CRITICAL APPRAISAL OF THE

TOPICS

SCREEN FOR INITIAL VALIDITY AND

RELEVANCE
The article is from a peer-reviewed journal
Object of the study is limited to animal, which is need more
research to make it applicable in human.
The study was not sponsored by any organization that
might influence the study design or results

SCREEN FOR INITIAL VALIDITY AND

RELEVANCE
The results, if valid, need more research for our practice, due to
this journal belongs to animal research
This information will have a direct impact on the health of our
patients & something they will care about, until it can be proven
safely in human being.
This information, if valid and proven safely in human, will require
us to change our current practice

DETERMINE THE INTENT

OF THE ARTICLE
To compare the outcome of the use silver
sulfadiazine (SSD) and olive oil in partial
thickness burn

Clinical
category

Description

Preferred Study
Design

Therapy

Tests the effectiveness of a

treatment, such as a drug,
surgical procedure, or other
intervention

Randomized, doubleblinded, placebocontrolled trial

Diagnosis

Measures the validity (is it

dependable?) and reliability
(will the same results be
obtained every time?) of a
diagnostic test, or evaluates
the effectiveness of a test in
detecting disease at a pre
symptomatic stage when
applied to a large population

Cross-sectional
survey (comparing
the new test with a
reference standard)

Causation

Assesses whether a substance

is related to the development
of an illness or condition

Cohort or case-

Determines the outcome of a

Longitudinal cohort

disease

study

Prognosis

control

LEVEL 1 OF EVIDENCE
Lev Therapy/Preventio
e
n,
l
Aetiology/Harm

Prognosis

Diagnosis

1a

SR (with
homogeneity*) of
RCTs

SR (with
homogeneity*)
of inception
cohort studies;
CDR validated
in different
populations

SR (with
homogeneity*) of
Level 1 diagnostic
studies; CDR with
1b studies from
different clinical
centres

1b

Individual RCT (with

narrow
Confidence Interv
al
)

Individual
Validating** cohort
inception
study with good
cohort study
reference
with > 80%
standards; or CDR
follow-up; CDR
tested within one
validated in a
clinical centre
single
population

1c

All or none

All or none case- Absolute SpPins and SnN

LEVEL 2 EVIDENCE
Leve
l

Therapy/Prevention,
Aetiology/Harm

Prognosis

Diagnosis

2a

SR (with homogeneity* )
of cohort studies

SR (with homogeneity*
) of either
retrospective cohort
studies or untreated
control groups in RCTs

SR (with homogeneity*) of
Level >2 diagnostic studies

2b

Individual cohort study

(including low quality
RCT; e.g., <80% followup)

Retrospective cohort
study or follow-up of
untreated control
patients in an RCT;
Derivation of CDR or
validated on splitsample only

Exploratory** cohort study

with goodreference
standards; CDR after
derivation, or validated
only on split-sample or
databases

2c

Outcomes" Research;"
Ecological studies

Outcomes" Research"

Level 3,4,5 of Evidence

Leve
l

Therapy/Prevention,
Aetiology/Harm

Prognosis

Diagnosis

3a

SR (with homogeneity*)
of case-control studies

SR (with homogeneity*) of
3b and better studies

3b

Individual Case-Control
Study

Non-consecutive study; or
without consistently
applied reference
standards

Case-series (and
Case-series (and
Case-control study, poor or
poor quality cohort and c poor quality prognostic
non-independent reference
ase-control studies
cohort studies***
standard
)
)
5
Expert opinion without Expert opinion without
Expert opinion without
explicit critical appraisal,
explicit critical explicit critical appraisal, or
or based on physiology,
appraisal, or based on
based on physiology,
bench research or "first
physiology, bench
bench research or "first
"principles
research or "first
"principles
"principles
4

GRADES OF
RECOMMENDATION
A

consistent level 1 studies

consistent level 2 or 3 studies or

extrapolations from level 1 studies

level 4 studies or extrapolations from

level 2 or 3 studies

level 5 evidence or troublingly

inconsistent or inconclusive studies of
any level

THANK YOU