Appraising Relevant Prognosis 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 a representative sample of patients as a well-defined point in the course of the disease?

Was the follow-up sufficiently long and complete?

Were the outcomes well-defined and unambiguously measurable?

Were important prognostic factors identified and were their effects on relevant outcomes reported?

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?

How large is the likelihood of the outcomes in a specified period of time?

Are confidence intervals reported?

Are the results applicable to my patients?

Was the study population sufficiently similar to my own?

Do the results help to identify which of my patients will most benefit from specific therapies?

Do the results allow me to tell my patients what they want to know?

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.