Critical appraisal of the orthopaedic literature: therapeutic and economic analysis.

When reading an article of interest in the orthopaedic literature it is necessary to appraise the quality of the evidence therein. First, the reader should determine the design of the study. If the level of the study design in the hierarchy of evidence is lower, the inferences that are drawn from the study are weaker. Second, the article should be assessed for the quality indicators relevant to the design. To the extent that the quality is high, the inferences that are drawn from the study will be strengthened. Making this process explicit, with guidelines to assess the strength of the available evidence, will serve to improve patient care.