> 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/configure-critical-appraisal.md).

# Configure Critical Appraisal

Learn how to configure a critical appraisal system in your nest.

Each appraisal system is built around the biases that are likely to occur in a particular study design. Therefore it is important to choose the correct tool to the included evidence.

### Choose Your System(s)

A quick guide to common choices:

| If your included studies are…           | Consider                                     |
| --------------------------------------- | -------------------------------------------- |
| Randomized controlled trials            | Cochrane RoB 2, Cochrane RoB 1               |
| Non-randomized studies of interventions | ROBINS-I 2016                                |
| Cohort or case-control (observational)  | Newcastle-Ottawa Scale                       |
| Diagnostic test accuracy studies        | QUADAS 2                                     |
| The systematic review itself            | ROBIS                                        |
| A broad checklist spanning many designs | JBI 2020, SIGN 2011, SIGN 2019               |
| Medication adherence studies            | RoBIAS (randomized), RoBOAS (non-randomized) |

### Configure Critical Appraisal

{% stepper %}
{% step %}

#### Select Your Appraisal System(s)

Open [Nest Settings](/your-nests/nest-settings.md) and select your appraisal system or systems. Each one you select shows as its own tab on the main Critical Appraisal page.
{% endstep %}

{% step %}

#### Configure Mode

Work in **Single mode**, or for greater reproducibility, **Dual mode** — two reviewers appraise independently and their judgments are reconciled, reducing the influence of any one reviewer's interpretation. Configure this here too.
{% endstep %}

{% step %}

#### Set The Scope Of Appraisal

Risk of bias can vary by outcome. Outcome-level tools such as RoB 2 and ROBINS-I are built around precisely this distinction.

That's why **Scope** lets you appraise either the entire study or specific outcomes:

* If you haven't [configured data elements for MA Extraction](/review-workflow/meta-analytical-extraction/configure-meta-analytical-extraction.md), leave the scope as **Entire Study**.
* If you have configured outcomes and want to appraise them individually, they appear here for selection.

<figure><img src="https://305208404-files.gitbook.io/~/files/v0/b/gitbook-x-prod.appspot.com/o/spaces%2Fxb7uNGATUgwQAjDVQRXG%2Fuploads%2FsOgrK5M9fvw8QsM9d4JC%2Fcritical%20appraisal%20settings.png?alt=media&amp;token=5824dd69-f27c-4930-834d-d010083ca03a" alt="The Scope setting offers Entire Study and individual outcome options for critical appraisal."><figcaption><p>Select whether to appraise the entire study or individual outcomes.</p></figcaption></figure>
{% endstep %}

{% step %}

#### Appraise Studies

Open Critical Appraisal and begin [appraising each study](/review-workflow/critical-appraisal/appraise-studies.md). Attach annotations linked directly to the text and to individual answers.

Alternatively run [Smart Critical Appraisal](/review-workflow/critical-appraisal/smart-critical-appraisal.md) for AI assistance.
{% endstep %}
{% endstepper %}

### FAQs

<details>

<summary>Can any reviewer adjudicate disagreements?</summary>

No — only users with admin privileges can adjudicate. Any user can act as a reviewer.

</details>

<details>

<summary>Can reviewers see each other's answers before adjudication?</summary>

No. A reviewer's answers, comments, and annotations are visible to adjudicators only, not to the other reviewer, until adjudication is complete.

</details>

<details>

<summary>What happens if I switch a nest from Dual back to Single mode?</summary>

Only adjudicated decisions carry over — no data is lost either way, so switching is safe to do freely.

</details>

<details>

<summary>Does Smart Critical Appraisal work with Dual mode?</summary>

Yes — it can generate recommendations at either the reviewer or final level. See [Smart Critical Appraisal](/review-workflow/critical-appraisal/smart-critical-appraisal.md) for how that generation run behaves.

</details>

<details>

<summary>Why can’t I see any outcomes when I set the scope to specific outcomes?</summary>

The **Individual Outcomes** scope works only when your nest uses Meta-Analytical Extraction. The outcomes list comes from the outcomes in your Meta-Analytical Extraction configuration. If your nest does not use Meta-Analytical Extraction, the list is empty.

We recommend that you use the **Entire Study** scope. Do not set up Meta-Analytical Extraction only to appraise specific outcomes. The extra work is usually not worth the benefit.

</details>

### 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-sparkles">:sparkles:</i><br><strong>Smart Critical Appraisal</strong></td><td>Pre-fill appraisal judgments 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-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-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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