication to include a new reference (reference 1.)

Read the full text or download the PDF:

Medicine: A Brief Guide to Critical Appraisal

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Have you ever seen a news piece about a scientific breakthrough and wondered how accurate the reporting is? Or wondered about the research behind the headlines? This is the beginning of critical appraisal: thinking critically about what you see and hear, and asking questions to determine how much of a 'breakthrough' something really is.

The article " Is this study legit? 5 questions to ask when reading news stories of medical research " is a succinct introduction to the sorts of questions you should ask in these situations, but there's more than that when it comes to critical appraisal. Read on to learn more about this practical and crucial aspect of evidence-based practice.

What is Critical Appraisal?

Critical appraisal forms part of the process of evidence-based practice. “ Evidence-based practice across the health professions ” outlines the fives steps of this process. Critical appraisal is step three:

  • Ask a question
  • Access the information
  • Appraise the articles found
  • Apply the information

Critical appraisal is the examination of evidence to determine applicability to clinical practice. It considers (1) :

  • Are the results of the study believable?
  • Was the study methodologically sound?  
  • What is the clinical importance of the study’s results?
  • Are the findings sufficiently important? That is, are they practice-changing?  
  • Are the results of the study applicable to your patient?
  • Is your patient comparable to the population in the study?

Why Critically Appraise?

If practitioners hope to ‘stand on the shoulders of giants’, practicing in a manner that is responsive to the discoveries of the research community, then it makes sense for the responsible, critically thinking practitioner to consider the reliability, influence, and relevance of the evidence presented to them.

While critical thinking is valuable, it is also important to avoid treading too much into cynicism; in the words of Hoffman et al. (1):

… keep in mind that no research is perfect and that it is important not to be overly critical of research articles. An article just needs to be good enough to assist you to make a clinical decision.

How do I Critically Appraise?

Evidence-based practice is intended to be practical . To enable this, critical appraisal checklists have been developed to guide practitioners through the process in an efficient yet comprehensive manner.

Critical appraisal checklists guide the reader through the appraisal process by prompting the reader to ask certain questions of the paper they are appraising. There are many different critical appraisal checklists but the best apply certain questions based on what type of study the paper is describing. This allows for a more nuanced and appropriate appraisal. Wherever possible, choose the appraisal tool that best fits the study you are appraising.

Like many things in life, repetition builds confidence and the more you apply critical appraisal tools (like checklists) to the literature the more the process will become second nature for you and the more effective you will be.

How do I Identify Study Types?

Identifying the study type described in the paper is sometimes a harder job than it should be. Helpful papers spell out the study type in the title or abstract, but not all papers are helpful in this way. As such, the critical appraiser may need to do a little work to identify what type of study they are about to critique. Again, experience builds confidence but having an understanding of the typical features of common study types certainly helps.

To assist with this, the Library has produced a guide to study designs in health research .

The following selected references will help also with understanding study types but there are also other resources in the Library’s collection and freely available online:

  • The “ How to read a paper ” article series from The BMJ is a well-known source for establishing an understanding of the features of different study types; this series was subsequently adapted into a book (“ How to read a paper: the basics of evidence-based medicine ”) which offers more depth and currency than that found in the articles. (2)  
  • Chapter two of “ Evidence-based practice across the health professions ” briefly outlines some study types and their application; subsequent chapters go into more detail about different study types depending on what type of question they are exploring (intervention, diagnosis, prognosis, qualitative) along with systematic reviews.  
  • “ Clinical evidence made easy ” contains several chapters on different study designs and also includes critical appraisal tools. (3)  
  • “ Translational research and clinical practice: basic tools for medical decision making and self-learning ” unpacks the components of a paper, explaining their purpose along with key features of different study designs. (4)  
  • The BMJ website contains the contents of the fourth edition of the book “ Epidemiology for the uninitiated ”. This eBook contains chapters exploring ecological studies, longitudinal studies, case-control and cross-sectional studies, and experimental studies.

Reporting Guidelines

In order to encourage consistency and quality, authors of reports on research should follow reporting guidelines when writing their papers. The EQUATOR Network is a good source of reporting guidelines for the main study types.

While these guidelines aren't critical appraisal tools as such, they can assist by prompting you to consider whether the reporting of the research is missing important elements.

Once you've identified the study type at hand, visit EQUATOR to find the associated reporting guidelines and ask yourself: does this paper meet the guideline for its study type?

Which Checklist Should I Use?

Determining which checklist to use ultimately comes down to finding an appraisal tool that:

  • Fits best with the study you are appraising
  • Is reliable, well-known or otherwise validated
  • You understand and are comfortable using

Below are some sources of critical appraisal tools. These have been selected as they are known to be widely accepted, easily applicable, and relevant to appraisal of a typical journal article. You may find another tool that you prefer, which is acceptable as long as it is defensible:

  • CASP (Critical Appraisal Skills Programme)
  • JBI (Joanna Briggs Institute)
  • CEBM (Centre for Evidence-Based Medicine)
  • SIGN (Scottish Intercollegiate Guidelines Network)
  • STROBE (Strengthing the Reporting of Observational Studies in Epidemiology)
  • BMJ Best Practice

The information on this page has been compiled by the Medical Librarian. Please contact the Library's Health Team ( [email protected] ) for further assistance.

Reference list

1. Hoffmann T, Bennett S, Del Mar C. Evidence-based practice across the health professions. 2nd ed. Chatswood, N.S.W., Australia: Elsevier Churchill Livingston; 2013.

2. Greenhalgh T. How to read a paper : the basics of evidence-based medicine. 5th ed. Chichester, West Sussex: Wiley; 2014.

3. Harris M, Jackson D, Taylor G. Clinical evidence made easy. Oxfordshire, England: Scion Publishing; 2014.

4. Aronoff SC. Translational research and clinical practice: basic tools for medical decision making and self-learning. New York: Oxford University Press; 2011.

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The Critical Appraisal of the Article

Introduction, critical appraisal, relevance of the study, validity of the study, results of the study, strengths and limitations of the study, recommendations, reference list.

Critical appraisal is an important factor to determine the relevance, validity, and transparency of the research. This paper presents the critical appraisal of the article ‘Light drinking in pregnancy, a risk for behavioral problems and cognitive deficits at 3 years of age’ with special focus on the relevance of this article, validity of the article, and validity of the result of the research in the article.

It is a critical appraisal of the article ‘Light drinking in pregnancy, a risk for behavioral problems and cognitive deficits at 3 years of age’ which was published by Oxford University Press on behalf of the International Epidemiological Association. “Critical appraisal is the process of systematically examining research evidence to assess its validity, relevance and results before using it to inform a decision.” (Abdel-Ghaffar, n.d., p.12). Critical appraisal is an important part of the evidence-based clinical practice to assess the validity of the research before going to implement the results of the study.

Researches have shown that heavy drinking during pregnancy affects children in their cognitive and behavioral development. But, there prevails ignorance on whether light drinking of the pregnant lady will affect the fetus. The objective of the study is to assess whether there is any behavioral problem and cognitive deficits among the children of those who drink lightly during pregnancy. It is a relevant subject for the time being. There are strong debates throughout the world that emphasizes the side effects of using alcohol by pregnant ladies. The result of the study shows that children born to mothers who drink lightly during pregnancy do not inflict the problem of behavioral disorders and cognitive deficits. But, the research reveals that children of heavy drinking mothers during pregnancy expose to different health issues. The result of the study can be taken for public information since there lacks of knowledge on the problem.

This study used the Millennium Cohort study which is a longitudinal study of infants who are born in the United Kingdom and the sample was taken from England, Wales, Scotland, and Northern Island. Interviews and home visits were the two methods used in the assessment. Three questionnaires were used, namely, Strengths and Difficulties Questionnaire (SDQ) to assess the behavioral problems and British Ability Scale (BAS) and the Bracken School Readiness Assessment (BSRA) to assess the cognitive deficits of the children. The questions in the interview focused on the socio-economic situation, health problems, and drinking during pregnancy. The study addressed the real problem and achieved its objectives. Interviews were conducted by experts. There were two steps in the study and the first part of the survey was conducted when the cohort members were aged 9 months and the second part of the survey was conducted when they became three years. Therefore, they completed the follow-up accurately.

The findings answer the research objective that drinking lightly during pregnancy will not lead to the behavioral problems and cognitive deficits of the children. The result is very significant and precise to the objective of the study. It was noticeable that the J-shaped relationship between drinking during pregnancy and scores obtained by the children. There were no variations between the results of abstinent mothers and light drinkers at the time of pregnancy.

In this study, two-third of the mothers were those who include in the category of abstinence, twenty-nine percent were light drinkers, six percent were moderate drinkers and two percent were heavy drinkers.

“The data used in our study were from a large nationally representative sample of young children that were collected prospectively. However, the Millennium Cohort Study sample is not representative of all pregnancies or births and so data on miscarriages, stillbirths, and neonatal deaths were not included.” (Kelly, Y., Sacker, Gray, Kelly, J., Wolke & Quigley, 2008, p.6). This study unravels the widespread alcohol consumption of pregnant women even though there is a social stigma. The main drawbacks in the study are when there is a stigma about the consumption of alcohol, people will be reluctant to be open about and it is very difficult to give correct measurements for the light drinkers. It cannot be defined accurately what amount is regarded as a light drink, and therefore, it may be hard to restrict the problem to a questionnaire. There may be some other causes for the behavioral problem of children other than the consumption of alcohol. Therefore, the factors like genetic make-up, social determinants such as financial condition; family background, etc also should be taken into consideration and should be assessed very systematically and scientifically.

Pregnant women may probably be loathed to reveal about the intake of alcohol since there exists stigma in society. Therefore the use of a questionnaire would be inappropriate to scribe the responses of the clients. There is vagueness in many of the terms used in the study. Some concepts are beyond the actual definition. For example, light drinking cannot be defined objectively and it varies from person to person. Social drinkers can be categorized as light drinkers but the question is up to what level and quantity. Therefore the responses of the client cannot be limited to some of the questions paused in the questionnaire. To get accurate data for the study and to get the pulse of the clients, it is better to use in-depth interviews and observant participation methods. The quantitative nature of the study may hamper accurate results and thereby reliability. The next flaw of this study is that it had two sweeps. The first had conducted when the children were at nine years of old and the second sweep was conducted when the children were at three years of old. These two sweeps of the study cannot bring effective and reliable information on how the slight drinking of mothers affects the children since there are other leading factors to the development of cognitive and behavioral defects. If the study is conducted using the interview method, the researcher can include the questions according to the changing perceptions of the social norms. When the social norms are being changed in time, the questionnaire which is developed years back will not be apt at the time of the study. Therefore what I would suggest is that it could have been made better and the result could have more been reliable if the study had been conducted qualitatively.

The consumption of alcohol by pregnant women is considered a risk factor for the physical, mental, and cognitive growth of children. Public people have not received accurate information on this issue. The above-referred article shows the outcome of the research on whether the light drinking habit of the mother hampers the development of the fetus in her womb. This paper substantiates the fact that slight drinking of pregnant women will not affect the cognitive and behavioral disorders of the children. The study is needed of the time and it is valid to provide current information on the problem. At the same time, it has underestimated the result of the study being used by questionnaire and quantitative study.

Abdel-Ghaffar, S. (n.d.). Critical appraisal: An overview: What is critical appraisal?. Faculty of Medicine, Cairo University. Web.

Kelly, Y., Sacker, A., Gray, R., Kelly, J., Wolke, D., & Quigley, M A. (2008). Light drinking in pregnancy, a risk for behavioral problems and cognitive deficits at 3 years of age: Strengths and limitations of the study. International Journal of Epidemiology , 1-12. Oxford University Press.

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Critical Appraisal of Clinical Research

Azzam al-jundi.

1 Professor, Department of Orthodontics, King Saud bin Abdul Aziz University for Health Sciences-College of Dentistry, Riyadh, Kingdom of Saudi Arabia.

Salah Sakka

2 Associate Professor, Department of Oral and Maxillofacial Surgery, Al Farabi Dental College, Riyadh, KSA.

Evidence-based practice is the integration of individual clinical expertise with the best available external clinical evidence from systematic research and patient’s values and expectations into the decision making process for patient care. It is a fundamental skill to be able to identify and appraise the best available evidence in order to integrate it with your own clinical experience and patients values. The aim of this article is to provide a robust and simple process for assessing the credibility of articles and their value to your clinical practice.

Introduction

Decisions related to patient value and care is carefully made following an essential process of integration of the best existing evidence, clinical experience and patient preference. Critical appraisal is the course of action for watchfully and systematically examining research to assess its reliability, value and relevance in order to direct professionals in their vital clinical decision making [ 1 ].

Critical appraisal is essential to:

  • Combat information overload;
  • Identify papers that are clinically relevant;
  • Continuing Professional Development (CPD).

Carrying out Critical Appraisal:

Assessing the research methods used in the study is a prime step in its critical appraisal. This is done using checklists which are specific to the study design.

Standard Common Questions:

  • What is the research question?
  • What is the study type (design)?
  • Selection issues.
  • What are the outcome factors and how are they measured?
  • What are the study factors and how are they measured?
  • What important potential confounders are considered?
  • What is the statistical method used in the study?
  • Statistical results.
  • What conclusions did the authors reach about the research question?
  • Are ethical issues considered?

The Critical Appraisal starts by double checking the following main sections:

I. Overview of the paper:

  • The publishing journal and the year
  • The article title: Does it state key trial objectives?
  • The author (s) and their institution (s)

The presence of a peer review process in journal acceptance protocols also adds robustness to the assessment criteria for research papers and hence would indicate a reduced likelihood of publication of poor quality research. Other areas to consider may include authors’ declarations of interest and potential market bias. Attention should be paid to any declared funding or the issue of a research grant, in order to check for a conflict of interest [ 2 ].

II. ABSTRACT: Reading the abstract is a quick way of getting to know the article and its purpose, major procedures and methods, main findings, and conclusions.

  • Aim of the study: It should be well and clearly written.
  • Materials and Methods: The study design and type of groups, type of randomization process, sample size, gender, age, and procedure rendered to each group and measuring tool(s) should be evidently mentioned.
  • Results: The measured variables with their statistical analysis and significance.
  • Conclusion: It must clearly answer the question of interest.

III. Introduction/Background section:

An excellent introduction will thoroughly include references to earlier work related to the area under discussion and express the importance and limitations of what is previously acknowledged [ 2 ].

-Why this study is considered necessary? What is the purpose of this study? Was the purpose identified before the study or a chance result revealed as part of ‘data searching?’

-What has been already achieved and how does this study be at variance?

-Does the scientific approach outline the advantages along with possible drawbacks associated with the intervention or observations?

IV. Methods and Materials section : Full details on how the study was actually carried out should be mentioned. Precise information is given on the study design, the population, the sample size and the interventions presented. All measurements approaches should be clearly stated [ 3 ].

V. Results section : This section should clearly reveal what actually occur to the subjects. The results might contain raw data and explain the statistical analysis. These can be shown in related tables, diagrams and graphs.

VI. Discussion section : This section should include an absolute comparison of what is already identified in the topic of interest and the clinical relevance of what has been newly established. A discussion on a possible related limitations and necessitation for further studies should also be indicated.

Does it summarize the main findings of the study and relate them to any deficiencies in the study design or problems in the conduct of the study? (This is called intention to treat analysis).

  • Does it address any source of potential bias?
  • Are interpretations consistent with the results?
  • How are null findings interpreted?
  • Does it mention how do the findings of this study relate to previous work in the area?
  • Can they be generalized (external validity)?
  • Does it mention their clinical implications/applicability?
  • What are the results/outcomes/findings applicable to and will they affect a clinical practice?
  • Does the conclusion answer the study question?
  • -Is the conclusion convincing?
  • -Does the paper indicate ethics approval?
  • -Can you identify potential ethical issues?
  • -Do the results apply to the population in which you are interested?
  • -Will you use the results of the study?

Once you have answered the preliminary and key questions and identified the research method used, you can incorporate specific questions related to each method into your appraisal process or checklist.

1-What is the research question?

For a study to gain value, it should address a significant problem within the healthcare and provide new or meaningful results. Useful structure for assessing the problem addressed in the article is the Problem Intervention Comparison Outcome (PICO) method [ 3 ].

P = Patient or problem: Patient/Problem/Population:

It involves identifying if the research has a focused question. What is the chief complaint?

E.g.,: Disease status, previous ailments, current medications etc.,

I = Intervention: Appropriately and clearly stated management strategy e.g.,: new diagnostic test, treatment, adjunctive therapy etc.,

C= Comparison: A suitable control or alternative

E.g.,: specific and limited to one alternative choice.

O= Outcomes: The desired results or patient related consequences have to be identified. e.g.,: eliminating symptoms, improving function, esthetics etc.,

The clinical question determines which study designs are appropriate. There are five broad categories of clinical questions, as shown in [ Table/Fig-1 ].

[Table/Fig-1]:

Categories of clinical questions and the related study designs.

2- What is the study type (design)?

The study design of the research is fundamental to the usefulness of the study.

In a clinical paper the methodology employed to generate the results is fully explained. In general, all questions about the related clinical query, the study design, the subjects and the correlated measures to reduce bias and confounding should be adequately and thoroughly explored and answered.

Participants/Sample Population:

Researchers identify the target population they are interested in. A sample population is therefore taken and results from this sample are then generalized to the target population.

The sample should be representative of the target population from which it came. Knowing the baseline characteristics of the sample population is important because this allows researchers to see how closely the subjects match their own patients [ 4 ].

Sample size calculation (Power calculation): A trial should be large enough to have a high chance of detecting a worthwhile effect if it exists. Statisticians can work out before the trial begins how large the sample size should be in order to have a good chance of detecting a true difference between the intervention and control groups [ 5 ].

  • Is the sample defined? Human, Animals (type); what population does it represent?
  • Does it mention eligibility criteria with reasons?
  • Does it mention where and how the sample were recruited, selected and assessed?
  • Does it mention where was the study carried out?
  • Is the sample size justified? Rightly calculated? Is it adequate to detect statistical and clinical significant results?
  • Does it mention a suitable study design/type?
  • Is the study type appropriate to the research question?
  • Is the study adequately controlled? Does it mention type of randomization process? Does it mention the presence of control group or explain lack of it?
  • Are the samples similar at baseline? Is sample attrition mentioned?
  • All studies report the number of participants/specimens at the start of a study, together with details of how many of them completed the study and reasons for incomplete follow up if there is any.
  • Does it mention who was blinded? Are the assessors and participants blind to the interventions received?
  • Is it mentioned how was the data analysed?
  • Are any measurements taken likely to be valid?

Researchers use measuring techniques and instruments that have been shown to be valid and reliable.

Validity refers to the extent to which a test measures what it is supposed to measure.

(the extent to which the value obtained represents the object of interest.)

  • -Soundness, effectiveness of the measuring instrument;
  • -What does the test measure?
  • -Does it measure, what it is supposed to be measured?
  • -How well, how accurately does it measure?

Reliability: In research, the term reliability means “repeatability” or “consistency”

Reliability refers to how consistent a test is on repeated measurements. It is important especially if assessments are made on different occasions and or by different examiners. Studies should state the method for assessing the reliability of any measurements taken and what the intra –examiner reliability was [ 6 ].

3-Selection issues:

The following questions should be raised:

  • - How were subjects chosen or recruited? If not random, are they representative of the population?
  • - Types of Blinding (Masking) Single, Double, Triple?
  • - Is there a control group? How was it chosen?
  • - How are patients followed up? Who are the dropouts? Why and how many are there?
  • - Are the independent (predictor) and dependent (outcome) variables in the study clearly identified, defined, and measured?
  • - Is there a statement about sample size issues or statistical power (especially important in negative studies)?
  • - If a multicenter study, what quality assurance measures were employed to obtain consistency across sites?
  • - Are there selection biases?
  • • In a case-control study, if exercise habits to be compared:
  • - Are the controls appropriate?
  • - Were records of cases and controls reviewed blindly?
  • - How were possible selection biases controlled (Prevalence bias, Admission Rate bias, Volunteer bias, Recall bias, Lead Time bias, Detection bias, etc.,)?
  • • Cross Sectional Studies:
  • - Was the sample selected in an appropriate manner (random, convenience, etc.,)?
  • - Were efforts made to ensure a good response rate or to minimize the occurrence of missing data?
  • - Were reliability (reproducibility) and validity reported?
  • • In an intervention study, how were subjects recruited and assigned to groups?
  • • In a cohort study, how many reached final follow-up?
  • - Are the subject’s representatives of the population to which the findings are applied?
  • - Is there evidence of volunteer bias? Was there adequate follow-up time?
  • - What was the drop-out rate?
  • - Any shortcoming in the methodology can lead to results that do not reflect the truth. If clinical practice is changed on the basis of these results, patients could be harmed.

Researchers employ a variety of techniques to make the methodology more robust, such as matching, restriction, randomization, and blinding [ 7 ].

Bias is the term used to describe an error at any stage of the study that was not due to chance. Bias leads to results in which there are a systematic deviation from the truth. As bias cannot be measured, researchers need to rely on good research design to minimize bias [ 8 ]. To minimize any bias within a study the sample population should be representative of the population. It is also imperative to consider the sample size in the study and identify if the study is adequately powered to produce statistically significant results, i.e., p-values quoted are <0.05 [ 9 ].

4-What are the outcome factors and how are they measured?

  • -Are all relevant outcomes assessed?
  • -Is measurement error an important source of bias?

5-What are the study factors and how are they measured?

  • -Are all the relevant study factors included in the study?
  • -Have the factors been measured using appropriate tools?

Data Analysis and Results:

- Were the tests appropriate for the data?

- Are confidence intervals or p-values given?

  • How strong is the association between intervention and outcome?
  • How precise is the estimate of the risk?
  • Does it clearly mention the main finding(s) and does the data support them?
  • Does it mention the clinical significance of the result?
  • Is adverse event or lack of it mentioned?
  • Are all relevant outcomes assessed?
  • Was the sample size adequate to detect a clinically/socially significant result?
  • Are the results presented in a way to help in health policy decisions?
  • Is there measurement error?
  • Is measurement error an important source of bias?

Confounding Factors:

A confounder has a triangular relationship with both the exposure and the outcome. However, it is not on the causal pathway. It makes it appear as if there is a direct relationship between the exposure and the outcome or it might even mask an association that would otherwise have been present [ 9 ].

6- What important potential confounders are considered?

  • -Are potential confounders examined and controlled for?
  • -Is confounding an important source of bias?

7- What is the statistical method in the study?

  • -Are the statistical methods described appropriate to compare participants for primary and secondary outcomes?
  • -Are statistical methods specified insufficient detail (If I had access to the raw data, could I reproduce the analysis)?
  • -Were the tests appropriate for the data?
  • -Are confidence intervals or p-values given?
  • -Are results presented as absolute risk reduction as well as relative risk reduction?

Interpretation of p-value:

The p-value refers to the probability that any particular outcome would have arisen by chance. A p-value of less than 1 in 20 (p<0.05) is statistically significant.

  • When p-value is less than significance level, which is usually 0.05, we often reject the null hypothesis and the result is considered to be statistically significant. Conversely, when p-value is greater than 0.05, we conclude that the result is not statistically significant and the null hypothesis is accepted.

Confidence interval:

Multiple repetition of the same trial would not yield the exact same results every time. However, on average the results would be within a certain range. A 95% confidence interval means that there is a 95% chance that the true size of effect will lie within this range.

8- Statistical results:

  • -Do statistical tests answer the research question?

Are statistical tests performed and comparisons made (data searching)?

Correct statistical analysis of results is crucial to the reliability of the conclusions drawn from the research paper. Depending on the study design and sample selection method employed, observational or inferential statistical analysis may be carried out on the results of the study.

It is important to identify if this is appropriate for the study [ 9 ].

  • -Was the sample size adequate to detect a clinically/socially significant result?
  • -Are the results presented in a way to help in health policy decisions?

Clinical significance:

Statistical significance as shown by p-value is not the same as clinical significance. Statistical significance judges whether treatment effects are explicable as chance findings, whereas clinical significance assesses whether treatment effects are worthwhile in real life. Small improvements that are statistically significant might not result in any meaningful improvement clinically. The following questions should always be on mind:

  • -If the results are statistically significant, do they also have clinical significance?
  • -If the results are not statistically significant, was the sample size sufficiently large to detect a meaningful difference or effect?

9- What conclusions did the authors reach about the study question?

Conclusions should ensure that recommendations stated are suitable for the results attained within the capacity of the study. The authors should also concentrate on the limitations in the study and their effects on the outcomes and the proposed suggestions for future studies [ 10 ].

  • -Are the questions posed in the study adequately addressed?
  • -Are the conclusions justified by the data?
  • -Do the authors extrapolate beyond the data?
  • -Are shortcomings of the study addressed and constructive suggestions given for future research?
  • -Bibliography/References:

Do the citations follow one of the Council of Biological Editors’ (CBE) standard formats?

10- Are ethical issues considered?

If a study involves human subjects, human tissues, or animals, was approval from appropriate institutional or governmental entities obtained? [ 10 , 11 ].

Critical appraisal of RCTs: Factors to look for:

  • Allocation (randomization, stratification, confounders).
  • Follow up of participants (intention to treat).
  • Data collection (bias).
  • Sample size (power calculation).
  • Presentation of results (clear, precise).
  • Applicability to local population.

[ Table/Fig-2 ] summarizes the guidelines for Consolidated Standards of Reporting Trials CONSORT [ 12 ].

[Table/Fig-2]:

Summary of the CONSORT guidelines.

Critical appraisal of systematic reviews: provide an overview of all primary studies on a topic and try to obtain an overall picture of the results.

In a systematic review, all the primary studies identified are critically appraised and only the best ones are selected. A meta-analysis (i.e., a statistical analysis) of the results from selected studies may be included. Factors to look for:

  • Literature search (did it include published and unpublished materials as well as non-English language studies? Was personal contact with experts sought?).
  • Quality-control of studies included (type of study; scoring system used to rate studies; analysis performed by at least two experts).
  • Homogeneity of studies.

[ Table/Fig-3 ] summarizes the guidelines for Preferred Reporting Items for Systematic reviews and Meta-Analyses PRISMA [ 13 ].

[Table/Fig-3]:

Summary of PRISMA guidelines.

Critical appraisal is a fundamental skill in modern practice for assessing the value of clinical researches and providing an indication of their relevance to the profession. It is a skills-set developed throughout a professional career that facilitates this and, through integration with clinical experience and patient preference, permits the practice of evidence based medicine and dentistry. By following a systematic approach, such evidence can be considered and applied to clinical practice.

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Nursing Assignment: Critical Appraisal Essay

Added on   2020-05-28

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This is a  Critical appraisal assignment example for nursing. This assignment can also be called a critical appraisal example essay, Critical appraisal essay example, Critical appraisal essay, Example of critical appraisal essay, Critical appraisal example, and Example of a critical appraisal essay, etc.  

   Added on  2020-05-28

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