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Department of Surgery, Division of Cardiothoracic Surgery, Tufts University School of Medicine, Tufts-New England Medical Center, 750 Washington Street, Boston, Massuchusetts 02111, USA. jurschel@buffalo.edu
In clinical research investigators generalize from study samples to populations, and in evidence-based medicine practitioners apply population-level evidence to individual patients. The validity of these processes is assessed through critical appraisal of published articles. Critical appraisal is therefore a core component of evidence-based medicine (EBM). The purpose of critical appraisal is not one of criticizing for criticism's sake. Instead, it is an exercise in assigning a value to an article. A checklist approach to article appraisal is outlined, and common pitfalls of analysis are highlighted. Relevant questions are posed for each section of an article (introduction, methods, results, discussion). The approach is applicable to most clinical surgical research articles, even those of a nonrandomized nature. Issues specific to evidence-based surgical practice, in contrast to evidence-based medicine, are introduced.
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