Audet N, Gagnon R, Ladouceur R, Marcil M
Unité de médecine familiale, hôpital Laval, Québec.
CMAJ. 1993 Mar 15;148(6):945-52.
To evaluate studies assessing the effectiveness of teaching critical appraisal of the literature to medical students. DATA SOURCES: French and English articles published between 1980 and 1990 indexed on MEDLINE or FAMLI as well as articles identified from the bibliographies. STUDY SELECTION: Studies were evaluated if the subjects were undergraduate or postgraduate medical students and if the teaching intervention was aimed at improving one or more of the following areas: knowledge in clinical epidemiology and biostatistics, reading habits and ability to critically appraise a scientific article. DATA EXTRACTION: The methodologic quality of the articles was assessed by three evaluators, who used a modified version of Poynard's checklist to assign a score. Articles with a score of 60% or more were considered satisfactory. The reliability of the checklist was evaluated by means of the kappa (kappa) coefficient and a coefficient of intraclass correlation. DATA SYNTHESIS: For the three evaluators the mean kappa coefficient was 0.33 and the coefficient of intraclass correlation 0.70. Five of the 10 studies had an overall score of 60% or higher. The quality of the individual sections of the articles varied: purpose of the study 85%, description of the population 58%, methods 44%, analysis of results 50%, and conclusions 90%. CONCLUSIONS: The effectiveness of teaching critical appraisal of the literature remains uncertain. More rigorous methods are needed in research in this area.
评估关于向医学生传授文献批判性评价有效性的研究。数据来源：1980年至1990年间发表在MEDLINE或FAMLI上的法语和英语文章，以及从参考文献中识别出的文章。研究选择：如果研究对象为本科或研究生医学生，且教学干预旨在改善以下一个或多个方面，则对研究进行评估：临床流行病学和生物统计学知识、阅读习惯以及批判性评价科学文章的能力。数据提取：由三名评估人员评估文章的方法学质量，他们使用Poynard清单的修改版来打分。得分60%或更高的文章被认为是令人满意的。通过kappa（kappa）系数和组内相关系数评估清单的可靠性。数据综合：对于三名评估人员，平均kappa系数为0.33，组内相关系数为0.70。10项研究中有5项的总体得分在60%或更高。文章各部分的质量各不相同：研究目的85%，人群描述58%，方法44%，结果分析50%，结论90%。结论：文献批判性评价教学的有效性仍不确定。该领域的研究需要更严格的方法。
