Health Evidence Bulletins - Wales (logo)

Appaisal Checklists

Health Evidence Bulletins - Wales: Questions to assist with the critical appraisal of a systematic review
[including at least one randomised controlled trial] (Type I evidence);
[including at least one non-randomised intervention study] (Type III evidence); or
[of observational studies] (Type IV evidence)

Adapted from the CASP questions (taken from Oxman AD et al. Users' guides to the medical literature. VI How to use an overview. Journal of the American Medical Association. 1994; 272(17): 1367-1371) and Barker, JM. Project for the enhancement of the Welsh Protocols for Investment in Health Gain. Project Methodology. Cardiff: Duthie Library. UWCM, 1996.

Paper details Authors:

A/ What is this review about and can I trust it.
    Screening questions.

  Yes Can't tell No
1. Is the review relevant to the needs of the Project? continue   discard
2. Did the review address a clearly focused issue?
in terms of:
  • the population studied
  • the intervention given
  • the outcomes considered.
3. Did the authors look for the appropriate sort of papers?
Did the studies address the review's question and have an appropriate study design?

Is it worth continuing?


Detailed questions

  Yes Can't tell No
4. Were the important, relevant studies included?
  • Databases searched, reference list follow-up,
  • Personal contacts, unpublished work
  • Non-English publications
  • Are the inclusion, exclusion criteria stated?
5. Did the authors assess the quality (rigour) of the included studies?      
6. If the results of the review have been combined, was this reasonable?
  • Were the studies sufficiently similar in design and results?
  • Are the results of included studies clearly displayed?
  • Are the reasons for any variation in the results discussed?

B/ What did they find?

7. What is the overall result of the review?
Include a numerical result with the confidence limits if available.


C/ Are the results relevant locally/to me?

  Yes Can't tell No
8. Can the results be applied to the local population?
  • Cultural differences?
  • Genetic differences?
  • Differences in medical practice?
9. Were all important outcomes considered?      
10. Is any information provided which could help you decide whether the benefits are worth the harms/costs (financial and otherwise)?
Summarise the cost information below, if available:
11. Accept for further use as Type I, III or IV evidence?   Refer to Team Leader  


Draft Statement (if appropriate):
(Remember to include the relevant target group (age range, sex etc.); the measured outcomes/benefits with quantitative information if available; and the Health gain notation)

Methodology Home Top