Conducting a literature review: Critical appraisal of a piece of non-research evidence (a website)

Conducting a literature review: Critical appraisal of a piece of non-research evidence (a website)

I have reviewed a piece of non-research evidence, in the form of a website

otter website

According to Sackett et al’s (1997) hierarchy of evidence, grey literature such as this is shouldn’t usually be the first source you turn to for evidence since there are other sources which are more reliable, for example because they have been peer-reviewed. However sometimes there may be an absence of quality sources or you are trying to gain an understanding of public opinion on a topic.

To help me assess the website I am going to use Aveyard et al’s (2001) ‘six questions to trigger critical thinking’, which are:

  1. Where does this information come from?
  2. What is being said?
  3. How did they write this?
  4. Who is telling me this?
  5. When was this written?
  6. Why has this been written?

Where does this information come from? I found this by searching for “guidelines stroke recovery eating” using the search engine DuckDuckGo to avoid any tracking cookies from Google biasing the results according to my previous search history.

What is being said? The website article’s title is ‘Eating well after a stroke’. It is written in a factual style and states that these are general guidelines to stay healthy after a stroke. It doesn’t offer specific guidelines for adaptions to the eating process after a stroke which is what I was looking for, but rather offers general advice on eating a healthy diet.

How did they write this? Presumably the author has come to their conclusions using the information contained within the reference list at the end of the article. The references themselves are reputable sources, although they are still grey literature and not research studies, as they are government or non-profit organisation websites. However the author hasn’t indicated which parts of the article are attributed to which reference, so it is not clear which parts are possibly opinion or from which source any specific facts came from.

Who is telling me this? The author of the page is stated as the Cleveland Clinic Foundation. It has a physical address in the US and contact details. It has a .org website address and in the ‘About’ section states that the Cleveland Clinic is a “non-profit academic medical centre that integrates clinical and hospital care with research and education”. At this stage it seems to be a genuine source of information without any obvious bias and doesn’t appear to be selling or endorsing any products or services.

When was this written?  It states that the article was last reviewed on 05.09.2014, but that the reference sources (which are all websites) were accessed on 06.05.2015. The difference in these dates would make me unsure as to the currency of the information from an academic point of view.

Why has this been written?  The website claims its aims are to provide health information to the general public. The information seems that it would be of use to the public but for academic reasoning it isn’t very robust.



Aveyard, H, Sharp, P. & Wooliams, M. (2011). A Beginner’s Guide to Critical Thinking and Writing in Health and Social Care. Maidenhead: McGraw Hill Open University Press. pp 14-16.

Cleveland Clinic Foundation (2015) ‘Eating Well After A Stroke’ Online at: [Accessed on 12 November 2015]

Sackett DL, Richardson WS, Rosenberg WM, Haynes RB. Evidence Based Medicine: How to practice and teach EBM. New York: Churchill Livingstone; 1997

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