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Systematic Reviews

Critically Appraising Evidence

Critical appraisal is an integral part of the process of Evidence Based Practice (EBP). Critical appraisal aims to identify methodological flaws in the literature and provide consumers of research evidence the opportunity to make informed decisions about the quality of the research evidence. When critically appraising the evidence, make sure to look at the study methodology, the statistical tests and methods used, and the results. If you have questions, find the answers to those questions!

Critical appraisal of randomized studies on effects of interventions

  • Julian PT Higgins, Douglas G Altman and Jonathan AC Sterne on behalf of the Cochrane Statistical Methods Group and the Cochrane Bias Methods Group. Assessing risk of bias in included studies. In Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011). Chapter 8. Available from
  • RoB 2 tool: For risk of bias in individually randomized, parallel group trials; cluster randomized, parallel group trials; and individually randomized, cross-over trials.

Critical appraisal of non-randomized studies on the effects of interventions (including observational studies)

  • ROBINS-I tool: For risk of bias in non-randomized quantitative studies (including cohort-like designs and quasi-randomized studies) estimating effectiveness of an intervention.
  • Newcastle-Ottawa Scale: For quality assessment of nonrandomised studies (including case-control and cohort studies) in meta-analyses.

Critical appraisal of cross-sectional studies

Critical appraisal of diagnostic test accuracy studies

Critical appraisal of measurement instruments

  • COSMIN Checklist: Risk of bias checklist for assessing the quality of studies involving outcome measurement instruments (mainly for patient reported outcome measures, or PROMs).
  • QODA Checklist: For critically appraising questionnaire origin (sources from which questionnaire elements are made) and initial development (process of making the questionnaire from its elements).

Critical appraisal in mixed studies reviews

Critical appraisal of narrative reviews (e.g., traditional lit reviews)

Critical appraisal of prediction model studies

Critical appraisal of qualitative research findings

Critical appraisal of systematic reviews of intervention studies

  • AMSTAR 2: For critically appraising systematic reviews of randomised and non-randomised studies of healthcare interventions.
  • ROBIS: For risk of bias in systematic reviews.

Critical appraisal of systematic review of public health interventions

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