1 / 25

Topic 6 CRITICAL APPRAISAL OF MEDICAL ARTICLES

Topic 6 CRITICAL APPRAISAL OF MEDICAL ARTICLES. Jarmila Potomková Medical Librarian Jan Strojil Department of Pharmacology Palacky University Faculty of Medicine Olomouc, Czech Republic Updated February 2009 potomkov@tunw.upol.cz. CRITICAL APPRAISAL IN GENERAL. Technique, skill

cortez
Download Presentation

Topic 6 CRITICAL APPRAISAL OF MEDICAL ARTICLES

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Topic 6CRITICAL APPRAISAL OF MEDICAL ARTICLES Jarmila Potomková Medical Librarian Jan Strojil Department of Pharmacology Palacky University Faculty of Medicine Olomouc, Czech Republic Updated February 2009 potomkov@tunw.upol.cz

  2. CRITICAL APPRAISALIN GENERAL Technique, skill • Increasing effectiveness of your reading • Excluding poorly designed studies • Helping decide • which articles could influence your daily work • which are unsuitable.

  3. Searching for Best Evidence„Well-built Questions“ Clinical Question for Today: Crohn´s Disease: A Role of Psychotherapy

  4. Live Case ScenarioUniversity Hospital Olomouc : 2007 • Case • 16-year old boy, Crohn´s diasease diagnosed in the age of 13; • Hospitalized for relapse of disease; • In a series of interviews he disclosed pharmacologic treatment noncompliance

  5. Foreground Question: PICO Format • P/Patient, population, problem adolescent boy; Crohn´s disease/relapse • I/Intervention drug treatment • C/Comparison druh treatment + psychological therapy • O/Outcome improved quality of life

  6. Background QuestionWhat is Crohn´s disease? • Crohn's disease is a chronic inflammation of the intestinal wall that may affect any part of the digestive tract. • In the past few decades, Crohn's disease has become more common worldwide. • It is most common among populations living in northern climates in developed areas of the world. • It occurs about equally in both sexes, often runs in families. • Most people develop Crohn's disease before age 35, usually between the ages of 15 and 25. • Typical symptoms include chronic diarrhea (which sometimes is bloody), crampy abdominal pain, fever, loss of appetite, and weight loss. • Although Crohn's disease has no known cure, many drugs help reduce inflammation and relieve symptoms. . Source: Merck Manual – Home Edition. Available from: http://www.merckmanual.com

  7. Merck Manual – Home Edition

  8. PubMed Search ConsolidationSearch Strategy • Selection of search terms • Keywords • Phrases • Synonyms • Combination of search terms • Boolean logic • Application of limits • Occurrence of search terms • Title, Title/Abstract, All fields • Types of articles • Age groups • Etc.

  9. Boolean logic • AND: Combines terms to limit your search as both concepts must be present in all retrieved articles • Example: Crohn* AND psychotherapy • OR: Widens your search as either term can be present in all retrieved articles • Example: psychotherap* OR psycholog* OR counsel* OR educat* • NOT: Limits your search by excluding a concept as one term must be present and the second term must not be present • Example: Crohn*NOTsurgery

  10. Truncation * • PubMed finds all terms that begin with a given text string • Example • Crohn* • PubMed retrieves: Crohn disease, Crohn´s disease ,,,,,,,,,

  11. Crohn´s disease : a role of psychotherapySearch terms Crohn(´s) disease • Psychotherapy • Psychological therapy • Counselling • Patient education • Psychosomatic

  12. Search Strategy Suggestions Step 1 Crohn* Limits: Title Step 2 psychotherap* OR psycholog* OR psychosomatic OR counsel* OR educat* Limits: Title/Abstract Step 3 Combine searches #1 AND#2 Step 4 Limits: Type of article/Randomized controlled trial

  13. Combine Searches

  14. Combine Searches - Results

  15. Limits: Type of Article: Randomized Controlled Trial

  16. Original ArticlesRandomized Controlled Trials

  17. PubMed Search Results • All: 145 • Reviews: 24 • Traditional („narrative“) • Systematic + Meta-analysis (pre-determined criteria of study inclusion) • Randomized Controlled Trials: 9

  18. Example of Randomized Controlled Trial • Keller W. et al. • Effect of psychotherapy and relaxation on the psychosocial and somatic course of Crohn's disease: main results of the German Prospective Multicenter Psychotherapy Treatment study on Crohn's Disease. • J Psychosom Res. 2004;56(6):687-96. J

  19. RCT for Critical Appraisal

  20. CASP – Critical Appraisal Skills Programme: Appraisal Tools http://www.phru.nhs.uk/Pages/PHD/CASP.htm

  21. CASPRCT – Screening Questions

  22. Any Published Comments on Article?

  23. Commentary

  24. Professional Databases with Critically Appraised Topics Clinical Evidence http://www.clinicalevidence.com (fee) • Systematic reviews • Question(s) • Option(s) • Grades of evidence • Beneficial • Likely beneficial • Trade off between benefit and harm • Unknown effectiveness • Unlikely beneficial • Etc.

  25. Clinical EvidenceInterventions: Questions

More Related