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Critical appraisal of an abstract URVASHI SINGH ACADEMIC FOUNDATION DOCTOR – MANCHESTER FOUNDATION TRUST EMAIL ID: URVASHI.SINGH@MFTWITTER: @HEYITSURVIHow to critically appraise an abstract? Break it down! Read the abstract and make your notes under the following headings ◦ Basic information about the journal and the paper given ◦ Methods + Systematic bias ◦ Statistical analysis ◦ Conclusion and clinical relevance ◦ Summarising your findings overallBasic information Journal information – journal name & impact factor if known Title of the paper – (mention authors et al. if given) & when published Type of study – Most likely to get RCTs for appraisal Main aim of the study – what main question are they trying to answer? PICO – ◦ Population: what demographic is being studied? ◦ Intervention: New technique/treatment ◦ Control: Gold standard/placebo ◦ Outcome: What is the intended goal? What does the paper eventually want to accomplish?Basic information Journal information – NEJM with IF of 91.47 (High impact) Title of the paper – A Randomized, Controlled Trial of Liraglutide for Adolescents with Obesity (published in 2020) by Kelly et.al Type of study – Randomized double blind control trial Main aim of the study –Compare liraglutude vs placebo in adolescents PICO – ◦ Population: Adolescents (12-18 years) ◦ Intervention: Liraglutide subcutaneous injection - 3mg (in addition to lifestyle interventions) ◦ Control: Placebo + lifestyle therapy ◦ Outcome: BMI standard deviation at 56 weeksMethods + systematic bias Methods are the most important section of any paper. Discuss the methods used and point out any bias to embellish your appraisal ◦ Inclusion vs exclusion criteria ◦ Randomization ◦ Sample size and power calculation these biases.ystematic bias – discuss whether the authors have controlled for a.Selection Bias b.Performance Bias c.Observation Bias d.Attrition Bias e.Confounding factorsResults and Statisticalanalysis a. Has the primary outcome been achieved? Is there a statistically significant difference with regard to primary outcomes? ◦ P-value and confidence intervals ◦ Type 1 vs Type 2 errors ◦ Odds ratios and relative risk b.Have any other outcomes been assessed and were these mentioned prior to the study in the methods section?Conclusion and clinical relevance ▪Have I drawn the same conclusions from these results as the authors of the study a. Internal validity b. External validity c. Number needed to treat ▪Summarise your findings Things to know – you might be asked ▪Definitions of key statistical measures – p-value, odds ratio, relative risk, confidence intervals ▪Different study types – their strengths and limitations ▪RCTs – how to design them? Strengths & Limitations? CASP- RCT checklist.Resources for critical appraisal ▪ Links for preparation ➢ https://library.medschl.cam.ac.uk/critical- appraisal-resources/ ➢ Journals for abstracts – NEJM, Nature etc. • Interview prep ➢ Clinical scenarios: Unofficial guide to prescribing ➢ Medical interviews book by ISC medical Thankyou! QUESTIONS? URVASHI.SINGH@MFT.NHS.UK