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Shimberg Health Sciences Library & Florida Blue Health Knowledge Exchange

Evidence Synthesis / Systematic Reviews

Assess quality of included studies using appropriate validated appraisal tools

Access the Quality of the Studies

Systematic examination of included studies to determine reliability, importance, and applicability of the evidence. Criteria should include measures such as appropriate study design, risk of bias, and other study quality issues. Evaluation tools will vary based on study designs so you may need to use more than one.

1. Critically appraise each study

Evaluate the methodology for each study to identify Risk of Bias (RoB)  According to the Center for Evidence-Based Medicine (CEBM), "critical appraisal looks at the way a study is conducted and examines factors such as internal validitygeneralizability and relevance."  Findings are generally reported in a tabular format based on domain/element of the assessment tool. 

2. Assess the overall quality and reliability of the evidence

Determine the Level of Confidence (LoC) in the comprehensive findings of the review. Look at each outcome identified in the protocol to see if the supporting evidence is strong or weak. For reviews of clinical interventions, GRADE is preferred. The LoC is often presented as an evidence summary table (e.g., GRADE Summary of Findings tables).