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Literature Reviews in the Health Sciences: Risk of Bias and Critical Appraisal

Checklists & Tools

Cochrane Collaboration Risk of Bias Tools

Cochrane Handbook for Systematic Reviews of Interventions - Chapter 8

Higgins, J. P., Altman, D. G., Gøtzsche, P. C., Jüni, P., Moher, D., Oxman, A. D., ... & Sterne, J. A. (2011). The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ: British Medical Journal, 343.

CASP UK (Critical Appraisal Skills Program)

Critical appraisal checklists for randomized controlled trials, systematic reviews, cohort studies, case control studies, qualitative research, economic evaluations, diagnostic tests, clinical prediction rules


Joanna Briggs Institute Critical Appraisal Tools

In Pearson, A., Field, J., & Jordan, Z. (2009). Evidence-based clinical practice in nursing and health care: assimilating research, experience and expertise.  Appendix 2.         Located in the Health Sciences Library RT42 .P43 2007


GRADE Guidelines

GRADE provides guidance for rating the quality of evidence and the  strength of recommendations in health care.  A series of articles describing the GRADE approach were published in the Journal of Clinical Epidemiology (2011, Vol 64, Issue 4).

GRADE guidelines: 1. Introduction—GRADE evidence profiles and summary of findings tables

GRADE guidelines: 2. Framing the question and deciding on important outcomes

GRADE guidelines: 3. Rating the quality of evidence

GRADE guidelines: 4. Rating the quality of evidence—study limitations (risk of bias)

GRADE guidelines: 5. Rating the quality of evidence—publication bias 

GRADE guidelines 6. Rating the quality of evidence—imprecision 

GRADE guidelines: 7. Rating the quality of evidence—inconsistency

GRADE guidelines: 8. Rating the quality of evidence—indirectness


Centre for Evidence Based Medicine

Critical Appraisal Worksheets

COSMIN checklist (to evaluate the methodological quality of the included studies on measurement properties)


Reading an Article Critically

A few resources that may be helpful in learning how to critically appraise an article are listed below.

JAMAEvidence "helps decision makers identify the best available evidence by providing guides to the systematic consideration of the validity, importance, and applicability of claims about the assessment of health problems and the outcomes of health care."

Cochrane Handbook For Systematic Reviews Of Interventions (in the Health Sciences Library, R723.7 .C63 2008 )

How To Read A Paper : The Basics Of Evidence-Based Medicine (in the Health Sciences Library,  R118.6 .G77 2010)

Reading Research : A User-Friendly Guide For Nurses And Other Health Professionals  (in the Health Sciences Library,  R852 .D38 2008)

Making Sense Of Critical Appraisal (in the Health Sciences Library,  R852 .A34 2002)

Guide to Evidence-based Physical Therapist Practice (in the Health Sciences Library,  RM700.J49 2011)