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. HEBW systematic review definition is based on the criteria used by NHS CRD for Database of Abstracts of Reviews of Effects (DARE.) http://agatha.york.ac.uk/faq4.htm
A/ What is this review about, and does it meet the systematic review criteria?
|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:
|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?
the important, relevant studies included?
|5. Did the authors assess the quality (rigour) of the included studies?|
Is it worth continuing?
B/ What are the findings and can they be trusted?
|6. If the results of the
review have been combined, was this reasonable?
|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?
|8. Can the results be
applied to the local population?
|9. Were all important
Consider reliability. Are outcome measures objective (i.e. a direct measure of change) or subjective (e.g. self reported).
|10. Is any cost information provided?||N/A|
|11. Accept for further use as Type I, III or IV evidence?||Refer to Team Leader|
To be classified as a systematic
review, the review should meet the criteria used by the NHS CRD for the Database
of Reviews of Effectiveness (DARE):
1) Are inclusion/exclusion criteria reported that address the review question?
2) Is there evidence of a substantial effort to search for all the relevant research literature;
3) Is the validity of the included studies adequately assessed?;
4) Is sufficient detail of the individual studies presented?;
5) Are the primary studies summarised appropriately?