Appraising therapeutic study (Part 1)

Now that we’ve identified evidence that matches our PICO or research question, the next step is to evaluate the quality of a therapeutic study.

Even a well-framed research question is useless if the study behind it is poorly conducted. This is where critical appraisal comes in—helping us determine whether the evidence is reliable, valid, and applicable.

Assessing Internal Validity

The key to appraising a study is internal validity, which refers to how well the research methods prevent bias from influencing the results. A study with strong internal validity ensures that any observed effects are truly due to the intervention and not external factors.

To systematically evaluate therapeutic studies, we can use structured appraisal tools like checklists. However, a more adaptable approach is the RAMMBO framework, which simplifies the process into six key areas:

1. Recruitment – Were study participants representative of the population? Was the sample size sufficient to produce reliable results? A poorly recruited sample can lead to misleading conclusions.

2. Allocation – In randomised controlled trials (RCTs), were participants randomly assigned to groups? Randomisation helps balance confounding factors, ensuring fair comparisons between treatment and control groups.

3. Maintenance – Were both groups treated equally apart from the intervention? Were procedures and follow-ups conducted in a consistent manner? Unequal treatment can introduce bias.

4. Measurement – Were variables measured objectively and consistently? Did researchers use validated tools and standardized methods? Measurement errors can distort study findings.

5. Blinding – Were participants and researchers blinded to treatment assignments? Blinding minimizes bias in how outcomes are reported or assessed. While not always possible, it strengthens a study’s credibility.

6. Outcomes – Were the outcomes well-defined, relevant, and measured precisely? Did researchers clearly describe how they measured them and whether blinding was applied in outcome assessment?

Why RAMMBO Matters?

By applying the RAMMBO framework, we can systematically assess whether a study is robust and trustworthy. This method ensures that we identify high-quality evidence and make well-informed decisions in clinical and public health practice. Additionally:

• Strong internal validity is essential for meaningful results.

• The RAMMBO framework provides a structured way to evaluate therapeutic studies.

• A well-conducted study minimizes bias and increases confidence in the findings.

In the next session, we will dive into interpreting study results and how to apply them effectively in practice.