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Evidence-Based Medicine: Critical Appraisals of Systematic Reviews

Critical Appraisal of Systematic Reviews

Systematic Reviews should be appraised for their quality in making evidence based practice decisions. Several checklists and tools can be used to appraise the review.

Basic Appraisal Questions

1. Did the review explicitly address a sensible clinical question?

2. Was the search for relevant studies detailed and exhaustive?

3. Were the primary studies of high methodological quality?

4. Were the selection and assessments of the studies reproducible?

5. Were the results similar from study to study? (check the forest plot and check the risk ratio and the line of confidence intervals)

6. What are the overall results of the review?

7. How precise were the results? (check the confidence interval for the summary or cumulative effect size)

Apply the results to patient care and clinical expertise. 

Forest Plots

Forest plots detail each randomized controlled trial included in the systematic review to see how homogenous or heterogeneous the studies are to one another and how much the results of the systematic review can be generalized. They include the confidence intervals for each study and the weight of each study within the analysis. 

Image of forest plot