Critical Appraisal of Primary and Secondary Evidence on the Use of SSRIs in Major Depressive Disorder

Assessment 3 Critical Appraisal

Table of Contents
Part 1................................................................................................................................................3
Primary Evidence.........................................................................................................................4
Secondary Evidence.....................................................................................................................4
Part 2................................................................................................................................................4
Clinical significance of the article...............................................................................................9
Relevance to the original question...............................................................................................9
Strengths and limitations of the evidence....................................................................................9
Part 3..............................................................................................................................................11
Clinical significance of the article.............................................................................................13
Relevance to the original question.............................................................................................14
Strengths and limitations of the evidence..................................................................................14
References......................................................................................................................................14

Part 1
When a research article is critiqued, it helps the appraiser picking the good quality of papers from the
bad ones (Harrison, Reid, Quinn, & Shenkin, 2017). Critical appraisal exhibit understanding of
the major health research logical perspectives and methodologies including their assumptions
and practical applications. The appraisal also differentiate between different evidence types and
research designs. The research question for the assignment is “In the target population of patients
with major depressive disorder can the use of SSRI depressants improve symptoms as compared
to standard treatment within 6 to 12 months?” This assignment critically reviews two research
papers, one is a primary evidence which is an observational study while the other is a secondary
evidence which is a systematic review. Same critiquing tool is used for both articles for the
purpoe of critical appraisal. The appraisal for both the papers will include a review of the aim,
research design, recruitment strategy, data collection and analysis methods, believability,
implications of the study, clinical significance, and strengths and limitations of the article.
Further, the appraisal will also include the relevance of the paper with the resarch question.
Various critiquing tools exist for the purpose of critically appraising all types of studies. But in
this assignment to appraise the primary and secondary evidence, Critical Appraisal Skills
Programme (CASP) tools has been used. This tool has a strategic approach to evaluate the rigour
of the research articles under consideration (Smith & Noble, 2016). In addition, the CASP tools
are brief yet comprehensive by including every aspect needed for critical review of literature
efficiently (Nadelson & Nadelson, 2014). In this assignment, the primary and secondary
evidence are critically appraised to answer relevant and organized questions through the use of
CASP tools. After the appraisal, the relevance of the paper to original research question is also
identified.

Primary Evidence
The primary evidence used for critical appraisal relevant to the chosen topic is an observational study
titled “Cognitive tolerability following successful long term treatment of major depression and
anxiety disorders with SSRI antidepressants”.
Secondary Evidence
The secondary evidence used for critical appraisal is a systematic review titled “Selective serotonin
reuptake inhibitors versus placebo in patients with major depressive disorder. A systematic
review with meta-analysis and Trial Sequential Analysis”.
Part 2
Paper chosen for the critical appraisal- Jakobsen, J. C., Katakam, K. K., Schou, A., Hellmuth, S.
G., Stallknecht, S. E., Leth-Møller, K., ... & Krogh, J. (2017). Selective serotonin
reuptake inhibitors versus placebo in patients with major depressive disorder. A
systematic review with meta-analysis and Trial Sequential Analysis. BMC psychiatry,
17(1), 58. Doi: 10.1186/s12888-016-1173-2
1. A clearly focused question was addressed in the review?
The review is clearly focused and addresses a direct question. The focus in terms of population studied
is the patients with the major depressive disorder. It is also focused in terms of the intervention
given which is the Selective serotonin reuptake inhibitors in the target population. The review
also focused on the comparison of the intervention which is placebo. The title of the article
mentions the type of research study, that is systematic review. The mention of the study type in