Is it worth reading this paper?

Abstract

How often have you asked yourself that question? Equally when you have finished reading a paper (or stopped reading it halfway through) how often have you asked what were they talking about? Or do you think, it's a good journal, they must know what they are talking about, I must be getting dull! As clinicians we need to be able to decide whether a particular treatment is worthwhile. If a new diagnostic test is better or more efficient than what was available previously; e.g. is E-speed X-ray film better than D-speed, or should we all be using digital radiography. In today's technological world we are faced with a mountain of information from different sources; books, journals, electronic journals, manufacturers' and distributors' information sheets. So how do we decide whether it is any good? Traditionally we might have looked at well-known standard textbooks or at papers in peer-reviewed journals. We might also look at the name of the author, or the institute from whence the authors came. If the authors or the institute had a good name or reputation we might then be more inclined to read them or give them more weight. But is this appropriate? When deciding if papers are any good a favoured method of readers is to look first at the introduction or abstract and conclusions. However, it is not unusual to find that often conclusions drawn from research papers are not related to the results presented or that the methodology used is able to answer the research question posed. So how can we assess whether a paper is worth reading? One method of achieving this is to have a systematic process of assessing the reliability, relevance and results of published papers. This is referred to as critical appraisal or critical reading. Critical appraisal can be practised by anyone with access to appropriate methodolo-gically sound appraisal criteria. Appraisal criteria can be found at several websites and there are also several books and CD-ROMs that now give information on how to carry this out. However, despite that range of criteria available for appraisal of papers there are only three essential questions that need to be asked of any paper: Is the study valid? What are the results? Are the results relevant? Is the study/paper valid? By valid we mean was the study conducted properly. This is also referred to as a study's internal validity, hence the question. To assess a study's internal validity we can ask a number of subsidiary questions.