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Grading the Quality of an Article

  • Find your article/study type in Table 1. This gives you an initial confidence grade in the quality of the article, relative to other study types.
  • Next, adjust the confidence "grade" up or down using the Table 2. This allows for weaknesses and strengths within the article/study.
  • Finally, assign a "grade" to the article from Table 3. You will then be able to use this in your synthesis of all your articles/studies to compare them against each other for the quality of the evidence.

Download the PDF of the tables below for printing.

Study Design (Table 1)

Study Design Quality Initial Confidence
Meta-Analysis of RCTs Best A+
Systematic Review Really Good A
Evidence-Based Practice Guideline Very Good B+
Randomized Control Trial (RCT) Good B
Cohort / Case Control Study Fair B-
Case Report / Case Series Poor C+
Expert Opinion Very Poor C

Adjustments for Factors (Table 2)

After getting an initial confidence "grade", then adjust it up or down based on factors such as these that would strengthen or weaken the overall quality of the study.

Lower if... Raise if...
  • Difficult to determine; not clearly focused or defined.
  • Easily identified; Focused and well defined.
  • Missing or minimal
  • They are extensive and from the primary literature.
Sample Size
  • Very small (not appropriate); Large # of drop outs.
  • Selection & exclusion criteria missing.
  • Appropriately large; small # of drop outs.
  • Reflects demographics of larger population.
  • You can't follow; understand what they did.
  • Very low response rates to data collection.
  • You can easily follow and understand.
  • Appropriately high response rates to data collection.
  • There is evidence of bias or conflict of interest.
  • There is no disclaimer to conflict of interest.
  • There is clear evidence and acknowledgement of no (or minimal) bias and conflict of interest.
  • They are incomplete, difficult to understand.
  • No statistical significance shown.
  • Easily interpreted, variables identified.
  • Statistical significance is shown.
  • Are unclear.
  • Are an honest objective interpretation of results.
  • Provide implications for your practice.

Final Quality Grade (Table 3)

Determine a final Confidence Level of the Quality.

Use this "grade" to compare between articles to identify the best quality and evidence.

Extremely High A+
Very High A
Moderate High A-
Moderate B+
Moderate Low B
Low B-
Very Low C+

[Home] Working w/ Literature | [1] Searching the Literature | [2] Types of Studies & Levels of Evidence | [3] Reviewing an Article | [4] Grading the Quality of an Article | [5] Synthesizing the Literature

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