Quick refernece sheet for critical appraisal teams

Appraisal Checklists

A systematic review

A randomised controlled trial

Another interventional study (eg before-and-after design)

An observational study (eg cohort, case-control)

Additional questions for a qualitative study

An economic analysis (cost-effectiveness analysis)

AGREE 0 Appraisal tool for guidelines, web-site link

Bulletin format

Quick reference sheet for critical appraisal teams

Health Evidence Bulletins - Wales: Reference page for Critical Appraisal Teams

Statements should include a brief summary of the supporting evidence including, where possible:

The relevant target group - age range, sex etc.
The measured outcomes/benefits with quantitative information where results are statistically significant (eg. % improvement, odds ratio etc. - and the confidence interval, if available)

Caveats should include any potential source of bias or other concerns about the quality and/or generalisability of the study.

Evidence should be cited:

using the Vancouver system (see below)
with an indication of the type of evidence (see below) and other relevant information as appropriate (eg "no. of patients in the trial = ...", "systematic review , literature search to December 2002, using Medline and Embase only” etc.)

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Guidance on Vancouver System

Standard periodical article:
You C H, Lee K Y, Chey R Y, Menguy R. Electrogastrographic study of patients with unexplained nausea, bloating and vomiting. Gastroenterology 1980; 79: 311-4.
(NB List all authors when six or less; when seven or more, list only first three and add et al)

Book or monograph:
Eisen H N. Immunology: an introduction to molecular and cellular principles of the immune response. 5th ed. New York: Harper and Row, 1974: 406.

Published proceedings:
DuPont B. Bone marrow transplantation in severe combined immuno-deficiency with an unrelated MLC compatible donor. In: White H J, Smith R, eds. Proceedings of the third annual meeting of the International Society for Experimental Hematology. Houston: International Society for Experimental Hematology, 1974:44-6.

World Wide Web page (no author)
High blood pressure in pregnancy [online]. 2001 [cited 2002 Oct 21]. Available from: URL: http://www.nhlbi.nih.gov/health/public/heart/hbp/hbp_preg.htm
(Author/editor (surname initials). Title [online]. Year [cited year month day]. Available from: URL:)

Type of evidence
‘Type I evidence’ - at least one good systematic review (including at least one randomised controlled trial).
‘Type II evidence’ - at least one good randomised controlled trial
‘Type III evidence’ - well designed other trials
‘Type IV evidence’ - well designed non-experimental studies
‘Type V evidence’ - expert opinion

Example

The Statements

The Evidence

1.25g. Standard self-help materials may increase quit rates compared to no intervention, but the effect is likely to be small. In 11 trials of self-help compared to no intervention there was a pooled effect that just reached statistical significance (odds ratio 1.24, 95% CI 1.07-1.45). No evidence was found that self-help interventions had an additional benefit when used alongside other interventions such as advice from a health care professional or nicotine replacement therapyi.

i. Lancaster T, Stead LF. Self-help interventions for smoking cessation. (Cochrane Review). In: The Cochrane Library, Issue 1 2003. Oxford: Update Software. (most recent update 11 April 2002)
http://www.update-software.com/abstracts/ab001118.htm [accessed 15.10.03]
(Type I evidence - systematic review, literature search to March 2002, of 51 trials)

Methodology

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