NSG7020 - Week 4 project

SU_NSG7020_RCA.zip

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SU_NSG7020_RCA_RandomizedClinTrials_Template.doc

Rapid Critical Appraisal Randomized Clinical Trials	Numbered Studies
Unless otherwise specified, answers are Y=yes; N=no; U-unknown

1. Are the results of the study valid?
A. Were the subjects randomly assigned to the experimental and control groups?
B. Was random assignment concealed from the individuals who were first enrolling subjects into the study?
C. Were the subjects and providers blind to the study group?
D. Were reasons given to explain why subjects did not complete the study?
E. Were the follow-up assessments conducted long enough to fully study the effects of the intervention?
F. Were the subjects analyzed in the group to which they were randomly assigned?
G. Was the control group appropriate?
H. Were the instruments used to measure the outcomes valid and reliable?
I. Were the subjects in each of the groups similar on demographic and baseline clinical variables?
2. What are the results?
A. How large is the intervention or treatment effect (number needed to treat (NNT), number needed to harm (NNH), effect size, level of significance)? Fill in (
B. How precise is the intervention or treatment (clinical intervention)? Fill in (
3. Will the results help me in caring for my patients?
A. Were all clinically important outcomes measured?
B. What are the risks and benefits of the treatment? Fill in (
C. Is the treatment feasible in my clinical setting?
D. What are my patient’s/family’s values and expectations for the outcome that is trying to be prevented and the treatment itself? Fill in (

SU_NSG7020_RCA_QualitativeEvidence.doc

Rapid Critical Appraisal Qualitative Evidence	Numbered Studies
Unless otherwise specified, answers are Y=yes; N=no; U-unknown

1. Are the results of the study valid (i.e. trustworthy and credible?
a. How were study participants chosen? Fill in (
b. How are accuracy and completeness of data assured? Fill in (
c. How plausible/believable are the results?
i) Are implications of the research stated?
1) May new insights increase sensitivity to others needs?
2) May understandings enhance situational competence?
d. What is the effect on the reader?
1) Are results plausible and believable?
2) Is the reader imaginatively drawn into the experience?
2. What were the results?
a. Does the research approach fit the purpose of the study?
i) How does the researcher identify the study approach?
1) Are language and concepts consistent with the approach?
2) Are data collection and analysis techniques appropriate?
ii) Is the significance/importance of the study explicit?
1) Does review of the literatures support a need for the study?
2) What is the study’s potential contribution? Fill in (
iii) Is the sampling strategy clear and guided by study needs?
1) Does the researcher control selection of the sample?
2) Do sample composition and size reflect study needs?
b. Is the phenomenon (human experience) clearly identified?
i) Are data collection procedures clear?
1) Are sources and means of verifying data explicit?
2) Are researcher roles and activities explained?
ii) Are data analysis procedures described?
1) Does analysis guide direction of sampling and when it ends?
2) Are data management processes described?
c. What are the reported results (description or interpretation)?
i) How are specific findings presented? Fill in (
1) Is presentation logical, consistent, and easy to follow?
2) Do quotes fit the findings they are intended to illustrate?
ii) How are overall results presented?
1) Are meanings derived from data described in context?
2) Does the writing effectively promote understanding?
3. Will the results help me in caring for my patients?
a. Are the results relevant to persons in similar situations?
b. Are the results relevant to patient values and/or circumstances?
c. How may the results be applied in clinical practice?

SU_NSG7020_RCA_EBGuidelines_Template.doc

Rapid Critical Appraisal Evidence-Based Clinical Practice Guidelines	Numbered Studies
Unless otherwise specified, answers are Y=yes; N=no; U-unknown

1. Are the results of the study valid?
1 . Who were the guideline developers? Fill in (
2. Were the developers representative of key stakeholders in this specialty (interdisciplinary?)
3. Who funded the guideline development? Fill in (
4. Were any of the guidelines developers funded researchers of the reviewed studies?
5. Did the team have a valid development strategy?
6. Was an explicit (how decisions were made), sensible and imperial process used to identify, select, and combine evidence?
7. Did its developers carry out a comprehensive, reproducible literature review within the pas 12 months of its publication/revision?
8. Were all important options and outcomes considered?
9. Is each recommendation in the guideline tagged by the level/strength of evidence upon which it is based and linked with the scientific evidence?
10. Do the guidelines make explicit recommendations (reflecting value judgments about outcomes)?
11. Has the guideline been subjected to peer review and testing?
2. Applicability/Generalizability
12. Is the intent of use provided (e.g. national, regional, local)?
13. Are the recommendations clinically relevant?
14. Will the recommendations help me in caring for my patients?
15. Are the recommendations practical/feasible (e.g. resources-people and equipment- available)?
16. Are the recommendations a major variation from current practice?
17. Can the outcomes be measured through standard care?

SU_NSG7020_RCA_CohortStudies_Template.doc

Rapid Critical Appraisal Cohort Studies	Numbered Studies
Unless otherwise specified, answers are Y=yes; N=no; U-unknown

1. Are the results of the study valid?
a. Was there a representative and well-defined sample of patients at a similar point in the course of the disease?
b. Was follow-up sufficiently long and complete?
c. Were objective and unbiased outcome criteria used?
d. Did the analysis adjust for important prognostic risk factors and confounding variables?
2. What are the results?
a. What is the magnitude of the relationship between predictors (i.e. prognostic indicators) and targeted outcome? Fill in (
b. How likely is the outcome event(s) in a specified period of time? Fill in (
c. How precise are the study estimates? Fill in (
3. Will the results help me in caring for my patients?
a. Were the study patients similar to my own?
b. Will the results lead directly to selecting or avoiding therapy?
c. Are the results useful for reassuring or counseling patients?

SU_NSG7020_RCA_Case-Control_Template.doc

Rapid Critical Appraisal Cohort Case-Control Studies	Numbered Studies
Unless otherwise specified, answers are Y=yes; N=no; U-unknown

1. Are the results of the study valid?
a. How were the cases obtained?
b. Were appropriate controls selected?
c. Were data collection methods the same for the cases and controls?
2. What are the results?
a. Is an estimate of effect given (do the numbers add up?)
b. Are there multiple comparisons of data?
c. Is there any possibility of bias or confounding?
3. Will the results help me in caring for my patients?
a. Were the study patients similar to my own?
b. How do the results compare with previous studies? Fill in (
c. What are my patient’s/family’s values and expectations for the outcomes? Fill in (

SU_NSG7020_How to use the Rapid Critical Appraisal.doc

How to Use the Rapid Critical Appraisal (RCA) Checklists

Once you have completed your literature search, organize the studies by following these steps:

1. Alphabetize the list of studies according to the first author’s last name and initials of the first name.

2. Number the listings.

3. Identify each study’s type after the author’s name. This information can be found in the abstract in the “design” area or in the body of the article under “methods”. For example, 1. Beckwith, MM - RCA. 2. Chesmann, CR - Qualitative

4. Since multiple articles can be included on each RCA checklist, identify them by number.

5. Determine which checklist template is appropriate for the first article, then:

a) Double-click the header and enter the number of the study in the first box. Click “close” to exit the header area.

b) Answer the questions using the legend mentioned in the header for each item. Some questions require you to type in the answers. These are identified by either “Fill in” or “”.

c) Repeat the process to add additional studies.

SU_NSG7020_RCA_SystematicReviews_Template.doc

Rapid Critical Appraisal Systematic Reviews of Clinical Intervention Studies	Numbered Studies
Unless otherwise specified, answers are Y=yes; N=no; U-unknown

1. Are the results of the study valid?
A. Are the studies contained in the review randomized controlled trials?
B. Does the review include a detailed description of the search strategy to find all relevant studies?
C. Does the review describe how validity of the individual studies was assessed (e.g. methodological quality, including the use of random assignments to study groups and complete follow-up of the subjects)?
D. Were the results consistent across studies?
E. Were individual patient data or aggregate data used in the analysis?
2. What are the results?
A. How large is the intervention or treatment effect (OR, RR, effect size, level of significance)? Fill in (
B. How precise is the intervention or treatment (CI)? Fill in (
3. Will the results help me in caring for my patients?
A. Are my patients similar to the ones included in the review?
B. Is it feasible to implement the findings in my practice setting?
C. Were all clinically important outcomes considered, including risks and benefits of the treatment?
D. What is my clinical assessment of the patient and are there any contraindications or circumstances that would inhibit me from implementing the treatment?
E. What are my patient’s and his or her family’s references and values about the treatment that is under consideration?