Critical Appraisal of a Diagnostic Accuracy paper

90 Pages·2016·1.96 MB·English

by  Microsoft Office User

Critical Appraisal of a
Diagnostic Accuracy
paper
PROF STACY GOERGEN MBBS MCLINEPI FRANZCR
CLIN. ASSOC PROF TARYN BESSEN MBBS PHD FRANZCR
What is Critical Appraisal?
A systematic process of evaluating the likelihood of biased results
that affect the validity of the conclusions drawn by the authors.
Consists of 3 steps in this
1. Is the study VALID?
2. What are the RESULTS ?
3. Should I APPLY this to my clinical practice?
What is required by the College?
A CAT refers to critical appraisal of ONE study, and can be in
the areas of diagnosis, treatment or harm
Need to have completed 4 CATs by end of third year of
training (2 in second year, 2 in third year)
Non-completion is a barrier to progression into fourth year.
What is involved in doing a CAT?
1. Construct 2. Search for 3. Critically
the research and select appraise the 4. Assessment
question article paper
1. Construct the Research Question
P Patient/population/problem
I Intervention/index text
C Comparator/control
O Outcome
Practice examples
1. Is nuchal translucency ultrasound + biochemistry testing in
the first trimester, as accurate as conventional amniocentesis
for diagnosing Down’s Syndrome?
2. How does radiofrequency ablation compare with surgery
for treatment of liver metastases from colorectal cancer?
Example 1
P = pregnant women
I = nuchal translucency ultrasound + biochemistry (first
trimester)
C = conventional amniocentesis
O = accurate diagnosis of Down’s syndrome
Example 2
P = Patients with colorectal cancer
I = Percutaneous RFA
C = Surgical resection
O = Annual recurrence or mortality rate
2. Search for & select article
https://www.nlm.nih.gov/bsd/disted/pubmedtutorial/020_010.html
3. Critically appraise the paper
Should I apply
Is the study What are the
this to my
valid? results?
clinical practice?