You've finally narrowed the thousands of citations down to a smaller, more relevant group of articles. Now what do you do to make sense of this information? Take a look below at the various tools and guides to help you determine the quality of and risk of bias for each article.
"Critical appraisal skills enable you to assess the trustworthiness, relevance and results of published papers so that you can decide if they are believable and useful." (Mayo Clinic)
*Our librarians do not provide consultations on critical appraisal, however we're happy to provide you with the information and resources below.
Systematic Reviews
| Tool | Organization | Description |
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A critical appraisal tool for systematic reviews that include randomised or nonrandomised studies of healthcare interventions, or both. Used to assess the methodological quality of a systematic review and as a guide to performing a systematic review. Two agreements are required during quality assessment ensuring lower risk of bias. AMSTAR has guidelines explaining each outlined item. |
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Critical Appraisal Skills Programme (CASP) Public Health Resource Unit, NHS, England |
A methodological checklist that provides key criteria relevant to systematic reviews. |
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Bristol Medical School: Population Health Sciences University of Bristol |
Tool for assessing the risk of bias in systematic reviews (rather than in primary studies), offering information to help you complete a ROBIS assessment, and resources to help you present the results of your ROBIS assessment. |
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The Centre for Evidence-Based Medicine (CEBM) University of Oxford |
A checklist with questions for assessing the reliability, importance, and applicability of the studies included based on the alignment of the research question and eligibility criteria. |
For other tools and appraisal worksheets on different types of medical evidence.
Randomized Controlled Trials
| Tool | Organization | Description |
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Critical Appraisal Skills Programme (CASP) Public Health Resource Unit, NHS, England |
RCT CAT is a methodological checklist which provides key criteria relevant to randomised controlled trials. |
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The Consolidated Standards of Reporting Trials (CONSORT) Statement |
A detailed document that outlines an explanation and elaboration of the CONSORT statement for reporting randomized controlled trials. It also includes a critical appraisal flow diagram. |
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RoB 2 Tool (New as of July 2019) |
University of Bristol |
A revised Cochrane risk of bias tool for randomized trials. Archived: There are 3 variations of the tool based on trial design. Choose the appropriate version. 1. Individually randomized, parallel group trials (traditional RCT) 2. Cluster randomized, parallel group trials (like traditional but randomized by groups) 3. Individual randomized, cross-over trials (randomization occurs to determine the order the patient receives both treatments) |
Non-randomized Studies or Observational Studies
| Tool | Author(s)/Organization | Description |
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Downes, M.J., Brennan. M.L., Williams, H.C., & Dean, R.S. |
A critical appraisal tool used to assess the quality of cross-sectional (prevalence) studies. |
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A quality appraisal checklist for case studies. |
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Includes checklists for various studies such as analytical cross-sectional studies, case-control studies, case reports, case series, cohort studies, diagnostic test accuracy studies, prevalence studies, quasi-experimental studies, randomized controlled trials, and systematic reviews. |
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The form is available for download in multiple languages, see bottom of the page. |
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Slim, K., Nini, E., Forestier, D. et al. |
Methodological Index for Non-Randomized Studies (MINORS). A tool for assessing non-randomized interventional studies. |
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The Ottawa Hospital Research Institute. Wells, G.A.,Shea, B., O'Connell, D., et al. |
The Newcastle-Ottawa Scale (NOS) Most widely used for case control or cohort studies. A modified scale for cross-sectional studies was made based on this article. |
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Centre for Research Synthesis and Decision Analysis University of Bristol |
Risk of Bias for non-randomized (observational) studies or cohorts of Intervention. Useful for conducting systematic reviews that include non-randomized studies. |
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Centre for Research Synthesis and Decision Analysis University of Bristol |
Risk of Bias for non-randomized (observational) studies or cohorts of Exposures Useful for conducting systematic reviews that include non-randomized studies. |
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Study Quality Assessment Tools for Controlled Intervention Studies, Systematic Reviews & Meta-Analyses, Observational Cohort and Cross-Sectional Studies, Case-Control Studies, Before-After (Pre-Post) Studies With No Control Group, Case Series Studies. |
Animal Research
| Tool | Author(s)/Organization | Description |
|---|---|---|
| ARRIVE guidelines | National Centre for the Replacement Refinement & Reduction of Animals in Research (NC3RS) |
The Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines. A checklist for improving the reliability and quality of reporting for animal research. |
| Critical Appraisal of Studies Using Laboratory Animal Models | O’Connor., A.M., & Sargeant, J.M. | Includes two tables covering the components of critical appraisal. |
| SYRCLE's RoB tool |
Hoojimans, C.R., Rovers, M.M, de Vries, R. et al. |
Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) A risk of bias assessment tool for assessing animal studies. |
Diagnostic Accuracy
| Tool | Author(s)/Organization | Description |
|---|---|---|
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Critical Appraisal Skills Programme (CASP) Public Health Resource Unit, NHS, England |
A methodological checklist that provides key criteria relevant to diagnostic test studies. |
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The Centre for Evidence-Based Medicine (CEBM) University of Oxford |
Helps assess the validity and applicability of included diagnostic tests. |
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Whitling, P.F., Rutjes, A.W., Westwood, M.E. et al. QUADAS-2 Group. |
A revised tool for the quality assessment of diagnostic accuracy studies. The current version of QUADAS and the tool that we recommend for use in systematic reviews to evaluate the risk of bias and applicability of primary diagnostic accuracy studies.
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Standards for the Reporting of Diagnostic accuracy studies (2015) Helps determine the accuracy and completeness of reporting of studies of diagnostic accuracy. The STARD Statement consists of a 30 item checklist and flow diagram. |
(Source: Mayo Clinic Libraries, 2021)
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