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Making sense of the quality of evidence.

In the last CONJ issue, the Research Reflections column focused on finding research to answer patient’s questions (Stacey et al., 2015). When you have found some research studies that might inform your practice, the next step is to look critically at those studies to discern the best available evidence so your practice is informed by the best of the best available information. The best evidence to integrate into decision-making for evidence-informed nursing practice includes research evidence, clinical expertise, and patients’ choices and concerns (Wilkins, 2013). Critical appraisal is a systematic method of evaluating the strengths and limitations of a research study, as well as its applicability to practice. A common assumption is, “It’s in a journal. Isn’t that enough?” The answer is, “No, not really.” Publication in a journal, even when peer-reviewed, does not guarantee quality or clinical relevance. How can you tell whether a research study has been done well and the information is reliable and relevant to your practice? How can you decide what to believe when research on the same topic has contradictory results? This is where critical appraisal skills can help. Critical appraisal may sound daunting. However, you do this every day to some extent. Whether you are reading the newspaper, using social media or watching television, you process what you read, see, and learn through your experiences. You are wise consumers of the information, filtering it so you focus on what is important. You critically analyze claims made; you do not take everything at face value. You need to do the same thing when you critically appraise research studies. So what is it you are critically appraising? You are appraising the quality of a research study, and whether or not the results can be applied to your own clinical situation. The three major questions to answer in doing a critical appraisal are: 1. Are the results of the study valid? 2. What are the results? 3. Will the results help me in caring for my patients?