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? |

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