Critical Appraisal Guidelines for Single Case Study Research

The use of critical appraisal guidelines to assess the validity of research findings has become an established technique in those disciplines, such as healthcare and medicine, that encourage the use of evidence-based practice. Critical appraisal guidelines provide a rigorous set of criteria, often in the form of a checklist, against which a piece of research can be assessed. Although well established criteria exist for many forms of quantitative research, such as clinical trials and cohort studies, qualitative research is less well served. Through a synthesis of existing best practices in interpretative research this paper provides comprehensive guidelines for the conduct of single case study research and extrapolates from them a set of critical appraisal guidelines to assist in the evaluation of such work

Can shared decision making reduce medical malpractice litigation? : A systematic review

© 2015 Durand et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise statedTo explore the likely influence and impact of shared decision-making on medical malpractice litigation and patients’ intentions to initiate litigation. We included all observational, interventional and qualitative studies published in all languages, which assessed the effect or likely influence of shared decision-making or shared decision-making interventions on medical malpractice litigation or on patients’ intentions to litigate. The following databases were searched from inception until January 2014: CINAHL, Cochrane Register of Controlled Trials, Cochrane Database of Systematic Reviews, EMBASE, HMIC, Lexis library, MEDLINE, NHS Economic Evaluation Database, Open SIGLE, PsycINFO and Web of Knowledge. We also hand searched reference lists of included studies and contacted experts in the field. Downs & Black quality assessment checklist, the Critical Appraisal Skill Programme qualitative tool, and the Critical Appraisal Guidelines for single case study research were used to assess the quality of included studiePeer reviewedFinal Published versio

Stroke and sexual health: A systematic review of psychological interventions aimed at improving sexual health of stroke survivors

Objectives: Evaluate the efficacy of non-pharmacological interventions and digital interventions aimed at improving the sexual health of stroke survivors documented in the literature. Method: The databases searched were MEDLINE (PubMed), Web of Science, EBSCO (APA PsycINFO and APA PsycArticles), and Cochrane. Following PRISMA guidelines, data were collected by a single author, with the consultation of co-authors when clarifications were needed. Only original publications in English were included. The risk of bias was assessed using tools such as ROBINS-I, Cochrane Collaboration's Risk of Bias Tool, and the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Results: From an initial total of 1053 publications identified, 5 studies were included. The study designs included randomized clinical studies, a quasi-experimental study, a cross-sectional study, and a case study. No studies were identified on the efficacy of digital interventions. The predominant intervention model used in most of the studies was the PLISSIT model, with or without psycho-educational supplements. Conclusions: Although available literature points to the benefits of psychotherapeutic interventions in promoting the sexual health of stroke survivors, the data showed differences in the degree of this efficacy, even among those based on the PLISSIT model. This research underscores the potential benefits of tailored interventions for post-stroke sexual rehabilitation and highlights areas for future research

The systematic guideline review: method, rationale, and test on chronic heart failure

Background: Evidence-based guidelines have the potential to improve healthcare. However, their de-novo-development requires substantial resources-especially for complex conditions, and adaptation may be biased by contextually influenced recommendations in source guidelines. In this paper we describe a new approach to guideline development-the systematic guideline review method (SGR), and its application in the development of an evidence-based guideline for family physicians on chronic heart failure (CHF). Methods: A systematic search for guidelines was carried out. Evidence-based guidelines on CHF management in adults in ambulatory care published in English or German between the years 2000 and 2004 were included. Guidelines on acute or right heart failure were excluded. Eligibility was assessed by two reviewers, methodological quality of selected guidelines was appraised using the AGREE instrument, and a framework of relevant clinical questions for diagnostics and treatment was derived. Data were extracted into evidence tables, systematically compared by means of a consistency analysis and synthesized in a preliminary draft. Most relevant primary sources were re-assessed to verify the cited evidence. Evidence and recommendations were summarized in a draft guideline. Results: Of 16 included guidelines five were of good quality. A total of 35 recommendations were systematically compared: 25/35 were consistent, 9/35 inconsistent, and 1/35 un-rateable (derived from a single guideline). Of the 25 consistencies, 14 were based on consensus, seven on evidence and four differed in grading. Major inconsistencies were found in 3/9 of the inconsistent recommendations. We re-evaluated the evidence for 17 recommendations (evidence-based, differing evidence levels and minor inconsistencies) - the majority was congruent. Incongruity was found where the stated evidence could not be verified in the cited primary sources, or where the evaluation in the source guidelines focused on treatment benefits and underestimated the risks. The draft guideline was completed in 8.5 man-months. The main limitation to this study was the lack of a second reviewer. Conclusion: The systematic guideline review including framework development, consistency analysis and validation is an effective, valid, and resource saving-approach to the development of evidence-based guidelines

Clinical practice guidelines for the foot and ankle in rheumatoid arthritis: a critical appraisal

Background: Clinical practice guidelines are recommendations systematically developed to assist clinical decision-making and inform healthcare. In current rheumatoid arthritis (RA) guidelines, management of the foot and ankle is under-represented and the quality of recommendation is uncertain. This study aimed to identify and critically appraise clinical practice guidelines for foot and ankle management in RA. Methods: Guidelines were identified electronically and through hand searching. Search terms 'rheumatoid arthritis', 'clinical practice guidelines' and related synonyms were used. Critical appraisal and quality rating were conducted using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Results: Twenty-four guidelines were included. Five guidelines were high quality and recommended for use. Five high quality and seven low quality guidelines were recommended for use with modifications. Seven guidelines were low quality and not recommended for use. Five early and twelve established RA guidelines were recommended for use. Only two guidelines were foot and ankle specific. Five recommendation domains were identified in both early and established RA guidelines. These were multidisciplinary team care, foot healthcare access, foot health assessment/review, orthoses/insoles/splints, and therapeutic footwear. Established RA guidelines also had an 'other foot care treatments' domain. Conclusions: Foot and ankle management for RA features in many clinical practice guidelines recommended for use. Unfortunately, supporting evidence in the guidelines is low quality. Agreement levels are predominantly 'expert opinion' or 'good clinical practice'. More research investigating foot and ankle management for RA is needed prior to inclusion in clinical practice guidelines

The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers

INTRODUCTION: Appraising the quality of studies included in systematic reviews combining qualitative and quantitative evidence is challenging. To address this challenge, a critical appraisal tool was developed: the Mixed Methods Appraisal Tool (MMAT). The aim of this paper is to present the enhancements made to the MMAT. DEVELOPMENT: The MMAT was initially developed in 2006 based on a literature review on systematic reviews combining qualitative and quantitative evidence. It was subject to pilot and interrater reliability testing. A revised version of the MMAT was developed in 2018 based on the results from usefulness testing, a literature review on critical appraisal tools and a modified e-Delphi study with methodological experts to identify core criteria. TOOL DESCRIPTION: The MMAT assesses the quality of qualitative, quantitative, and mixed methods studies. It focuses on methodological criteria and includes five core quality criteria for each of the following five categories of study designs: (a) qualitative, (b) randomized controlled, (c) nonrandomized, (d) quantitative descriptive, and (e) mixed methods. CONCLUSION: The MMAT is a unique tool that can be used to appraise the quality of different study designs. Also, by limiting to core criteria, the MMAT can provide a more efficient appraisal

PRECEPT: an evidence assessment framework for infectious disease epidemiology, prevention and control

Decisions in public health should be based on the best available evidence, reviewed and appraised using a rigorous and transparent methodology. The Project on a Framework for Rating Evidence in Public Health (PRECEPT) defined a methodology for evaluating and grading evidence in infectious disease epidemiology, prevention and control that takes different domains and question types into consideration. The methodology rates evidence in four domains: disease burden, risk factors, diagnostics and intervention. The framework guiding it has four steps going from overarching questions to an evidence statement. In step 1, approaches for identifying relevant key areas and developing specific questions to guide systematic evidence searches are described. In step 2, methodological guidance for conducting systematic reviews is provided; 15 study quality appraisal tools are proposed and an algorithm is given for matching a given study design with a tool. In step 3, a standardised evidence-grading scheme using the Grading of Recommendations Assessment, Development and Evaluation Working Group (GRADE) methodology is provided, whereby findings are documented in evidence profiles. Step 4 consists of preparing a narrative evidence summary. Users of this framework should be able to evaluate and grade scientific evidence from the four domains in a transparent and reproducible way.Funding Agencies|European Centre for Disease Prevention and Control (ECDC) [2012/040, 2014/008]</p

Which interval is most crucial to presentation and survival in gastroesophageal cancer: a systematic review

Aim: The aim of this study was to identify the most crucial interval to encourage earlier diagnosis in with gastroesophageal cancer and to identify potential factors effecting this interval. Background: Gastroesophageal malignancy is the eighth most commonly presenting cancer with one of the worst survival rates. Identifying the most crucial period for intervention to inform earlier diagnosis is an important step towards improving survival. Design: Mixed methods literature review. Data Sources: CINAHL, MEDLINE and Academic search primer online databases were searched using keywords and inclusion/exclusion criteria. Empirical evidence published between 2000–2016 with a focus on gastroesophageal cancer presentation and survival was reviewed to inform this study. Review methods: Twelve studies were extracted for further review. Selected studies were appraised and presented through Olensen's “delay interval” framework to inform the most crucial interval to survival in gastroesophageal cancer. Results: The findings identify the patient interval as the most critical period for encouraging earlier presentation and reducing advanced stage presentation in gastroesophageal cancer. The article also highlighted some methodological limitations to cancer research, such as a lack of consensus in definitions which prevent statistical meta-analysis of cancer data, survivor bias in gastroesophageal cancer studies and a significant lack of qualitative evidence to reveal patient experience in presenting with this cancer. Conclusion: Further research into the patient interval is required to elicit information on how and why patients present with their cancer symptoms

Comparative Effectiveness Review Within the U.K.'s National Institute for Health and Clinical Excellence

Examines lessons from the National Institute for Health and Clinical Excellence's use of comparative effectiveness reviews and decision-making process on evidence-based standards, uptake of medical innovations, and investment for maximum health benefit