Summary Criteria for Critical Appraisal of Journal Articles

Are the results valid?

Therapy	Prevention Diagnosis	Screening, Prognosis, Etiology	Harm	Causation Systematic Overview
Was the assignment of patients to treatment randomized?	Was there an independent, blind comparison with a reference standard?	Was a defined representative sample of patients assembled at a similar point in the course of disease?	Except for the exposure under study, were the compared groups similar to each other?	Does this review address a focused clinical question?
Were all the patients who entered the trial accounted for and attributed at its conclusion?	Did the patient sample include an appropriate spectrum of patients to whom the test will be applied?	Was follow-up sufficiently long and complete?	Were the outcomes and exposures measured in the same ways in both groups?	Were the criteria for article inclusion appropriate?
Were patient's clinicians and study personnel kept "blind" to treatment received?	Did the results of the test influence the decision to perform the reference standard?	Were objective and unbiased outcome criteria used?	Was the follow-up for patients sufficiently long and complete?	Is it unlikely that relevant studies appraised?
Were the groups similar at the start of the trial?			Is the temporal relationship correct?	Was the validity of included studies appraised?
Were the groups treated equally apart from the study intervention?			Is there a dose-response gradient?	Were assessments of studies reproducible? Were the results similar from study to study?

What are the results?

Therapy	Prevention Diagnosis	Screening, Prognosis, Etiology	Harm	Causation Systematic Overview
How large was the treatment effect? Absolute Risk Reduction/ Relative Risk Reduction/ Number Needed to Treat	What are the likelihood ratios for the test results?	How likely are the outcomes over time? Survival Curves	How strong is the association between exposure and outcome? Odds Ration/Relative Risk	What are the overall results of the review? Summary likelihood ratios/Absolute Risk Reduction/Number Needed to Treat/ Odds Ration/Relative Risk Effect Size
How precise was the estimate of treatment effect? Confidence Interval		How precise are the estimates or prognosis?	How precise is the estimate of risk? Confidence Interval	How precise are the results? Confidence Interval

Will the results help me in my patient care?

Therapy	Prevention Diagnosis	Screening, Prognosis, Etiology	Harm	Causation Systematic Overview
Were all clinically relevant outcomes considered?	Are the results applicable to patients?	Will the results lead directly to selecting therapy?	What is the magnitude of risk?	Were all clinically important outcomes considered?
Can the results be applied to my patients?	Will the test be reproducible and well interpreted in my practice setting?	Were the study patients similar to own?	Are the results applicable to my patients?	Can the results be applied to my patients?
Are the benefits worth the harms and costs?	Will the results change my management?	Are the results useful for counseling patients?	Should I attempt to stop the exposure?	Are the benefits worth the harms and costs?
	Will my patients be better off because of the test?