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Aspect of the Article
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Critical Appraisal Questions
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Title
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- Is the title a good one, succinctly suggesting key variables, the nature of the design, and the study population?
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Abstract
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- Does the abstract clearly and concisely summarize the main features of the report (problem, methods, results, conclusions)?
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Introduction
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Problem Statement
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- Is the problem stated unambiguously, and is it easy to identify?
- Is the problem significant for nursing?
- Does the problem statement build a persuasive argument for the new study?
- Was there a good match between the research problem and the methods used? Was a quantitative approach appropriate?
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Hypothesis and/or Research Question(s)
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- Are research questions and/or hypothesis stated?
- Are questions and hypotheses appropriately worded, with clear specifications of key variables and the study populations?
- Are the questions/hypotheses consistent with existing knowledge?
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Literature Review
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- Is the literature review up-to-date?
- Does the review provide a state-of-the-art synthesis of evidence on the research problem?
- Does the literature review provide a strong rationale for the new study?
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Conceptual/Theoretical Framework
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- Were key concepts adequately defined conceptually?
- Was there a conceptual/theoretical framework, rationale, and/or map, and (if so) was it appropriate?
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Methodology
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Protection of human rights
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- Were appropriate procedures used to safeguard the rights of study participants?
- Was the study reviewed by an IRB/ethics review board?
- Was the study designed to minimize risks and maximize benefits to participants?
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Research Design
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- Was the most rigorous design used, given the study purpose?
- What is the level of evidence for the type of question asked? Was this level the highest possible?
- Were appropriate comparisons made to enhance interpretability of the findings?
- Was the number of data collection points appropriate? Was the period of follow-up appropriate?
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Population and Sample
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- Was the population clearly identified? Was the
- sample described in sufficient detail?
- Was the best possible sampling design used to enhance the sample’s representativeness?
- Were sample biases minimized?
- Was the sample size adequate? Was a power analysis used to estimate sample size needs?
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Data Collection and Measurement
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- Were key variables operationalized using the best possible method (e.g., interviews, observations, and so on)?
- Were clinically important and patient-centered outcomes measured?
- Were specific measures adequately described, and were they good choices, given the study population and the variables under study?
- Did the report provide evidence that the data collection methods yielded data that were reliable and valid?
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Procedures
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- Were key stakeholders involved in developing the research question, providing input on methodological decisions, or interpreting results?
- If there was an intervention, was it adequately
- described, and was it rigorously developed and implemented? Did most participants allocated to the intervention group actually receive it? Was there evidence of intervention fidelity?
- Were data collected in a manner that minimized bias?
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Results
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Data Analysis
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- Were appropriate statistical methods used, given the level of measurement of the variables, number of groups being compared, and assumptions of the tests?
- Was a powerful analytic method used? (e.g., did the analysis help to control for confounding variables)?
- Were Type I and Type II errors avoided or minimized?
- Were subgroup analyses undertaken to better understand the applicability of the results to different types of people?
- In intervention studies, was an intention-to-treat analysis performed?
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Findings
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- Was information about statistical significance presented? Was information about effect size and precision of estimates (confidence intervals) presented?
- Were the findings adequately summarized, with good use of tables and figures?
- Were findings reported in a manner that facilitates a meta-analysis and with sufficient information needed for EBP?
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Discussion
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Interpretation of the Findings
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- Were major findings interpreted and discussed within the context of prior research and/or the study’s conceptual framework?
- Were causal inferences, if any, justified? Was the issue of clinical significance discussed? Were interpretations well founded and consistent with the study’s limitations?
- Does the report address the issue of the generalizability and applicability of the findings?
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Implications/Recommendations
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- Did the researchers discuss the implications of the study for clinical practice or further research, and are those implications reasonable and complete?
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General Issues
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Presentation
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- Is the report well written, organized, and sufficiently detailed for critical analysis?
- In intervention studies, was a flowchart presented to show the flow of participants in the study?
- Was the report written in a manner that makes the findings accessible to practicing nurses?
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Researcher Credibility
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- Do the researchers’ clinical, substantive, or methodological qualifications and experience enhance confidence in the findings and their interpretation?
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Summary Assessment
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- Despite any limitations, do the study findings appear to be valid—do you have confidence in the truth value of the results?
- Does the study contribute any meaningful evidence that can be used in nursing practice or that is useful to the nursing discipline?
- Does the report inspire confidence about the types of people and settings for whom the evidence is applicable?
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