APPRAISAL FORM FOR THERAPY

I.

II.
1.

APPRAISING DIRECTNESS
Does the study provide a direct enough answer
to your clinical question in terms of type of
patients (P), exposure/ intervention (E) and
outcome (O)?
APPRAISING VALIDITY
Were patients randomly assigned to treatment
groups?

2.

Was allocation concealed?

3.

Were baseline characteristics similar at the start

of the trial?

4.

Were patients blinded to treatment assignment?

5.

Were caregivers blinded to treatment

assignment?

6.

Were outcome assessors blinded to treatment

assignment?

Were all patients analyzed in the groups to

which they were originally randomized?

Was follow-up rate adequate?

III.
1.

APPRAISING RESULTS
How large was the effect of treatment?

2.

How precise was the estimate of the treatment

effect?

IV.
1.

ASSESSING APPLICABILITY:
Are there biologic issues that may affect
applicability of treatment? (Consider the
influence of sex, co-morbidity, race, age and
pathology)
Are there socio-economic issues affecting
applicability of treatment?

2.

V.
1.

INDIVIDUALIZING THE RESULTS:

What is the likely effect of the treatment on your
individual patient? (Estimate the individualized
NNT for your patient)

2.

Would you offer the treatment to your patients?

appraisal forms_2011

APPRAISAL FORM FOR A SYSTEMATIC REVIEW OR META-ANALYSIS

I.

II.
1.

APPRAISING DIRECTNESS
Does the study provide a direct enough answer
to your clinical question in terms of type of
patients (P), exposure/ intervention (E) and
outcome (O)?
APPRAISING VALIDITY
Were the criteria for inclusion of studies
appropriate?

2.

Was the search for eligible studies thorough?

3.

Was the validity of the included studies

assessed?

4.

Were the assessments of the studies

reproducible?

III.
1.

APPRAISING RESULTS
What are the overall results of the review?

2.

Were the results similar from study to study?

3.

How precise were the results?

IV.
1.

ASSESSING APPLICABILITY
Are there biologic issues affecting applicability?
(Consider the influence of sex, co-morbidity,
race, age and pathology)

2.

Are there socio-economic issues affecting

applicability?

3.

If the overall results of the review are not directly

applicable to your patient, are there credible
subgroup analyses that you could use?

V.
1.

INDIVIDUALIZING THE RESULTS

What is the implication of study findings on your
individual patient? (Estimate the individualized
NNTs for your patient)

2.

Would you offer the treatment to your patients?

appraisal forms_2011

APPRAISAL FORM FOR DIAGNOSIS

I.

APPRAISING DIRECTNESS
Does the study provide a direct enough answer
to your clinical question in terms of patients (P),
examination (E) used and disease or outcome
(O) being diagnosed?

II.
1.

APPRASING VALIDITY
Was the reference standard an acceptable one?

2.

Was the reference standard interpreted

independently from the test in question?

III.

APPRAISING RESULTS
What likelihood ratios were associated with the
range of possible test results?

IV.
1.

ASSESSING APPLICABILITY
Are there biologic issues that may affect
accuracy of the test? (Consider the influence of
sex, co-morbidity, race, age and pathology)

2.

Are there socio-economic issues that may affect

accuracy of the test?

V.
1.

INDIVIDUALIZING THE RESULTS

How will the test results affect the probability of
disease in your patient? (Estimate the
individualized post-test probability of your
patient)

2.

Is this test useful for your patient?

appraisal forms_2011

APPRAISAL FORM FOR HARM

I.

II.
1.

APPRAISING DIRECTNESS
Does the study provide a direct enough answer
to your clinical question in terms of type of
patients (P), exposure/ intervention (E) and
outcome O)?
APPRAISING VALIDITY
Did exposure precede outcome in the study?

2.

Were the patient groups being compared

sufficiently similar with respect to baseline
characteristics? If not, were statistical
adjustments made?

3.

Were unbiased criteria used to determine

exposure in all patients?

4.

Were unbiased criteria used to detect outcome in

all patients?

5.

Was follow-up rate adequate?

III.
1.

APPRAISING RESULTS
How strong is the association between exposure
and outcome?

2.

How precise is the estimate of the risk?

IV.
1.

ASSESSING APPLICABILITY
Are there biologic issues that may affect
applicability of treatment? (Consider the
influence of sex, co-morbidity, race, age and
pathology)
Are there socio-economic issues affecting
applicability of treatment?

2.

V.
1.

INDIVIDUALIZING THE RESULTS

What is the likely effect of the exposure on the
risk of your individual patient? (Estimate the
individualized NNT/NNH for your patient)

2.

Would you ask the patient to avoid the

exposure?

appraisal forms_2011

APPRAISAL FORM FOR PROGNOSIS

I.

APPRAISING DIRECTNESS
Does the study provide a direct enough answer
to your clinical question in terms of type of
patients (P), exposure/ intervention (E) and
outcome O)?

II.
1.

APPRAISING VALIDITY
Was the sample of patients representative?

2.

Were patients (or subgroups of patients)

sufficiently homogeneous with respect to
prognostic factors?

3.

Were objective & unbiased outcome criteria

used?

4.

Was follow-up rate adequate?

III.
1.

APPRAISING RESULTS
How likely are the outcomes over time?

2.

How precise are the estimates of likelihood?

IV.
1.

ASSESSING APPLICABILITY
Are there biologic issues that may affect
applicability? (Consider the influence of sex, comorbidity, race, age and pathology)

2.

Are there socio-economic issues affecting

applicability?

V.

INDIVIDUALIZING THE RESULTS

What is the estimate of prognosis in your
patient?

appraisal forms_2011