Introduction to Using the Evidence Base - Critical Care New Starters

Need to grade, critique and investigate the validity of a study, but don't know where to start? Check out the resources and tools below to get you started. 

Critical appraisal is an essential part of evidence-based healthcare. Critical appraisal is important so that the good studies can be found amongst the many. These can then be used to confirm or change treatments and advice given to patients.

Critical appraisal generally seeks to answer two broad questions.

• Is this study likely to be accurate (validity)?
• Can we use its findings (relevance)?

Online tools and courses to support Critical Appraisal

• Critically Appraising the Evidence Base: A new course in 2023, this series of online Critical Appraisal modules has been created specifically for NHS colleagues. There are 8 sections that should take around 30 minutes each to complete. Each session includes reference links to further resources should learners choose to check their understanding throughout the programme. 
• Understanding health research: a simple tool to guide you through a series of questions to help you to review and interpret a published health research paper.
• Critical Appraisal Techniques for Healthcare Literature: This 3 week FutureLearn course (free to join whilst the course is running) will help you to learn how to critically appraise published medical research literature to keep up with research developments in your field.
• Finding & Appraising the Evidence: These 6 modules by Amanda Burls and Anne Brice take you through the process of how to find the evidence and then how to assess the validity and reliability of the published research in order to provide effective and efficient healthcare. 
• Critical Appraisal Skills Programme (CASP): CASP offers critical appraisal skills training, workshops and tools. These help you read and check health research for trustworthiness, results & relevance. There are downloadable checklists for a range of different study types. 
  • Critical Appraisal of a Qualitative Study: Video from the University of Sheffield on the critical appraisal of a qualitative study.
  • Critical Appraisal of a Quantitative Study: Video from the University of Sheffield on the critical appraisal of a quantitative study.
  • Critical Appraisal of an RCT using CASP Checklist: Series of videos from Barts Health NHS Trust
  • Explanation of CASP Checklists: Video from the University of Sheffield explaining the Critical Appraisal Skills Programme (CASP) checklists.
• Open University: Medical Statistics: This free course with 4 sections is concerned with some of the statistical methods used in epidemiology and more widely in medical statistics.
• Critically Appraising for Antiracism : Racial bias in research impacts a study’s relevancy, validity and reliability, though presently this aspect is not addressed in critical appraisal tools, and consequently appraisers may often not take racial bias into account when assessing a paper’s quality. In response to this, a supplementary tool has been developed, to support appraisers in explicitly addressing racial bias.

Websites to support Critical Appraisal

• AGREE (Appraisal of Guidelines for Research and Evaluation): Provides a tool for evaluating the quality and reporting of practice guidelines.
• BMJ Endgames: Statistics: Dr Philip Sedgewick is the author of the BMJ Endgames statistcs series. These are short clinically relevant explainations of statistical concepts. Note: no new content since 2015. Log in with OpenAthens to access these articles.
• Cochrane Handbook for Systematic Reviews of Interventions. Version 6.3, 2022. Chapter 7 & 8: Guidance to authors preparing Cochrane reviews. Provides comprehensive explanations of bias.
• CONSORT (Consolidated Standards of Reporting Trials): Evidence-based, minimum set of recommendations for reporting randomized trials. Provides a checklist for how RCTs are reported. This also helps to develop understanding of research design.
• PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analysis): Evidence-based minimum set of items for reporting in systematic reviews and meta-analyses. Provides a checklist and flow diagram. This also helps to develop understanding of research designm, which can inform critical appraisal. 
• STROBE (Strengthening the Reporting of Observational studies in Epidemiology): STROBE is an international, collaborative initiative of epidemiologists, methodologists, statisticians, researchers and journal editors involved in the conduct and dissemination of observational studies, with the common aim of STrengthening the Reporting of OBservational studies in Epidemiology. Provides checklists and also helps to develop understanding of research design. 

Books to support Critical Appraisal

• Critical Appraisal 
• Qualitative Research
• Statistics
• How to Read a Paper, 2019: How to Read a Paper demystifies evidence-based medicine and explains how to critically appraise published research and also put the findings into practice 
• Medical Statistics at a Glance, 2020: A concise and accessible introduction to this complex subject. It provides clear instruction on how to apply commonly used statistical procedures in an easy-to-read, comprehensive and relevant volume. 

Would like more support on critical apprsial? Consider attending one of our training sessions.

If you are unable to make the course consider on enrolling on one of the elearning sessions. Available through the eLearning for Healthcare Hub, this programme aims to support NHS colleagues with understanding the different methods and tools to carry out critical appraisal of research, through 8 bite-sized modules. The sessions are short, with each topic taking approximately 30 minutes to complete.

Need  evidence based recommendations for your daily work? See the below resources for information you can trust.

• BMJ Best Practice: Log in with your OpenAthens account. Step by step guidance on diagnosis, prognosis, treatment and prevention is updated daily using robust evidence based methodology and expert opinion. View the introduction to BMJ Best Practice for junior doctors and healthcare professionals
• Clinical Knowledge Summaries (CKS)-NICE: The CKS webpages have a new feature, which allows you to download a version of CKS onto your desktop or mobile phone. The progressive web app is available in most browsers, including Edge and Chrome - but isn't currently supported by IE11 or Safari. You can find the download icon in your browser address bar when you're on a CKS webpage.
  • If you install it on your desktop/laptop, you can access it from the start menu in Windows.
  • If you install it on your phone, an icon will appear in your list of apps, just like any other apps.
• Nice Guidance
• ICS Guidlines
• NPSA Guidlines
• Leeds Health Pathways contains guidelines from all Leeds Healthcare Trusts and other organisations including the Yorkshire Cancer Network, NICE and various professional bodies.  This resource is only available on an NHSnet computer.
• Trip Pro (sign in with OpenAthens for access to Pro version). This database i aims to deliver the highest quality literature to support evidence based practice. The content includes evidence-based guidelines.
•  Critical Care Review Books

Keep uptodate with the latest developments in your speciality. 

Critical Care Nursing

• Intensive care nursing books and ebooks
• Critical care ejournals

Want to have a browse and see whats out there?

• Use Browzine to explore the full range of nursing journals available to you through your OpenAthens account. Search 'Leeds' to find your organisation and then navigate to the nursing subject section to explore. 

Want information straight to your inbox on a specific topic?

Contact the library at lthstafflibraries@nhs.net and we can set up a current awareness bulletin tailored to your interest.