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AKU-KE | Introduction to Critical Appraisal Skills: Why critically appraise?

Why critically appraise?


  • Supports sound decision making based on best available evidence
  • Helps to determine:
  • How rigorous a piece of research is/ are the results of the study valid
  • What the results are telling us
  • How relevant it is to patient

How to critically appraise or what to look for.
When critically appraising evidence the following are the key areas to look at:

  • Introduction:

Is the information provided in the introduction logical and knowledgeable?

  • Aim/research question

 Is the research question of the study clearly stated?

  • Methods

Is the research methodology and research methods fully described?

  • Analysis

Has the appropriate statistics being used in the analysis of the research findings?

Have all the subjects in the study being accounted for?

  • Conclusions

Are the conclusions provided well justified and valid?

Is the Cost/benefits discussed?

How do I critically appraise? RAMMbo

The acronym RAMMbo (Represent, Allocation/Adjustment, Maintain, Measured, Blind or objective) is used to guide the critical appraisal process to ask the key questions about potential bias in a study.

1. Recruitment

  • Who did the subjects represent?

2. Allocation 

  • Was the assignment to treatments randomised? 
  • Were the groups similar at the trial’s start?

3. Maintenance

  • Were the groups treated equally?
  • Were outcomes ascertained & analysed for most patients?

4. Measurements

  • Were patients and clinicians “blinded” to treatment? OR
  • Were measurements objective & standardised?