HYMR Critical Appraisals

Question 1

Which of the following best describe a systematic approach to the review of a clinical trial published in a medical journal?

A. Critical Appraisal Tool

B. Systematic Appraisal Tool

C. CONSORT Statement

D. QUADAS-2 Tool

Answer 1

A. Critical Appraisal Tool

• Critical appraisal tools (CATs) provide a systematic approach to reading a number of study or publication types in the medical literature. There are a number of these tools that have been validated for use.
• While a systematic appraisal tool sounds like a good name, the correct reference for these are CATS.
• The CONSORT statement is not a CAT, but rather a criteria set for how to write and publish an RCT for submission to be published.
• The QAUDAS-2 tool is a CAT for evaluating diagnostic studies, not RCTs.

High-Yield Core Concept:
* Critical appraisal tools (CATS) provide a reader with a systematic approach to reviewing and/or evaluating a paper in the medical literature. There are different CATS for different types of publications (RCTs, Diagnostics Studies, Cohort Studies etc).

Question 2

Which of the following critical appraisal tool (CAT) is used to evaluate a systematic review? (Select ALL that apply)

A. AMSTAR

B. AGREE

C. QAUDAS-2

D. PRISMA

Answer 2

A. AMSTAR, D. PRISMA

• The PRISMA and AMSTAR tools are the two main critical appraisal tools (CATs) used in evaluating a systematic review in a standardized approach. Of the two, PRISMA is the most commonly used.
  AGREE is a CAT used for guidelines published in a journal.
• QAUDAS-2 is a CAT used when reviewing a diagnostic study published in a journal.

Question 3

CATEGORY: BIOSTATISTICS » PUBLICATION BIAS
What can be done to detect presence of publication bias on a certain subject in the literature?

A. Jadad scale

B. Funnel plot analysis

C. Meta-analysis

D. Descriptive study

Answer 3

B. Funnel plot analysis

• The only answer even close is a funnel plot analysis.
  
  • Note: each dot on the graphs below represent a publication of a study in the medical literature and results they reported in context of an odds ratio (OR): an ORD of 1 means there is no difference between the interventions studied.
  • You should be able to look at a graph and be able to draw the imaginary dotted line to see if the inverted funnel has scattered dots throughout.
• A Jadad scale is a method used to grade the quality of the studies used in a meta- analysis.
• A meta-analysis and descriptive study will not provide you with information about publication bias.

Question 4

You have received a copy of a new set of guidelines for the management of pneumonia that were just released and are preparing to read the publication. Which of the critical appraisal tools (CAT) is most likely to be found or used by new guideline committees that are assessing the strength and quality of the research they base their recommendations on?

A. AMSTAR

B. CASP

C. GRADE

D. QAREL

Answer 4

C. GRADE

• GRADE was developed in 2000 to address the problems and failures of the grading systems in health care and is now utilized by many guideline committees when publishing a new set of guidelines that also provide a strength of recommendation.
• AMSTAR is a critical appraisal tool (CAT) used in evaluating systematic reviews.
• CAPS is an organization that publishes a number of their own CATS that can be used for a number of different publication types.
• QAREL is a CAT used to evaluate diagnostic studies.

High-Yield Core Concept:
The GRADE tool is now one of the standards used by guideline committees when providing evidence-based recommendations and helps the reviewers to grade the quality of the evidence in a transparent and systematic way.

Question 5

Which of the following reporting guidelines (ie., the format) are used for diagnostic studies that are being written for publication in a medical journal and is also sometime used by readers to ensure the article was written correctly once published?

A. CARE

B. CONSORT

C. PRISMA

D. STARD

Answer 5

D. STARD

• Over the years editors and publishers have come up with criteria for the publication of different study types. It is not only important for the authors to submit articles for publication using these formats, but it is also important for readers to know when reading and evaluating a published study.
• STARD (Standards for Reporting Diagnostic Accuracy Studies) is the standard publication criteria for diagnostics studies.
• CARE (CASE REport) is the reporting or publishing criteria for case reports.
• CONSORT (Consolidated Standards of Reporting Trials) is the reporting or publishing criteria for randomized controlled trials.
  PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) is the reporting or publishing criteria for systematic reviews.

Question 6

True/False: The abstract in a clinical trial contains a brief summary of the most significant results while the results section in a clinical trial provides results data in extensive detail.

A. True

B. False

Answer 6

A. True

• An abstract is a succinct summary of a clinical study and is often broken into the study subcategories (e.g., objective, methods, results), while the results section of a clinical trial provides in-depth detail of the study outcomes including baseline characteristics, statistical results, dropout data, as well as side effect information.

High-Yield Core Concept:
* Key components of a well written abstract include the title, authors, introduction, methods, results, and conclusions for the purpose of providing accurate, yet concise, information that is consistent with the full text of the paper.