Critical appraisal skills programme Flashcards
give examples of sources of information
- primary and secondary literature
- can be time consuming
- requires subscriptions - NHS website
- Cochrane database- source of detailed info on meta analysis of clinical trials
- NICE guidelines
what is the critical appraisal skills programme
has appraisal checklists designed for use with systematic reviews, randomised control trials, cohort studies and case control studies
what are the steps in making an appraisal
- is the study valid- type of study
- evidence of bias
- methods used - what are the results- are they significant
- are the results useful- do they apply to a population of patients
what is the nature of the evidence
- a scientific study- animals, in vitro
- observational studies- case study, cohort study, cross sectional study
- clinical trial
- meta analysis or systematic review
what is the CASP checklist for RCTs
- section A- is the study design valid
- section B- is the study methodologically sound
- section C- what are the results
- section D- will the results help locally
what is involved in critical appraisal 1- did the trial address a clearly focussed research question
- was the study designed to assess the outcomes of an intervention
- is the research question focussed in terms of
- population studied
- intervention given
- comparator given
- outcomes measured
what questions are involved in critical appraisal 2- was the assignment of patients to treatments randomised
- how was randomisation carried out and was the method appropriate
- was randomisation sufficient to eliminate systematic bias
- was the allocation sequence concealed from investigators and participants
what questions are involved in critical appraisal 3- were all participants who entered the study accounted for at its conclusion
- were losses to follow up and exclusions after randomisation accounted for
- were participants analysed in the study group to which they were randomised
- was the study stopped early
what questions are involved in critical appraisal 4- was the study blinded
- were the participants blind to the intervention they were given
- were the investigators blind to the intervention that were giving to participants
- were the people assessing and analysing outcome blinded
what questions are involved in critical appraisal 5- were the study groups similar at the start of the randomised control trial
- were the baseline characteristics of each study group clearly set out
- were there any differences between the study groups that could affect outcome
what questions are involved in critical appraisal 6- apart from the experimental intervention, did each study group receive the same level of care
- were they treated equally
- was there a clearly defined study protocol
- were the follow up intervals the same for each study group
what questions are involved in critical appraisal 7- were the effects of intervention reported comprehensively
- was a power calculation undertaken
- what outcomes were measured
- how were the results expressed
- was there any missing or incomplete data
- which statistical tests were used
what questions are involved in critical appraisal 8- was the precision of the estimate of the intervention or treatment effect reported
- what statistically rigorous measures of precision were used
- were confidence intervals reported
what questions are involved in critical appraisal 9- do the benefits of the experimental intervention outweigh the harms and costs
- what was the size of the intervention or treatment effect
- were harms or unintended effects reported for each study group
- was a cost effectiveness analysis undertaken
what questions are involved in critical appraisal 10- can the results be applied to your local population
- are the study participants similar to the people in your care
- are the outcomes important to your population
- are there any limitations of the study that would affect your decision
what questions are involved in critical appraisal 11- would the experimental intervention provide greater value to people in your care than any other existing interventions
- what resources are needed to introduce this intervention
- are you able to disinvest resources in 1 or more existing interventions in order to be able to reinvest in the new intervention
outline the CASP checklist for meta analyses
- did the review address a clearly focussed question
- did the authors look for the right type of papers
- do you think all the important, relevant studies were included
- did the reviews authors do enough to assess quality of the included studies
- if the results of the review have been combined, was it reasonable to do so
- what are the overall results of the review
- how precise are the results
- can the results be applied to the local population
- were all important outcomes considered
- are the benefits worth the harms and costs
