Evidence-Based Practice PT

The appraisal methods refers to the systematic methodology that you are going to use to read, appraise, compare, and contrast the included evidence. Either by comparing the results of previously appraised evidence, for instance by comparing systematic literature reviews with or without meta-analysis and/or CPGs; or by critically appraising the not yet synthesized evidence using appraisal forms as the one attached as PDF file. Appraisal forms facilitate the process of assessment of the methodological quality of the found evidence. The goal is to systematically examine the research evidence to judge its applicability, validity, and quality of the evidence.

The structure of a literature review should include the following:

• An overview of the subject, issue, or theory under consideration, along with the objectives of the literature review,
• Division of works under review into themes or categories [e.g. works that support a particular position, those against, and those offering alternative approaches entirely],
• An explanation of how each work is similar to and how it varies from the others,
• Conclusions as to which pieces are best considered in their argument, are most convincing of their opinions, and make the greatest contribution to the understanding and development of their area of research.

The critical evaluation of each work should consider:

• Provenance -- what are the author's credentials? Are the author's arguments supported by evidence [e.g. primary historical material, case studies, narratives, statistics, recent scientific findings]?
• Methodology -- were the techniques used to identify, gather, and analyze the data appropriate to addressing the research problem? Was the sample size appropriate? Were the results effectively interpreted and reported?
• Objectivity -- is the author's perspective even-handed or prejudicial? Is contrary data considered or is certain pertinent information ignored to prove the author's point?
• Persuasiveness -- which of the author's theses are most convincing or least convincing?
• Value -- are the author's arguments and conclusions convincing? Does the work ultimately contribute in any significant way to an understanding of the subject?

While conducting a review of the literature, maximize the time you devote to writing this part of your paper by thinking broadly about what you should be looking for and evaluating. Review not just what the articles are saying, but how are they saying it.

Some questions to ask:

• How are they organizing their ideas?
• What methods have they used to study the problem?
• What theories have been used to explain, predict, or understand their research problem?
• What sources have they cited to support their conclusions?
• How have they used non-textual elements [e.g., charts, graphs, figures, etc.] to illustrate key points?
• When you begin to write your literature review section, you'll be glad you dug deeper into how the research was designed and constructed because it establishes a means for developing more substantial analysis and interpretation of the research problem.

Now, that you have found articles based on your research question you can appraise the quality of those articles. These are resources you can use to appraise different study designs.

• Critical Appraisal Tools

  Centre for Evidence Based Medicine (Oxford)

• Evidence-Based Practice (EBP) checklists

  University of Glasgow

• Strength of Recommendation Taxonomy (SORT), American Academy of Family Physicians

  "AFP uses the Strength-of-Recommendation Taxonomy (SORT), to label key recommendations in clinical review articles."

• SORT: Rating the Strength of Evidence   American Family Physician and other family medicine journals use the Strength of Recommendation Taxonomy (SORT) system for rating bodies of evidence for key clinical recommendations.