EBVM Toolkit 15: clinical guidelines checklist

Introduction

Critical appraisal is a process which is used to help you identify the strengths and weakness of a research paper.  Understanding how appropriate the study design is for the question you are seeking to answer, how well the study was carried out, and how good the reporting in the paper is helps you to assess whether the paper is likely to provide reliable evidence.  

This page is designed to help you appraise clinical guidelines. We define clinical guidelines as systematically developed, evidence-based statements that can help practitioners and clients make decisions about the care of patients in specific clinical circumstances. As the purpose of guidelines is to aid decision-making, it is important to ensure that the recommendations are evidence-based and applicable to your patients. Answering the following questions will help you to reflect on how the guidelines were developed and whether the recommendations are appropriate to your local circumstances.

Clinical guidelines checklist

For each question think about whether the answer is yes, no or not sure and what your reasoning is for that answer.

1. Was the scope and purpose of the guideline clearly defined?

[text needed here]

2. Is the subject matter relevant to your practice?

[text needed here]

3. Do the authors have appropriate knowledge and expertise to write this guideline?

e.g. specialist status or appropriate postgraduate qualifications.

4. How up to date is the guideline?

Is there likely to be more recent evidence that has been published since the guidelines were developed? Is a date for review included in the guideline?

5. Was the methodology for developing the guideline clearly described?

[text needed here]

6. Was the methodology for retrieving relevant literature clearly described?

Is the search strategy clearly stated and appropriate to the purpose? Have the literature searches been carried out using appropriate search terms and databases? Are the results of the searches clearly described or made available as supplementary materials?

7. Was the way that the literature was reviewed, and the recommendations developed clearly described?

Have the authors critically appraised the evidence? Has the grading of the evidence been clearly described? Is a full list of references included in the guideline?

8. Did the authors include a range of suitable evidence?

Did the papers included address relevant questions and have an appropriate study design? Have differing viewpoints and knowledge gaps been discussed? Is there any evidence of bias in the evidence included or its interpretation?

9. Are the recommendations clear and relevant?

Are the recommendations easily identified, either through formatting or in a separate table? Is the evidence supporting each recommendation clearly identified? Are the recommendations clinically sound and applicable to practice? Are there any barriers to implementation? e.g. recommended products are not licensed or readily available.

10. Are all the important aspects of the subject considered?

Are there any questions that you would consider important that were not addressed in the guidelines?

11. Can information from the guidelines be applied to your practice?

What steps would need to be taken to implement these changes? e.g. staff training, new equipment or protocols. Would there be any problems in implementing these changes? Are there any potential adverse effects of the change? What costs would the change incur?

12. Having read the guidelines are there any primary sources or other references that you want to access?

[text needed here]

Try it out yourself

You could use the following paper to try out the questions:

Bowen, M. et al. (2019) Primary care clinical guidelines: Analgesia. Equine Veterinary Journal, 52 (1), pp. 13-27. DOI: https://doi.org/10.1111/evj.13198