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Critical Appraisal

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"Critical appraisal is the process of carefully and systematically examining research to judge its trustworthiness, and its value and relevance in a particular context. It is an essential skill for evidence-based medicine because it allows clinicians to find and use research evidence reliably and efficiently"

Burls, A. (2009) What is...? series, 'What is critical appraisal?', Harvard Medical Communications
Available at
 (accessed 24/08/2021)


Levels of Evidence

You may be familiar with the Evidence Based Medicine 'Triangle' or hierarchy of evidence, where research is ranked, with supposedly 'weaker' studies at the bottom, more 'robust' research models further up and systematic reviews and meta-analyses at the very top. 

While the EMB Triangle is a useful tool, it should be noted that the trustworthiness of research depends on more than just the type or level of the evidence.

For more on evidence pyramids please see the following:


Murad MHAsi NAlsawas M, et al New evidence pyramid. BMJ Evidence-Based Medicine 2016;21:125-127. available at (accessed 24/08/2021)

Anthony L. Rosner, Evidence-based medicine: Revisiting the pyramid of priorities, Journal of Bodywork and Movement Therapies, Volume 16, Issue 1, 2012, Pages 42-49, ISSN 1360-8592,


Critical appraisal of a Randomised Controlled Trial (Using CASP Checklist)

Barts Health Knowledge and Library Services’ Assad Lahlou and Adam Tocock use the CASP Checklist to critically appraise the following paper:

Uchio Y, Enomoto H, Alev L, Kato Y, Ishihara H, Tsuji T, Ochiai T, Konno S. A randomized, double-blind, placebo-controlled Phase III trial of duloxetine in Japanese patients with knee pain due to osteoarthritis. J Pain Res. 2018 Apr 18;11:809-821. doi: 10.2147/JPR.S164128. PMID: 29713194; PMCID: PMC5912377.

[Link to checklist]

Question 1


Question 2


Question 3

Question 4

Question 5

Question 6

Question 7

Question 8

Question 9

Question 10/11





Page created Aug 2021

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