Appraising Relevant Therapy 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 the study randomized?

Was follow-up complete and adequate and were all patients kept in the groups to which they were assigned?

Was the study blinded?

Aside from the intervention(s) being studied, were the patients treated identically in the different groups?

Were the groups similar at the start of the study?

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?

Did the study CLEARLY show harm or benefit?

Were confidence intervals reported and was the entire interval on one side

or the other of the HARM-BENEFIT line?

 

If no confidence intervals, were P values reported and were they less then .05

Are the results applicable to my patients?

Were all clinically important outcomes reported?

Were absolute risk data reported for dichotomous outcomes ?

What was the number needed to treat for the important dichotomous outcomes?

Number needed to treat calculator

Are the overall results clinically significant?

Would these results apply to my patients?

Did the treatment cause harm which might outweigh the benefit for my patient(s)?

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.