How to Appraise Research: A Guide for Chiropractic Students and Practitioners

How to Appraise Research: A Guide for Chiropractic Students and Practitioners

Clinical Chiropractic (2003) 6, 154—155 BOOK REVIEW How to Appraise Research: A Guide for Chiropractic Students and Practitioners C. Hagino, Churchi...

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Clinical Chiropractic (2003) 6, 154—155

BOOK REVIEW

How to Appraise Research: A Guide for Chiropractic Students and Practitioners C. Hagino, Churchill Livingstone, Edinburgh With the current emphasis on evidence-based practice, it is essential that practitioners are able to read and critically appraise published research so they can determine its value and relevance to clinical practice. The text ‘‘How to appraise research’’ focuses on the evaluation of eight previously published papers, using notes and questions to help the reader through the evaluation process. From the title of the book and its description on the jacket, you could be lead to believe that this text will teach you how to critically appraise clinical research papers. However, this book is not for the novice; it requires a good basic understanding of research methods, or would need to be read in conjunction with other texts such as Greenhalgh1 and Sackett et al.2 In fairness, this point is accepted by the author in the ‘‘How to use this workbook’’ section, but to read this you would have already bought the book! Even a short introduction to the research methods used in the papers covered, and their individual strengths and weaknesses would have made this a more user-friendly text. In contrast, the questions and notes on statistical tests (the curse of critical appraisal unless you happen to be a statistician) are very informative and well explained. The author provides ‘‘quick and dirty’’ checklists to use in appraising papers in the ‘‘How to use this workbook’’ section, but then does not refer back to them in the appraisal chapters. A completed example of the checklist for each paper would have demonstrated to the reader a structured approach to appraisal, which they could apply in their own appraisal of further papers. The questions posed by the author alongside the papers will help the reader learn, but they may be uncertain how to review a paper without these questions to prompt their thinking. Many of the questions posed by the author

are related to how a research paper is written and are editorial in nature. These are not strictly related to the quality of the research itself and might be confusing to some readers; it must be remembered that a poorly structured paper may still have very important findings. Unfortunately, there is a bias towards appraisal of intervention research designs, in particular clinical trails, in this book. As a result, some quantitative research methods are not covered and, moreover, qualitative research is ignored completely. There is a growing acceptance of the importance of qualitative research in medicine2—4 and the chiropractic profession has long advocated a patient-centred paradigm for health care which requires the inclusion of qualitative research techniques.5 It is, therefore, regrettable that this chiropractic text is not inclusive of qualitative research methods. In conclusion, this text is useful to review and extend knowledge of critical appraisal for practitioners with an existing understanding of the topic, or to be used in combination with other critical appraisal texts. As such, it is a valuable addition to a chiropractor’s bookshelf. It contains some good explanations of statistical testing and illustrates some important concepts in appraising research. However, if a novice in critical appraisal bought this book, expecting to be able to appraise any research paper after reading it, they would be sorely disappointed. The reviewer suggests that the reader should first study the relevant research method and its critical appraisal before using this text to test and expand their knowledge.

References 1. Greenhalgh T. How to read a paper: the basics of evidencebased medicine, 2nd ed. London: BMJ Publishing Group; 2001. 2. Sackett DL, Strauss SE, Richardson WS, Rosenberg W, Haynes RB. Evidence-based medicine: how o practice

1479-2354/$30.00 ß 2003 The College of Chiropractors. Published by Elsevier Ltd. All rights reserved. doi:10.1016/S1479-2354(03)00044-0

How to appraise research: a guide for chiropractic students and practitioners

and teach EBM, 2nd ed. Edinburgh: Churchill Livingstone; 2000. 3. Green J, Britten N. Qualitative research and evidence-based medicine. BMJ 1998;316(7139):1230—2. 4. Verhoef MJ, Casebeer AL, Hilsden RJ. Assessing efficacy of complementary medicine: adding qualitative research methods to the ‘‘gold standard’’. J Altern Complement Med 2002;8(3):275—81. 5. Gatterman MI. A patient-centered paradigm: a model for chiropractic education and research. J Altern Complement Med 1995;1(4):371—86.

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Amanda R. Jones-Harris, BSc, DC, MSc (Clinical Chiropractic), FCC (Orth) Active Chiropractic Clinic, The Orchard Surgery, Baldock Road Buntingford, Hertfordshire SG9 9DL, UK Tel.: þ44-1763-274646. E-mail address: [email protected] (A.R. Jones-Harris). 11 July 2003