Principles of Clinical Research: Systematic Review Appraisal Report

This report presents a critical appraisal of two systematic reviews, one focusing on cannabinoids in dermatology and the other on the influence of diet in multiple sclerosis. The analysis utilizes the AMSTAR 2 critical appraisal tool to evaluate the research questions, inclusion/exclusion criteria, search strategies, and overall methodology of each review. The report highlights the strengths and limitations of the studies, including the clarity of research questions, the rationale for study selection, the assessment of bias, and the handling of heterogeneity. The appraisal of the cannabinoid study reveals weaknesses in its structure, lack of a clear research question, and insufficient detail in describing included studies. The appraisal of the diet in multiple sclerosis study identifies issues with unclear inclusion/exclusion criteria and an imprecise research question. Both appraisals assess the presence or absence of conflict of interest statements and the overall quality of the reviews, offering recommendations for future research and improvements in reporting. The report concludes by summarizing the key findings and offering suggestions for enhancing the rigor and clarity of systematic reviews.

Running head: CRITICAL APPRAISAL OF A PUBLISHED SYSTEMATIC REVIEW
Critical appraisal of a published systematic review
Name of the student:
Name of the university:
Name of the Author:

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CRITICAL APPRAISAL OF A PUBLISHED SYSTEMATIC REVIEW
Table of Contents
Introduction..........................................................................................................................2
Research Question...............................................................................................................2
Inclusion/exclusion criteria..................................................................................................2
Review protocol...................................................................................................................3
Search strategies..................................................................................................................3
Rationale of selection of the study designs for inclusion in the review..............................4
Provided a list of excluded studies and justify the exclusions.............................................4
Description of the included studies in adequate detail........................................................4
Assessment of risk of bias in included studies....................................................................4
Sources of funding in the included studies..........................................................................5
Satisfactory explanation for, and discussion of, any heterogeneity observed in the results
of the review....................................................................................................................................5
Potential sources of conflict of interest of the review authors.............................................5
Strengths / limitations of review paper................................................................................5
Reference List......................................................................................................................7

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CRITICAL APPRAISAL OF A PUBLISHED SYSTEMATIC REVIEW
Introduction
In this paper a detailed critical analysis have been done on the following article:
Eagleston LRM, Kalani NK, Patel RR, Flaten HK, Dunnick CA, Dellavalle RP.
Cannabinoids in dermatology: a scoping review. Dermatol Online J.
2018;24(6):13030/qt7pn8c0sb. Published 2018 Jun 15.
The critical appraisal of the article have been done by the help of AMSTAR 2 critical
appraisal tool which is used for systematic reviews1.
Research Question
The main aim of the article is to find out whether cannabis and cannabinoids must be
used in dermatology. The article also looks at the various reasons for the limited use of cannabis
in treating skin diseases. There is absence of any kind of well-structured research question in the
report. In this article the authors have put all their effort in making the reader understand about
the various process by the help of cannabis can be used in rectifying the various implications of
skin diseases. How doctors have implemented the use of cannabis in the medical line have also
been discussed by the authors in this article.
Inclusion/exclusion criteria
Primary articles have been used for research in this article which contains a systematic
reviews and even a meta-analytical analysis. The articles which have been selected for research
in this report is from the last 10 years and all of them involves the various uses of cannabis and
in conditions for dermatology.
1 Shea, B. J., Reeves, B. C., Wells, G., Thuku, M., Hamel, C., Moran, J., ... & Henry, D. A. (2017).
AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised
studies of healthcare interventions, or both. bmj, 358, j4008.

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CRITICAL APPRAISAL OF A PUBLISHED SYSTEMATIC REVIEW
The articles which are not written in English have been excluded along with opinion
articles. The articles which are not written in the last 10 years are excluded and which do not
state the use of cannabis and for dermatology purpose.
Review protocol
There are absence of any kind of review protocol in the article and no new
implementation have been found.
Search strategies
EMBASE and Ovid MEDLINE have been selected for searching the various articles
which were pertaining to the topic which have been researched in this article. 432 articles have
been selected from MEDLINE and 18 from Ovid2. After the removal of duplicates it was seen
that 442 articles remained. After the removal of the articles which were not having the topic at
hand 38 articles were used for the scoping view of this article.
The literature review used in this article is very specific to the topic which have been
described in this report. Any outside reference have not been used in this article or any kind of
outside contact with expert have not been done.
When the article was written there were presence of limited amounts of placebo
controlled studies and most of the data which were available to the authors were pre-clinical on
which a definite conclusion cannot be drawn.
The structure of the article was poor with the absence of clear aim and any kind of
research question which lacks in creating any interest among the reviewers.
2 Eagleston LRM, Kalani NK, Patel RR, Flaten HK, Dunnick CA, Dellavalle RP. Cannabinoids in
dermatology: a scoping review. Dermatol Online J. 2018;24(6):13030/qt7pn8c0sb. Published 2018 Jun
15.

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CRITICAL APPRAISAL OF A PUBLISHED SYSTEMATIC REVIEW
The screening of the articles have been done by a single reviewer and merely 38 articles
were selected for the conduction of the study.
Rationale of selection of the study designs for inclusion in the review
There is absence of any kind of rationale in this article.
Provided a list of excluded studies and justify the exclusions
A flow diagram have been provided in the article which shows the various reason by the
help of which the articles have been selected and the articles which have been rejected. The
reasons which have been stated for the exclusion of certain articles are justified. The various
keywords which have been used for the search of the articles have been depicted in a figure.
A list containing the various articles which have been excluded from the study have not
been provided in the report.
Description of the included studies in adequate detail
The list of the various studies which have been selected in the article does not provide a
clear description about the various detailing of the studies. There is absence of the sample size
and the process which have been carried out for performing the study is absent from the article.
There is absence of any kind of data and the research process in the provided studies.
Assessment of risk of bias in included studies
Biasness have been seen by the authors in explaining the various advantages of cannabis
but there is absence of any kind of reasons by the help of which cannabis might be harmful. The
various description provided in the report did not allow the readers to come up with a specific
conclusion and understanding.

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CRITICAL APPRAISAL OF A PUBLISHED SYSTEMATIC REVIEW
The authors did not pay enough attention to the various effects of excessive cannabis in
the treatment of skin diseases.
The various limitations of the studies used in the report have not been explained by the
authors in the article.
Sources of funding in the included studies
The various sources of funding in the given studies have not been addressed in the article.
Satisfactory explanation for, and discussion of, any heterogeneity observed in the results of
the review
This part has been explain in a partial way. In some cases there were clear explanation
and in some parts there was absence of clear reference and reasons.
Potential sources of conflict of interest of the review authors
There is absence of any kind of statement regarding the conflict of interest among the
authors of the article.
Strengths / limitations of review paper
The review paper is very weak when it comes to critical analysis of the topic as it merely
narrates the various studies which have been done in the selected articles. There is absence of
any kind of perfect research from which the reader can come to any kind of definite conclusion.
Less number of selected articles is the main problem of the article and absence of any
kind of primary research in the article is a huge problem for this article. The various skin
diseases on which usage of cannabis can be helpful have been discussed in this report in a proper
way. There are presence of clear recommendations in this article.

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CRITICAL APPRAISAL OF A PUBLISHED SYSTEMATIC REVIEW
With the help of AMSTAR 2 tool the critical appraisal have been conducted for the
article and it was found that the article cannot be used for gathering a pure idea about the
inclusion cannabis in dermatology.

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CRITICAL APPRAISAL OF A PUBLISHED SYSTEMATIC REVIEW
Reference List
Eagleston LRM, Kalani NK, Patel RR, Flaten HK, Dunnick CA, Dellavalle RP. Cannabinoids in
dermatology: a scoping review. Dermatol Online J. 2018;24(6):13030/qt7pn8c0sb.
Published 2018 Jun 15.
Shea, B. J., Reeves, B. C., Wells, G., Thuku, M., Hamel, C., Moran, J., ... & Henry, D. A.
(2017). AMSTAR 2: a critical appraisal tool for systematic reviews that include
randomised or non-randomised studies of healthcare interventions, or both. bmj, 358,
j4008.