Home>Systematic Review-Appraisal Guide

Systematic Review Appraisal Guide

Therapy Focus

Questions to Ask Yourself

Are the results valid?

* Note that these validity criteria can be applied to systematic reviews in any domain (Therapy, Diagnosis, Harm, Prognosis)

1. Did the overview address a focused clinical question?

arrowPatients? Exposures? Outcomes?
arrowTherapy? Causation? Diagnosis? Prognosis?


2.Were the criteria used to select articles for inclusion appropriate?

arrowPatients? Exposures? Outcomes? Methodological standards?
arrowWas there a thorough literature review conducted?


3. Is it unlikely that important, relevant studies were missed? All

arrowRelevant databases searched?
arrowReference lists?
arrowPersonal contacts?
arrowDetailed search strategy provided?


4. Was the validity of the included studies appraised?

arrowValidity criteria?


5. Were assessments of studies reproducible?

arrowBlinded reviewers?
arrowInter-observer agreement?


6. Were the results similar from study to study?

arrowTests of homogeneity?


What are the results?

*Note that these questions apply only to systematic reviews of therapy

1.What are the overall results of the review?

arrowOverall ORs,RRs?
arrowWeighting of studies?


2. How precise were the results?

arrowConfidence intervals?


3. Did the study have a sufficiently large sample size?

Vanderbilt- Power and Sample Size Calculator


Will the results help me in patient care?

*Note that these questions apply only to systematic reviews of therapy

1. Can the results be applied to my patients?

arrowPatients similar for demographics, severity, co-morbidity and other prognostic factors?
arrowCompelling reason why they should not be applied?


2. Were all clinically relevant outcomes considered?

arrowAre surrogate endpoints valid?


3. Are the benefits worth the harms and costs?

arrowNNT for different outcomes?