The Pocket Guide to Critical Appraisal: A Handbook for Health Care Professionals
CMAJ 1997;157:447
© Canadian Medical Association
Iain K. Crombie. 66 pp. BMJ Publishing Group, London. 1996. Distributed in Canada by the Canadian Medical Association, Ottawa. $28.95 ($23.95 CMA members). ISBN 0-7279-1099-X
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| Overall rating: |
Very good |
| Strengths: |
Concise, understandable, informative; reader-friendly; useful checklists |
| Weaknesses: |
Lack of references. Limited number of study types addressed: surveys, casecontrol and cohort studies, clinical trials and reviews |
| Audience: |
Medical students, postgraduate trainees, practising clinicians |
Dr. Crombie has created a valuable and useful resource.
The pocket guide contains 2 parts. The initial 5 chapters are a general introduction to the rationale and conduct of critical appraisal. Although this section can be omitted by experienced appraisers, it effectively and efficiently addresses several important issues. It includes a discussion of the various sections of a paper and the questions that should be considered for each; a description of the characteristics of surveys, casecontrol and cohort studies and clinical trials; and an overview of fundamental concepts required to interpret study results -- data analysis, bias and confounding.
The concluding 6 chapters provide detailed, annotated checklists of questions to guide the critical appraisal of surveys, casecontrol and cohort studies, clinical trials and reviews. Examples of the questions asked: Are the aims [of the study] clearly stated? Are the measurements likely to be valid and reliable? Do the numbers add up? and What implications does the study have for your practice? The explanations of the appraisal questions are not only informative, they are written in a simple, user-friendly manner.
The book has 2 limitations, both identified by its author. First, it contains no references. This is in stark contrast to the many useful references found in an alternative resource: the "Users' Guides to the Medical Literature" series, initiated in the Nov. 3, 1993, issue of the Journal of the American Medical Association. The second concern is that only a limited number of study types are addressed. Scenarios such as diagnostic tests, qualitative methods and decision analyses were omitted to ensure that the book remained a simple-to-use pocket guide.
I highly recommend this book as a valuable resource to assist in the critical appraisal of the health sciences literature. It not only is useful for health sciences trainees and critical appraisal novices, but is also an easy-to-carry, valuable reference for their more experienced counterparts.
Bart J. Harvey, MD, PhD
Assistant Professor and
Director, Community Medicine
Residency Program
Department of Public Health Sciences
Faculty of Medicine
University of Toronto
Toronto, Ont.
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