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Critiquing the Evidence: How do I know if I can use the evidence?

Questions to consider:

1. Do my clients have this clinical problem?
2. Do my clients manifest the problem in the same manner as described in the article?
3. Are there differences between my clients and the research participants that could cause differences in the treatment response?
4. Do my clients have co-morbid conditions that are contraindications for the treatment or intervention?
5. Are there economical or social factors (e.g. insurance) that would affect my clients' compliance?
6. Are my clients and practice similar to the research participants and providers?
7. Would the treatment/intervention match my clients' desires and morals?
8. Is this treatment/intervention in my clients' best interests?
9. Are the potential harms and costs worth the possible treatment benefits?
10. Are the results of the study valid for my clients and are the results from the study valid? (i.e. Were the participants randomized? Was the sample size sufficient? Were the instruments valid and reliable?  Were all of the clinically important outcomes considered? Can the results be generalized to my clients?)

Many of the following websites provide information on how to critique research articles to determine if the findings are applicable to your practice.

• Centre for Health Evidence (2003). How to decide on the applicability of clinical trials results to your patient. Retrieved December 1, 2003 from Centre for Health Evidence
  
• EBM Toolkit (2003). Worksheet for using an article about therapy or prevention. Retrieved December 1, 2003 from University of Alberta
  
• Erickson-Owens, D. A., & Kennedy, H. (2001). Fostering evidence-based care in clinical teaching. Journal of Midwifery & Women's Health, 46, 137-145.
  National Center for Biotechnology Information