> For the complete documentation index, see [llms.txt](https://docs.nested-knowledge.com/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://docs.nested-knowledge.com/review-workflow/critical-appraisal.md).

# Critical Appraisal

Learn how to choose an appraisal system and appraise included studies.

**Critical Appraisal** assesses each included study's risk of bias using a structured checklist built for that study's design.

Use it to interpret findings, run sensitivity analyses, and report limitations transparently. Completing appraisal produces [Critical Appraisal Visuals](/review-workflow/synthesis/navigate-synthesis-outputs/critical-appraisal-outputs.md) on Synthesis. This consists of stoplight diagrams and Domain Distribution charts. Add this optional module in [Nest Settings.](/your-nests/nest-settings.md)

### Critical Appraisal Systems

The following systems are available for use in your nest:

* SIGN 2011
* SIGN 2019
* Cochrane RoB 1
* Cochrane RoB 2
* JBI 2020
* Newcastle-Ottawa Scale
* ROBINS-I 2016
* QUADAS 2
* ROBIS
* RoBIAS
* RoBOAS

After choosing a system(s). There are two ways to appraise:

* **Appraise manually**, study by study — full control over what's captured, at the cost of reviewer time. Extract in Single or Dual mode.
* **Run Smart Critical Appraisal,** which reads your full texts and provides an annotated recommendation for each answer.

### Tools Available

Below is a summary of the Critical Appraisal AI tools offered and what they do.

| Tool                                                                                            | Answers checklist                                                                                               | Reads                                           |
| ----------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------- | ----------------------------------------------- |
| [**Smart Critical Appraisal**](/review-workflow/critical-appraisal/smart-critical-appraisal.md) | Yes — recommends an answer to every question, with a supporting annotation, for you to Accept, Revise, or Clear | Full-text PDFs only — skips studies without one |

### What Happens After Records Are Appraised?

Appraisal decisions stay available to review and edit. They also generate **Critical Appraisal Visuals** in **Synthesis**, including stoplight diagrams and domain-distribution charts.

[Review appraisal decisions](/review-workflow/critical-appraisal/appraise-studies.md) — Review and edit study assessments.

[Critical Appraisal Visuals](/review-workflow/synthesis/navigate-synthesis-outputs/critical-appraisal-outputs.md) — View stoplight diagrams and domain-distribution outputs.

### Next Steps

<table data-card-size="large" data-view="cards"><thead><tr><th></th><th></th><th data-hidden data-card-target data-type="content-ref"></th></tr></thead><tbody><tr><td><i class="fa-sliders">:sliders:</i><br><strong>Configure Critical Appraisal</strong></td><td>Choose appraisal systems, reviewer mode, and appraisal scope.</td><td><a href="/review-workflow/critical-appraisal/configure-critical-appraisal.md">Configure Critical Appraisal</a></td></tr><tr><td><i class="fa-clipboard-check">:clipboard-check:</i><br><strong>Appraise Studies</strong></td><td>Assess included studies against your configured appraisal system.</td><td><a href="/review-workflow/critical-appraisal/appraise-studies.md">Appraise Studies</a></td></tr><tr><td><i class="fa-sparkles">:sparkles:</i><br><strong>Smart Critical Appraisal</strong></td><td>Review AI-generated appraisal recommendations from full-text PDFs.</td><td><a href="/review-workflow/critical-appraisal/smart-critical-appraisal.md">Smart Critical Appraisal</a></td></tr><tr><td><i class="fa-chart-simple">:chart-simple:</i><br><strong>Critical Appraisal Visuals</strong></td><td>View stoplight diagrams and domain-distribution outputs.</td><td><a href="/review-workflow/synthesis/navigate-synthesis-outputs/critical-appraisal-outputs.md">Critical Appraisal Outputs</a></td></tr></tbody></table>


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