The second day of Critical Appraisal focussed on understanding bias in research using Randomised Control Trials as an example.
Unlike the first session, where a paper was selected and a tool used (e.g. CASP) to critically appraise it, this session took a different approach. Michelle used the example of an RCT to explain each aspect that you need to be aware of when appraising a paper. RCTs were used as most aspects of research that you need to be aware of to appraise a paper occur in an RCT.
In teams we were given a flipchart of the process for an RCT as reminder from the last session and asked to place the types of bias on the process where we thought they might occur. Some of the delegates had more understanding than others but the task worked as a measurement of what everyone already understood. Using intuition and the knowledge of my team members we placed all the notes on the process before Michelle taught us what they meant. Once we’d finished Michelle then worked through the notes one by one explaining what they meant in practice and where in the RCT process you’d expect them to appear with examples from different studies for clarity – we weren’t that far off on most which was reassuring. This worked really well for me as I felt that I was getting an understanding of the concepts first then seeing them in the context of papers, it didn’t really matter what the content of the paper was.
I came away from the day with an understanding of the points to be aware of when appraising e.g. randomising, but also with ideas of how we might deliver the training. We also concluded that we can only appraise what is provided in front of us in writing; if the author doesn’t specify they randomised, or how, even if they did, we must assume they didn’t when we appraise the paper unless we can get copies of the research protocol to confirm. Finally we looked again at the different tools available to support critical appraisal; Scales, CASP and Domain-based. Armed with an understanding of the concepts we were able to assess the usefulness of the tools in different scenarios meaning we could identify when to use them with our colleagues in any training we deliver. I came away from the day with a much deeper understanding of the concepts to be aware of and another idea for a way in which we could potentially deliver training. The third and final session will look at statistics (everyone’s favourite subject!) but I’m sure with Michelle’s guidance we’ll all get through it…