Rapid critical appraisal of an RCT Step 1

Step 1: What question did the study ask (the PICO)?

If you have not done so already, comparing the PICO of your question with the PICO of the article by Spink MJ, et al. is a good place to start. You may not wish to go any further with appraising this study if it is not applicable to what you want to find out.

The applicability of evidence to individuals is sometimes called the external validity or generalisability of the search results.

Using the PICO method for constructing a clinical question, think about how you would structure a PICO format for this paper. When you are ready click on the Answer icon(s) to see the suggested answers.

PICO for the paper by Spink:

Population	Community dwelling, aged over 65 years with disabling foot pain
Intervention	Multifaceted intervention package: footwear, education, and exercise
Comparison	No intervention apart from usual podiatry treatment
Outcomes	Reduction in falls

Question: The population being studied in this paper is community-dwelling elderly people with disabling foot pain. Is this population close enough to your population of interest - people over 65 in aged care facilities - to make the results of this study applicable or generalisable to your clinical question?

Check your answer.

Answer	This is a judgement you will have to make based on your clinical experience and on the availability of other published studies

External validity: The degree to which the results of a clinical study can be applied to clinical practice in a specific setting

Generalisability: The ability to reliably apply the results of a study to other populations, based on the characteristics of the subjects, size of the sample, the setting, and trustworthiness of the study

Applicability: Is related to whether a particular treatment or form of care that demonstrated an overall effect in a study can be expected to provide the same effect for an individual or group in a specific clinical or population setting.