Critical Appraisal: Where do I Start?

An overview of critical appraisal, with emphasis on process and key critical appraisal tools

Join us in an Education Session

Basic Searching on the KRS Website
Learn how to conduct a quick search on the KRS website

Finding Literature in MEDLINE
Learn how to conduct a search in MEDLINE.

Finding Literature in CINAHL
Learn how to conduct a search in CINAHL.

Introduction to Grey Literature
Learn how to search for and assess the quality of grey literature.

Where Do I Start?

Start by determining your PURPOSE in conducting a critical appraisal of the literature.  Ensure that you are clear about WHY you are gathering evidence and HOW you intend to use it.  Being clear about WHY you are gathering evidence will help you develop your search strategy by: 

  • determining the type of evidence that best aligns with your purpose; and 
  • refining your choice of critical appraisal tools. 

For example, if your purpose is to develop or adapt clinical guidelines, consider looking for evidence in both published literature and grey literature. It is important to select critical appraisal tools that match your purpose. For developing or adapting clinical guidelines, look for tools specific to appraising guidelines rather than those appraising a randomized control trial (RCT), a meta-analysis or a systematic review.

Learn more about how to Identify Appropriate Sources of Evidence 

Learn more about how to Plan and Execute Your Search 

How Can I Ask the Right Question?

There are several tools that can assist you in developing your research question.  A tool like PICOT is useful for developing clinical questions.  The PICOTS, SPICE, and SPIDER tools are particularly useful when examining interventions.  Other tools such as ECLIPSE and PEO support looking at qualitative topics such as correlations/associations of risk factors/exposures, policy, improvement strategies, service outcomes. 

  • PICO - Population/Patient, Intervention, Comparison/Control, Outcome.  PICOT is a standard and useful tool for clinical questions 
  • PICOTS - Population/Patient, Intervention, Comparison/Control, Outcome, Time 
  • SPICE and SPIDER - Setting, Perspective/Population, Intervention (Program/Service), Comparison (Optional), Evaluation (Outcome) 
  • ECLIPSE - Expectation, Client Group, Location, Impact, Professionals 
  • PEO - Population, Exposure, Outcomes 

Learn more on how to Ask a Searchable Question

Additional Resources 

PRISMA (prisma-statement.org)

PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviewsBMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n160 (Published 29 March 2021) Cite this as: BMJ 2021;372:n160

Knowlege Check: Crafting Questions Using Frameworks