Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013;20(2):127-41.
doi: 10.1080/08989621.2013.768931.

The cycle of bias in health research: a framework and toolbox for critical appraisal training

Donna H Odierna  1 , Susan R Forsyth, Jenny White, Lisa A Bero
Affiliations

The cycle of bias in health research: a framework and toolbox for critical appraisal training

Donna H Odierna et al. Account Res. 2013.

Abstract

Recognizing bias in health research is crucial for evidence-based decision making. We worked with eight community groups to develop materials for nine modular, individualized critical appraisal workshops we conducted with 102 consumers (four workshops), 43 healthcare providers (three workshops), and 33 journalists (two workshops) in California. We presented workshops using a "cycle of bias" framework, and developed a toolbox of presentations, problem-based small group sessions, and skill-building materials to improve participants' ability to evaluate research for financial and other conflicts of interest, bias, validity, and applicability. Participant feedback indicated that the adaptability of the toolbox and our focus on bias were critical elements in the success of our workshops.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Cycle of Bias Framework for Evaluating Health Studies
Figure 2
Figure 2. Excerpts from a Journal Article Abstract1 and Discloaures, Annotated with the PECO Mnemonic (Population, Exposure, Comparison, Outcome) and Commentary
1 Enstrom and Kabat, 2003 COI = Conflict of intest
Figure 3
Figure 3. Annotated Meta-Analysis1 Forest Plots and Summary Statistics of the Relationship between Industry Sponsorship and Research Outcome
1 Lundh et al., 2012
Figure 4
Figure 4. Excerpts from a Journal Article1 Abstract and Disclosures, and Subsequent Media Reports2-4 Annotated to Show Study Population, Outcome, Conflicts of Interest, and Presentation of Results
ARR = Absolute risk reduction. RRR = Relative risk reduction. COI = conflict of interest 1Ridker 2008; 2Belluck 2008, 3 New York Times 2008; 4 Parker-Pope 2008
See this image and copyright information in PMC

References

    1. Akl EA, Oxman AD, Herrin J, Vist GE, Terrenato I, Sperati F, Costiniuk C, Blank D, Schunemann H. Using alternative statistical formats for presenting risks and risk reductions. Cochrane Database Syst Rev. 2011;3 CD006776. - PMC - PubMed
    1. Aveyard H. Doing a Literature Review in Health and Social Science: A Practical Guide. McGraw-Hill; New York: 2007.
    1. Barnes DE, Bero LA. Why review articles on the health effects of passive smoking reach different conclusions. JAMA. 1998;279(19):1566–70. - PubMed
    1. Belluck P. Cholesterol-fighting drugs show wider benefit. New York Times. 2008 Nov 10; November 10.
    1. Berger B, Steckelberg A, Meyer G, Kasper J, Muhlhauser I. Training of patient and consumer representatives in the basic competencies of evidence-based medicine: a feasibility study. BMC Med Educ. 2010;10:16. - PMC - PubMed

Publication types

LinkOut - more resources