Subject Guides: Systematic Reviews: A How-To Guide: Step 5: Assess Quality

Step 5: Assess Quality (Critical Appraisal)

"Critical appraisal includes recognizing and evaluating various study designs and their ranking in order of strength, judging relevance to the question at hand, identifying potential sources of bias, and determining whether the data presentation, statistical analysis, and conclusions are appropriate." - Morris MJ, Fewell AE, Oleszewski RT. Evidence-Based Medicine. Southern Medical Journal. 2012; 105 (3): 114-119.

Critical appraisal is an important step in the systematic review process. Expect to:

Perform critical appraisal/quality assessment of studies you wish to include. Critical appraisal checklists are available to assist with this step.

Critical Appraisal Tools & Checklists

Risk of bias tools
A collection of tools to help determine the risk of bias in various types of studies. Information is included on RoB 2 tool, a revised Cochrane risk of bias tool for randomized trials.
Best BETs (Best Evidence Topics)
Checklists by type of study
CASP - Critical Appraisal Skills Programme
Centre for Evidence Based Medicine (Oxford)
JBI's Critical Appraisal Tools

Appraisal Tools on JAMAevidence

Appraisal is identified as one of the core topics in Evidence-Based Medicine on JAMAevidence. The JAMAevidence website provides a number of resources for sharpening critical appraisal skills and applying them to the medical literature, including help guides and customizable critical appraisal worksheets.

JAMAevidence: Appraise
Content is based off of the Users' Guides to the Medical Literature.
Critical Appraisal Worksheets
You will need to create a free JAMAevidence account in order to save and use the worksheets.

Articles on How to Do Critical Appraisal

Critical Appraisal Process: Step-by-Step. Timm DF, Banks DE, McLarty, J. (2012). Southern Medical Journal, 105(3), 144-148.

Evidence-Based Medicine: Specific Skills Necessary for Developing Expertise in Critical Appraisal. Morris MJ, Fewell AE, Oleszewski RT. (2012). Southern Medical Journal, 105(3), 114-119.

Impact of Patient Selection in Various Study Designs: Identifying Potential Bias in Clinical Results. Berbano EP, Baxi N. (2012). Southern Medical Journal, 105(3), 149-155.