Frameworks for critical thinking about treatment claims, comparisons, and choices: a mapping review

Article type
Authors
Martínez García L1, Oxman A2
1Iberoamerican Cochrane Centre, Sant Pau Biomedical Research Institute (IIB-Sant Pau)
2Centre for Informed Health Choices, Norwegian Institute of Public Health
Abstract
Background: the Informed Health Choices (IHC) Key Concepts are standards for judgment or principles for evaluating the trustworthiness of claims about healthcare interventions, comparisons, and choices. The IHC Key Concepts provide a framework for identifying and developing learning resources to help people understand and apply the concepts when claims about the effects of interventions are made and when they make health choices.

Objectives: the objective of this study is to systematically compare the IHC Key Concepts to other frameworks that are relevant to learning how to think critically about claims, comparisons, and choices.

Methods: we designed a pragmatic search strategy to identify relevant frameworks. We included frameworks that provide a structure for teaching or learning to think critically about the basis for claims, evidence used to support claims, or making informed health choices. Two authors independently assessed frameworks for eligibility and extracted data from included frameworks.

Results: currently, we have assessed 29 frameworks for inclusion (118 references) and have included 17 frameworks:
1) AIR model of epistemic cognition
2) Allen’s taxonomy of concepts and critical abilities for evaluation of verbal arguments
3) Baron’s model of the good thinker
4) Bradford Hill’s criteria for causal inference
5) Brown’s evidence-based reasoning framework
6) Core competencies in evidence-based practice for health professionals
7) Ennis’ taxonomy of critical thinking dispositions and abilities
8) Frameworks of health literacy
9) GRADE criteria for judgements about the certainty of evidence and evidence to decision frameworks
10) Halpern’s list of critical thinking skills
11) Models of epistemological beliefs
12) Oxford Centre for Evidence Based Medicine’s catalogue of bias
13) Paul’s model of critical thinking
14) Schraw’s framework for metacognitive theories
15) Taxonomies of cognitive biases
16) Taxonomies of logical fallacies
17) U.S. National Research Council’s framework for K-12 science education

Few frameworks included a description of the methods used to develop them and even fewer have been formally evaluated. There are multiple frameworks with very similar purposes with little consensus regarding their advantages and disadvantages. There are also frameworks with different purposes with substantial overlap across them. We will discuss the relevance of the included frameworks to the IHC Key Concepts, focusing on implications for improving the purpose, scope, content, usefulness, and further development and evaluation of the IHC Key Concepts.

Conclusions: this review has helped to improve the IHC Key Concepts and clarify the relationship of different frameworks that are used for curriculum development, teaching and learning, and assessment of critical thinking. It will be used to inform further development and evaluation of the IHC Key Concepts.

Patient or healthcare consumer involvement: none