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. Back in the bad old days aspiring consultants used to have to complete a Clinical Topic Review on a subject of their choice, nowadays you have a management portfolio. Lots of these links are a little older and reference CTR but don’t be put off, the critical thinking behind them is still as relevant today.

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. 

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.
  • Concepts and definitions
  • Statistics
  • Evaluation of a therapy
  • Evaluation of service organisation and delivery
  • Evaluation of a diagnostic test
  • Systematic reviews

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

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
  • CTR how to put it together for FCEM
  • CTR the link between structure and marking at FCEM
  • CTR falling in love with the examiner at FCEM

Link to a discussion and resources involving the targeted temperature management paper JC Oct 2014