Fillable 10!questions!to!help!you!make!sense!of!a! Three!broad!issues!need!to!be!considered!when!appraising!a! !Are!the!results!of!the!study!valid?!(Section!A)! !What!are!the!results?! (Section!B)! Systematic!

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10!questions!to!help!you!make!sense!of!a! Three!broad!issues!need!to!be!considered!when!appraising!a! !Are!the!results!of!the!study!valid?!(Section!A)! !What!are!the!results?! (Section!B)! Systematic!Review How!to!use!this!appraisal!tool:!

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The 10!questions!to!help!you!make!sense!of!a! Three!broad!issues!need!to!be!considered!when!appraising!a! !Are!the!results!of!the!study!valid?!(Section!A)! !What!are!the!results?! (Section!B)! Systematic! form is 4 pages long and contains:

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CASP!Checklist:
!
10!questions!to!help!you!make!sense!of!a!
Systematic!Review
!
How!to!use!this!appraisal!tool:!
Three!broad!issues!need!to!be!considered!when!appraising!a!
systematic!review!study:
!
!Are!the!results!of!the!study!valid?!(Section!A)!
!What!are!the!results?! (Section!B)!
!Will!the!results!help!locally?! (Section!C)!
The!10!questions!on!the!following!pages!are!designed!to!help!you!think!about!these!issues!
systematically.!The!first!two!questions!are!screening!questions!and!can!be!answered!quickly.!
If!the!answer!to!both!is!“yes”,!it!is!worth!proceeding!with!the!remaining!questions.!There!is!
some!degree!of!overlap!between!the!questions,!you!are!asked!to!record!a!“yes”,!“no”!or!
“can’t!tell”!to!most!of!the!questions.!A!number!of!italicised!prompts!are!given!after!each!
question.!These!are!designed!to!remind!you!why!the!question!is!important.!Record!your!
reasons!for!your!answers!in!the!spaces!provided.!
About:
!These!checklists!were!designed!to!be!used!as!educational!pedagogic!tools,!as!part!of!a!
workshop!setting,!therefore!we!do!not!suggest!a!scoring!system.!The!core!CASP!checklists!
(randomised!controlled!trial!&!systematic!review)!were!based!on!JAMA!'Users’!guides!to!the!
medical!literature!1994!(adapted!from!Guyatt!GH,!Sackett!DL,!and!Cook!DJ),!and!piloted!with!
health!care!practitioners.!
For!each!new!checklist,!a!group!of!experts!were!assembled!to!develop!and!pilot!the!checklist!
and!the!workshop!format!with!which!it!would!be!used.!Over!the!years!overall!adjustments!
have!been!made!to!the!format,!but!a!recent!survey!of!checklist!users!reiterated!that!the!basic!
format!continues!to!be!useful!and!appropriate.!
Referencing:
!we!recommend!using!the!Harvard!style!citation,!i.e.:!Critical!Appraisal!Skills!
Programme!(2018).!CASP!(insert!name!of!checklist!i.e.!Systematic!Review)!Checklist.![online]!
Available!at:!!URL.!Accessed:!Date!Accessed.!
©CASP!this!work!is!licensed!under!the!Creative!Commons!Attribution!–!Non-Commercial-
Share!A!like.!To!view!a!copy!of!this!license,!visit!http://creativecommons.org/licenses/by-nc-
sa/3.0/!www.casp-uk.net!!
Critical Appraisal Skills Programme (CASP) part of Oxford Centre for Triple Value Healthcare Ltd www.casp-uk.net
2!
Section!A:!Are!the!results!of!the!review!valid ?!
1. Did!the!review!address!a
clearly!focused!question?
Yes!
HINT:!An!issue!can!be!‘focused’!In!terms!of!
•
the !population!studied
•
the!intervention!given
•
the !outcome!considered
Can’t!Tell!
No!
Comments:!
2. Did!the!authors!look!for!the
right!type!of!papers?
Yes!
HINT:!‘The!best!sort!of!studies’!would!
• addres s!t he!review’s!question
• have!an!appropriate!study!design
(usually !RCTs!for!papers!evaluating
int erventions)!
Can’t!Tell!
No!
Comments:!
Is!it!worth!c o ntinuing?!
3. Do!you!think!all!the
impor ta n t ,!re levant!st u d ie s
were!included?
Yes!
HINT:!Look!for!
•
!whic h !bibliographic!databases!were
used!
•
!follow!up!from!reference!lists
•
!personal!contact!with!experts
•
!unpublished!as!well!as!published!studies
•
!non- English !language!studies
Can’t!Tell!
No!
Comments:!
Paper for appraisal and reference:
3!
4. Did!the!review’s!authors!do
enough!to!assess!qu ality!of
the!included!stud ies?
Yes!
HINT:!The!authors!need!to!consider!the!
rigour!of!the!studies!they!have!identified.!
Lack!of!rigour!may!affect!the!studies’!
results!(“All!that!glisters!is!not!gold”!
Merchant!of!Venice!–!Act!II!Scene!7)!
Can’t!Tell!
No!
Comments:!
5. If!the!results !o f!th e !re vie w
have!been!combined,!was!it
reasonable!to!do !so?
Yes!
HINT:!Consider!whe ther!
•
!results!were !si milar!from!study!to!study
•
!results!of!all!the!included!studies!are
clearly!displayed !
•
!results!of!differen t!studies!are!similar
•
!reasons!for!any!variations!in !results!are
discussed!
Can’t!Tell!
No!
Comments:!
Section!B:!What!are!the!results?!
HINT:!Consider!
•
!If!you!are!clear!about!the!review’s
‘bottom!line’!results!
•
!what!these!are!(numerically !if
appropriat e)!
•
!how!were!the!results!expressed!(NNT,
odds!ratio!etc.)!
Comments:!
!!
!
!
!
4!
HINT:!Look!at!the!confide nce!intervals,!if!
given !
Comments:!
!
Section!C:!Will!the!re sults!help!locally?!
!
8.!Can!the!results!be!applied!to!
the!local!popula tion? !
Yes!
!
!
HINT:!Consider!whether!
• the!patients!covered!by!the!review!
could!be!sufficiently!different!to!your!
population!to!cause!concern!
• your!local!s e tt in g !is !lik e ly !to!differ!much!
from!that!o f!the !re view !
Can’t!Tell!
!
!
No!
!
!
!
Comments:!
!
9.!Were!all!impor ta n t !o u tc omes!
considered?!
Yes!
!
!
HINT:!Consider!whether!
• there!is!other!information!you!w o uld!
like!to!h a v e !s e e n !
Can’t!Tell!
!
!
No!
!
!
!
Comments:!
!
!
!
!
10.!Are!the!benefits!worth!the!
harms!and!costs?!
Yes!
!
!
HINT:!Consider!
• even!if!this!is!not!addressed!by!the!
review,!what!do !
you
!think?!
Can’t!Tell!
!
!
No!
!
!
!
Comments:!
!
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10questionstohelpyoumakesenseofa Threebroadissuesneedtobeconsideredwhenappraisinga Aretheresultsofthestudyvalid(SectionA) Whataretheresults (SectionB) SystematicReview Howtousethisappraisaltool:

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