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3 Key concepts for teaching critical thinking and critical appraisal
  1. Andy Oxman1,
  2. Iain Chalmers2,
  3. Astrid Austvoll-Dahlgren3
  1. 1Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
  2. 2James Lind Initiative, Oxford, UK
  3. 3Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway


Objectives Claims about interventions are ubiquitous. The ability to assess these claims and make informed choices depends on understanding and applying key concepts that are essential for making judgements about whether a claim is justified, whether comparisons are fair and reliable, and what action to take.

The Informed Health Choices (IHC) project has developed educational resources for schoolchildren and their parents to help improve their ability to assess claims about treatment effects. As our starting point, we developed a list of Key Concepts that people need to understand to assess these claims. The list currently includes 36 concepts and serves as a syllabus or curriculum.

The objectives of this workshop are to discuss the Key Concepts, their potential uses, whether they are sensible, and their further development. We will also discuss applicability of the concepts to claims and decisions about tests; and to other areas, such as education and environmental management.

Method We generated an initial list of concepts by identifying key concepts in literature and tools written for the general public, journalists, and health professionals, and by considering concepts related to assessing the certainty of evidence for treatment effects. We established a project advisory group composed of key researchers, journalists, teachers, and others with expertise in health literacy and teaching or communicating evidence-based healthcare to patients. Based on feedback collected online and at a workshop we have updated the list of IHC Key Concepts yearly (in 2016 and 2017).

Results The IHC Key Concepts provide a basis for developing learning resources to help people understand and apply the concepts when claims are made about the effects of treatments (and other interventions), and when health choices are made. The list of concepts also forms the basis for a database of multiple-choice questions which can be used to assess people’s ability to apply the IHC Key Concepts.

The IHC Key Concepts serve as standards for judgment, or principles for evaluating the trustworthiness of treatment claims, comparisons, and choices. The list is intended to be universally relevant. The concepts can help people to:

  1. Recognise claims about the effects of treatments which have an unreliable basis.

  2. Understand whether comparisons of treatments are fair and reliable.

  3. Make informed choices about treatments.

Conclusions This workshop will be a structured discussion of the potential uses of the IHC Key Concepts, the extent to which they are sensible and useful, and ways in which they might be improved. The Key Concepts are reviewed annually to allow for revisions of existing concepts and identification and inclusion of additional concepts. This discussion will feed into this process.

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