Critical Appraisal of a Systematic Review: A Concise Review

OBJECTIVES: Concise definitive review of how to read and critically appraise a systematic review.

DATA SOURCES: None.

STUDY SELECTION: Current literature describing the conduct, reporting, and appraisal of systematic reviews and meta-analyses.

DATA EXTRACTION: Best practices for conducting, reporting, and appraising systematic review were summarized.

DATA SYNTHESIS: A systematic review is a review of a clearly formulated question that uses systematic and explicit methods to identify, select, and critically appraise relevant original research, and to collect and analyze data from the studies that are included in the review. Critical appraisal methods address both the credibility (quality of conduct) and rate the confidence in the quality of summarized evidence from a systematic review. The A Measurement Tool to Assess Systematic Reviews-2 tool is a widely used practical tool to appraise the conduct of a systematic review. Confidence in estimates of effect is determined by assessing for risk of bias, inconsistency of results, imprecision, indirectness of evidence, and publication bias.

CONCLUSIONS: Systematic reviews are transparent and reproducible summaries of research and conclusions drawn from them are only as credible and reliable as their development process and the studies which form the systematic review. Applying evidence from a systematic review to patient care considers whether the results can be directly applied, whether all important outcomes have been considered, and if the benefits are worth potential harms and costs.