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Research Guides@Tufts

Evidence-Based Dentistry (EBD)

Appraising the Evidence

Evidence Pyramid" by Tufts University can be reused under the CC BY-NC-SA license

It is not enough to find the evidence, one must also read and critically appraise it by determining its quality and applicability to your patient.

Critical appraisal helps you answer three key questions:

  1. Is it [the study] valid and unbiased?
    Using your expertise, determine the quality of the study.

  2. What are the results?
    Using your expertise, come to understand the results reported.

  3. Are the results relevant to my clinical question?
    Using your expertise and considering your patient’s needs and preferences, determine if the evidence is applicable in your particular clinical situation.

As you spend time in the profession, your ability to do this will improve. In the meantime, there are tools to help you. In order to be able to use these appraisal tools, you need to be able to:

  • Describe Level of Evidence
  • Classify evidence as Unfiltered or Filtered Information
  • Define the three study types included in Filtered Information
  • Use the Evidence Pyramid as a guide to appraising the evidence
  • Summarize what is needed to complete the EBD Cycle

Relevant Tutorial

Learn more with the Appraising the Evidence tutorial. 

  • For describing Level of Evidence:
  • For classifying evidence as Unfiltered or Filtered Information: For defining the three study types included in Filtered Information:
  • For using the Evidence Pyramid as a guide to appraising the evidence:
  • For summarizing what is needed to complete the EBD Cycle:

Unfiltered Information Study Types

While understanding the Filtered Information will get you started, understanding each type of Unfiltered Information in the Pyramid is also essential, since it is rare to be able to stop your evidence search with only Filtered Information.

Relevant Tutorial

Learn more with the Unfiltered Information Study Types tutorial. 

  • For Absolute SpPins & SnNouts:
  • For Audit:
  • For Case-Control Study:
  • For Case Series:
  • For Cohort Study:
  • For Costs and Costs Analysis:
  • For Expert Opinion:
  • For Outcomes Research:
  • For Randomized Controlled Trial (RCT):

Searching PubMed: Using the Working Set

Once you've created a working set* in PubMed, there are ways you can use the working set to aid you in appraising the evidence. 

In order to do this, you need to be able to:

  • Describe when it is useful to search within the working set for levels
  • Use three methods to search within the working set for levels of evidence
  • Identify a citation and its elements in PubMed
  • Explain three useful elements ona  full record on PubMed
  • Show how to find the full text of an article from PubMed

*Not sure what a working set is? See "Acquiring the Evidence" tab on the left-hand side.

Relevant Tutorial

Learn more with the Searching PubMed: Using the Working Set tutorial. 

  • For describing when it is useful to search within the working set for levels:
  • Use three methods to search within the working set for levels of evidence
  • Identify a citation and its elements in PubMed
  • Explain three useful elements on a full record on PubMed
  • Show how to find the full text of an article from PubMed

Checklists to Help Appraise Quality

AMSTAR (A Measurement Tool to Assess Systematic Reviews) Checklist
An appraisal tool to evaluate systematic reviews.

 

 

CASP (Critical Appraisal Skills Programme)
Provides checklists, elearning, and workshops on critical appraisal.

 

CONSORT (Consolidated Standards of Reporting Trials)
An evidence-based, minimum set of recommendations for reporting randomized trials. It offers a standard way for authors to prepare reports of trial findings, facilitating their complete and transparent reporting, and aiding their critical appraisal and interpretation.

 

SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) Checklist
Provides recommendations for a minimum set of scientific, ethical, and administrative elements that should be addressed in a clinical trial protocol.

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