Appraising Relevant Overview or Meta-Analysis

To appraise a systematic overview, there is a series of questions that you must answer.

First of all, was the study valid?

Did the overview address a focused clinical question?

Were the criteria used to select articles for inclusion clearly stated and appropriate?

Is it likely that important relevant studies were missed by the search strategies employed?

Was the validity of the included studies appraised?

Were the validity criteria used appropriate to the nature of the clinical question?

Were the assessments of the studies with respect to inclusion criteria reproducible?

Were the results similar from study to study? If heterogeneity was present, was it clinically significant?

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?

Were the results reported in the form that you need to apply them to your practice?

i.e. relative risk or odds ratio for therapy, likelihood ratio for diagnosis, etc.

If not, is data given which allows you to calculate the needed parameters from the reported results?

Were the results pooled, and were the confidence intervals sufficiently narrow to eliminate ambiguity?

Are the results applicable to my patients?