Appraising Relevant Diagnosis Studies

The first question to be answered is:

Did you find a systematic overview or meta-analysis? - If you did, click HERE to go to the section on using overviews or meta-analyses.


To appraise a study, there is a series of questions you must answer.

First of all, was the study valid?

Was there an independent comparison with an acceptable " Gold Standard "

Did the study population involve an appropriate spectrum of disease?
Were subjects without disease clinically symptomatic?

Was the gold standard test performed on all patients who underwent the diagnostic test in question?

Were the methods described in sufficient detail to permit duplication?

After thinking about the above questions, Is there a FATAL flaw in the study?

If there is, then toss this study and go onto the next one. If not, continue the appraisal.


What were the results?

What are the likelihood ratios(s)?

likelihood ratio calculator


Are the results applicable to my patients?

Did the disease spectrum in the study population reflect that of the patients for whom I might need this test?

Are there other reasons that this test might perform differently in my patient population?

Can the accuracy reported for this test be achieved in my practice setting?

Will the results effect my management of my patients?
Bayes Theorem nomogram (you must have entered figures into calculator above)

Do the benefits of this test justify the costs, risks, and inconvenience to my patients?


Overall: Does this study answer the original clinical question and is the answer meaningful?


If this study is does not answer the original question or if the answer is not meaningful after the above appraisal, then toss out the study and proceed to the next one.

If the answer to the above overall question is YES, then write a C.A.T. so the rest of us don't need to look this up again for a while.