Checklists and Methodological filters

Question 1

checklist for prognosis studies (internal (7) and external (3) validity)

Answer 1

internal validity:

• longitudinal study
• prospective
• consecutive sampling
• representative population
• inception cohort
• adequate follow-up
• large sample size

External validity:

• patients similar? (clinical profile, prognostic factors)
• similar setting?
• outcomes relevant to Pt (type and timing)?

Question 2

checklist for diagnosis studies

• internal (5)
• external (3)

Answer 2

internal validity:
•	Gold standard – MRI 
•	Cross-section (taken at same time point) 
•	Both way blind 
•	Appropriate group selection  
•	Large numbers

external validity:
• Patients similar
• Can I do this test
• Will this affect my diagnosis

Question 3

Cochrane ROB tool (8)

Answer 3

• random sequence generation
• allocation concealment
• blinding of participants
• blinding of personnel
• blinding of outcome assessors
• incomplete data (attrition)
• incomplete data (participant exclusion)
• selective outcome reporting

Question 4

Features of well-designed research (believable study) (12)

Answer 4

• Large size study
	• Randomised to group
	• Adequate sequence generation
	• Concealed allocation
	• Baseline compatible
	• Few drop outs that are missing at random
	• Intention to treat analysis
	• Blind subject (or low ROB when not)
	• Blind therapist (or low ROB when not)
	• Blind assessor (or low ROB when not)
	• Data appropriately presented
		○ Point estimates and variability of primary outcomes
		○ Between-group comparisons made
- Followed up for reasonable period of time

Question 5

Clinical guidelines checklist (5)

Answer 5

1. systematic review of evidence
2. clear criteria for evidence
3. report strength of evidence
4. external review
5. balance harm vs benefit

Question 6

Forrest Plots Checklist (8)

Answer 6

Does it make sense they combined this data

1. method design
2. risk of bias
3. clinical diversity
4. patients
5. treatments
6. control
7. outcomes
8. timing

Question 7

Internal validity of systematic reviews (4)

Answer 7

1. Clear criteria of studies to be reviewed (scope, timeframe, inclusion and exclusion criteria)
2. all relevant studies included (check for publication bias)
3. quality filter applied to studies
4. data summarised appropriately (degree of heterogeneity)

Question 8

External validity of systematic reviews (5)

Answer 8

1. appropriately applied intervention (time period)
2. appropriate comparators (subjects, active control?)
3. relevant outcomes - to the patient
4. size of the effect - summary of evidence
5. risk of bias