CASP Checklist: 10 questions for Systematic Review Appraisal

This document provides a checklist of 10 questions to help researchers and healthcare practitioners appraise the validity and relevance of a systematic review. The checklist covers issues such as the clarity of the research question, the inclusion of relevant studies, the assessment of study quality, the appropriateness of combining results, and the applicability of the results to the local population. The checklist is designed for use in educational workshops and does not include a scoring system.

CASP Checklist:10 questions to help you make sense of aSystematic Review
How to use this appraisal tool:Three broad issues need to be considered when appraising
systematic review study:
Are the results of the study valid? (Section A)
What are the results?(Section B)
Will the results help locally?(Section C)
The 10 questions on the following pages are designed to help you
systematically.The first two questions are screening questions and can be
If the answerto both is “yes”, it is worth proceeding with the rem
some degree of overlap between the questions, you are asked to reco
“can’t tell” to most of the questions. A number of italicised prom
question. These are designed to remindyou why the question is impo
reasons for your answers in the spaces provided.
About: These checklists were designed to be used as educational peda
workshop setting, therefore we do not suggest a scoringsystem.
(randomised controlled trial & systematic review) were based on JAMA 'Use
medical literature 1994 (adapted from Guyatt GH, SackettDL, and Cook DJ),
health care practitioners.
For each new checklist, a group of experts were assembled to deve
and the workshop format with which it would be used. Over the years over
have been made to the format, but a recent survey of checklist user
format continues to be useful and appropriate.
Referencing: we recommend using the Harvard style citation, i.e.: Critical
Programme (2018). CASP (insert name of checklist i.e. Systematic Review) Chec
Available at: URL. Accessed: Date Accessed.
©CASPthis work is licensed under the Creative Commons Attribution –
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Section A: Are the results of the review valid?
1. Did the review address a
clearly focused question?
Yes HINT: An issue can be ‘focused’ I
• the population studied
• the intervention given
• the outcome considered
Can’t Tell
No
Comments:
2. Did the authors look for the
right type of papers?
Yes HINT: ‘The best sort of studies’ wo
• address the review’s question
• have an appropriate study design
(usually RCTs for papers evaluating
interventions)
Can’t Tell
No
Comments:
Is it worth continuing?
3. Do you think all the
important, relevant studies
were included?
Yes HINT: Look for
• which bibliographic databases w
used
• follow up from reference
• personal contact with expe
• unpublished as well as publish
• non-English language stud
Can’t Tell
No
Comments:
Paper for appraisal and reference:
✔
✔
✔

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4. Did the review’s authors do
enough to assess quality of
the included studies?
Yes HINT: The authors need to consider
rigour of the studies they have identifie
Lack of rigour may affect the stu
results (“All that glisters is not go
Merchant of Venice – Act II
Can’t Tell
No
Comments:
5. If the results of the review
have been combined, was it
reasonable to do so?
Yes HINT: Consider whether
• results were similar from study to
• results of all the included
clearly displayed
• results of different studies are
• reasons for any variations in
discussed
Can’t Tell
No
Comments:
Section B: What are the results?
6. What are the overall results of the review? HINT: Consider
• If you are clear about
‘bottomline’ results
• what these are (numerically
appropriate)
• how were the results expressed
odds ratio etc.)
Comments:
✔
✔

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7. How precise are the results? HINT: Look at the confidence interva
given
Comments:
Section C: Will the results help locally?
8. Can the results be applied to
the local population?
Yes HINT: Consider whether
• the patientscoveredby the review
could be sufficiently different to
population to cause concern
• your local setting is likely to differ
from that of the review
Can’t Tell
No
Comments:
9. Were all important outcomes
considered?
Yes HINT: Consider whether
• there is other information you wo
like to have seenCan’t Tell
No
Comments:
10. Are the benefitsworth the
harms and costs?
Yes HINT: Consider
• even if this is not addresse
review, what doyou think?Can’t Tell
No
Comments:
✔
✔
✔