Everything you learn in medicine (and life) needs to be critically appraised. This can be mentally exhausting but is essential as you develop your own understanding of the evidence (and dogma) on which current medical practice is based. Below are a series of links to resources you may find useful in critically appraising papers. If you are thinking of starting work on your Clinical Topic Review for your FCEM then think long and hard about a topic, use your educational supervisor and any other resources you can get your hands on and know the college guidelines inside out. There is a St Emlyns series on this (links below).
Emergency Medicine Ireland
Andy Neill has put together a fantastic compilation of resources for Critical Appraisal on his website; Emergency Medicine Ireland. He also has some CTR resources for those sitting the old-style exams. Well worth checking these out.
St Emlyns blog and podcast
St.Emlyns Critical Appraisal Resources
- Critical appraisal quality checklists – An excellent collection of CA tools originally developed for use with Best BETs
- An introduction to power calculations – a guide with associated video presentation
- FCEM Critical Appraisal guide – including links to two video presentations on an introduction to stats
- Podcasts (player opens in separate window)
- Understanding Diagnostics 1 – SNout, SPin and probability
- Understanding Diagnostics 2 – Beyond simple yes vs no diagnostics
- Understanding Diagnostics 3 – Why prevalence helps us stay in practice
- Understanding Diagnostics 4 – Delving into the NNT, RRR, ARR and why we love natural frequencies
EMJ – Steve Goodacre critical appraisal series
- Links to these resources (Athens password required) and others from the excellent FCEMprep website which has free registration.
STARD
- The STARD initiative aims to improve the accuracy and completeness of reporting of studies of diagnostic accuracy, to allow readers to assess the potential for bias in the study (internal validity) and to evaluate its generalisability (external validity).
- The STARD statement consist of a checklist of 25 items and recommends the use of a flow diagram which describe the design of the study and the flow of patients.
COCHRANE
- Before you start your Clinical Topic Review (CTR) then why not see what the Cochrane Collaberation are using by checking out their handbook. The tool varies depending on the paper type. NB they now recommend QUADAS 2 for diagnostic tests but have not updated the handbook. QUADAS 2 website.
Oxford Centre for Evidence Based Medicine
- The Centre for Evidence Based Medicine contains a wealth of critical appraisal resources
The Skeptics Guide to Emergency Medicine
- The SGEM is a great podcast using the BEEM Appraisal tool to critically appraise papers an apply them to clinical scenarios in an attempt to reduce the knowledge translation time
The NNT
- the The NNT is great resource which applies the Number Needed to Treat to common interventions in Emergency Medicine with some interesting results.
Other St.Emlyns Resources
- Emergency Medicine a Risky Business – Not critical appraisal but a series of 6 blogs asking you to apply critical thinking to your clinical practice. These will certainly make you re-assess your patient encounters. Parts 1, 2, 3, 4, 5, 6.
- How to pass your CTR
Link to a discussion and resources involving the targeted temperature management paper JC Oct 2014