title: How to appraise the effectiveness of treatment.
abstract: BACKGROUND
  Advances in treatment and disease prevention occur frequently in urology. Urologists must identify a framework within which to evaluate these therapeutic innovations.
  
  
  METHODS
  The evidence-based approach to critical appraisal is described using an example from the urological literature. A three-part assessment of the trial validity, treatment effect, and applicability of results will permit the urologist to critically incorporate medical and surgical advances into practice.
  
  
  RESULTS
  Validity of clinical trials hinges upon balancing patient prognosis at the initiation, execution, and conclusion of the trial. Readers should be aware of not only the magnitude of the estimated treatment effect, but also its precision. Finally, urologists should consider all patient-important outcomes as well as the balance of potential benefits, harms, and costs, and patient values and preferences when making treatment decisions.
  
  
  CONCLUSIONS
  Use of this framework for critical appraisal will lead to a more evidence-based application of new therapies for patients. Incorporation of a more evidence-based practice within urology will lead to an increase in the quality of patient care.
authors.affiliation: Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Suzanne B
authors.initials: SB
authors.lastname: Stewart
authors.forename: Phillip
authors.initials: P
authors.lastname: Dahm
authors.forename: Charles D
authors.initials: CD
authors.lastname: Scales