Critically appraising research for antiracism

When critically appraising research, there are a number of checklists available from CASP for different types or research. However, none of these checklists include questions to help address possible racial bias.

Ramona Naicker, a medical librarian in Australia, has developed a checklist specifically to help identify any issues around underrepresentation and interpretation that may impact on a study's relevancy, validity and reliability.

The tool can be used as a supplement to another checklist (such as one of the CASP checklists) that look at specific research methodologies.

Access Naicker's Critically Appraising for Antiracism Quality Appraisal Tool

Benefiting from the ‘research effect’: The case for trusts supporting clinicians to become more research active and innovative

In November 2019, the Royal College of Physicians published a document entitled 'Benefiting from the ‘research effect’: The case for trusts supporting clinicians to become more research active and innovative', suggesting a number of ways that NHS Trusts can support staff to become more research active, and how this will benefit both patients and staff.

It showed that involvement by staff in research can improve their morale, and can help the recruitment and retention of staff. One finding is that staff lack protected time to do research, and this reports suggests that this should be a key priority. Two-thirds of RCP members surveyed said they want to do more research.

Patient outcomes in Trusts that are more research-active are better, and CQC inspections include research activity in their remit. In addition, patients feel more valued by being involved in research, learn more about their treatment, and gain a sense of pride in helping others.

Research tends to be concentrated in certain areas such as the South East of England, or large urban areas. Smaller and rural hospitals must also be encouraged to become more research active and benefit from the research effect.

The report makes clear that research is more than clinical trials, and can include anything that provides new evidence, including robust service evaluation.

How do Shrewsbury and Telford Health Libraries support research?

The report suggests that it is it is ‘increasingly important to ensure that the clinical workforce is equipped to appraise and generate evidence’ (p. 11). We support the appraisal of evidence with the provision of critical appraisal training, which can be provided to groups of staff. We also signpost to resources such as the CASP critical appraisal checklists, or to PRISMA guidelines for systematic reviews. Our Knowledge Navigator tool provides advice on how to search for different types of research such as randomised controlled trials, observational studies and qualitative research.

Our librarians can also assist in creating systematic reviews, by designing and carrying out search strategies, providing advice on databases, or advising on where to publish. Recently, a systematic review was published that involved one our librarians, who was listed as a co-author. We can also carry out literature searches for other research.

We also attend the SaTH Research & Innovation committee, to advocate for library services and also gain a better understanding of the local issues. As part of our work with Research & Innovation, we manage a staff publications database, to track and promote local research publications, and these include conference abstracts, poster presentations and innovations such as those published on Fab NHS Stuff. Staff of SaTH can submit details of their own publications to the collection.

For 2020, we're planning to introduce a course for nurses and midwives called 'Research Ready' that will include training on how to find and appraise the research literature, and the opportunity to discuss and reflect on a journal article as a way of gaining hours for revalidation. We're also looking to run some timetabled training on critical appraisal that will include a look at how to interpret the statistics in a research paper. Keep an eye out for further details in the New Year!

Sources of bias in health research

The Centre for Evidence Based Medicine at the University of Oxford has developed a catalogue of sources of bias that may affect health care evidence, and may need to be taken into account when performing a critical appraisal on a published piece of research.

Just a few of the examples include:

Allocation bias

Systematic difference in how participants are assigned to treatment and comparison groups in a clinical trial.

Hot stuff bias

When a topic is fashionable (‘hot’)  investigators may be less critical in their approach to their research, and investigators and editors may not be able to resist the temptation to publish the results.

Positive results bias

The tendency to submit, accept and publish positive results rather than non-significant or negative results.

Volunteer bias

Participants volunteering to take part in a study intrinsically have different characteristics from the general population of interest.

For more information, including ways to reduce possible bias when carrying out research, visit the Catalogue of Bias.