CASP Checklist: Assessing Validity, Results, and Relevance of a Randomised Controlled Trial

In this document we will discuss about CASP Checklist and below are the summary points of this document:- CASP Checklist: 11 questions to assess a Randomised Controlled Trial's validity, results, and local relevance. Three broad issues to consider when appraising a trial: validity of results, understanding the results, and local applicability. Designed to aid systematic thinking, the checklist helps assess the trial's validity and determine its relevance.

CASP Checklist: 11 questions to help you make sense of a Randomised
Controlled Trial
How to use this appraisal tool: Three broad issues need to be
considered when appraising a trial:
Are the results of the study valid? (Section A)
What are the results? (Section B)
Will the results help locally? (Section C)
The 11 questions on the following pages are designed to help you think
about these issues systematically. The first three questions are screening
questions and can be answered quickly. If the answer to both is “yes”, it
is worth proceeding with the remaining questions. There is some degree
of overlap between the questions, you are asked to record a “yes”, “no”
or “can’t tell” to most of the questions. A number of italicised prompts are
given after each question. These are designed to remind you why the
question is important. Record your reasons for your answers in the spaces
provided.
About: These checklists were designed to be used as educational
pedagogic tools, as part of a workshop setting, therefore we do not
suggest a scoring system. The core CASP checklists (randomised
controlled trial & systematic review) were based on JAMA 'Users’ guides
to the medical literature 1994 (adapted from Guyatt GH, Sackett DL, and
Cook DJ), and piloted with health care practitioners.
For each new checklist, a group of experts were assembled to develop
and pilot the checklist and the workshop format with which it would be
used. Over the years overall adjustments have been made to the format,
but a recent survey of checklist users reiterated that the basic format
continues to be useful and appropriate.
Referencing: we recommend using the Harvard style citation, i.e.:
Critical Appraisal Skills Programme (2018). CASP (insert name of checklist
i.e. Randomised Controlled Trial) Checklist. [online] Available at: URL.
Accessed: Date Accessed.
©CASP this work is licensed under the Creative Commons Attribution –
Non-Commercial-Share A like. To view a copy of this license, visit
http://creativecommons.org/licenses/by-nc-sa/3.0/ www.casp-uk.net

Critical Appraisal Skills Programme (CASP) part of Oxford Centre for Triple Value Healthcare Ltd www.casp-uk.net

Paper for appraisal and reference:............................................................................................................
Section A: Are the results of the trial valid?
1. Did the trial address a
clearly Yes Yes
HINT: An issue can be ‘focused’ In
terms of
focused issue? Can’t Tell • the population studied
• the intervention given
No • the comparator given
• the outcomes considered
Comments:
The issue have been considered
absolutely clearly in the articles.
The article not only articulates the
beneficial facts related to Fish oil
and the fish oil supplements.
Rather, why the issue highlighted
is an issue now, have also been
justified in here. The viewpoints of
the experts in the field of medicine
have been also considered in order
to substantiate the facts against
which the issue have been
evaluated in this article. Through
the two articles, the impacts of fish
oil have been considered from
various perspectives. In the first
article, the researchers highlight
the impacts of fish oil in memory
replenishment. Again, in the
second article, the importance of
dish oil have been established from
the perspective of combating the
impacts of junk food. In the first
article the issue of mental disparity
have been highlighted in detail and
the ways in which fish oil impacts
in order to combat mental disorder
have been discussed.
On the contrary in the second
article, the causative agents and the
external sources like junk foods
that can in turn cause mental
disorder have been mentioned.
Again, the role of fish oil in
subsidising the impacts of such
things has been discussed.
2. Was the
assignment of
patients to
tr eatments randomised?

Yes
Can’t Tell
Cannot tell
No
HINT:
Consider
• how this was carried
out
• was the allocation sequence
concealed from
researchers and
patients
Comments:
The allocation sequence had been concealed for the
researcher. However, the assignment was not absolutely
randomised. The research is related to the course of study
and the research work involved the empirical findings of
doctors, dieticians and other experts also. Hence, clearly
stating whether the allocation process of this assignment
was randomised or not is beyond the scope of the
researcher.
3. Were all of the patients Yes
who entered the trial
properly accounted for at Can’t Tell
its conclusion?
No
HINT: Consider
• was the trial stopped
early
• were patients analysed in the
groups to which they
were randomised
There was adequate representation of the patient’s’ data that had been accumulated in the research study. The
consequences that they were suffering and the causative agents of such consequences had been considered properly. As
an outcome, the way in which the research respondents were incorporated in the research study had been discussed in
detail in the concluding part of the research study. The interpretation of the patients’ data had been presented in a
simplified way by the researcher and this had been done. The expert’s decisions and the opinions have been
wonderfully tallied with the data that have been collected from the patients who have been assimilated for observation.
Is it worth continuing?
This is indeed worth continuing as future research regarding the impacts of fish oil as
treatment and cure can help people in the long run. The oily fishes are part of staple diet
of most of the people. As such, the medicinal values can be explored with great impact.
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4. Were patients, health Yes
workers and study
personnel
‘blind’ to treatment? Can’t Tell
No No
The health workers, patients
as well as the study
personnel, most importantly,
had considered the ways in
which fish oil can be used for
the purpose of creating
medicine. Most prominently,
as the articles discusses, the
level of omega 3 fatty acids
is present in reduced
proportion in the people who
are having the Alzheimer’s.
This is why an in depth
research and reflection have
been made in the article
regarding how supplements
can be prepared from the
fish oil. In the second article,
the researcher has
considered and analysed on
what occasions, the fatty
acid supplements made
from fish oil can be used as
cure to various diseases
also.
5. Were the groups similar at Yes the
start of the trial
Can’t Tell
No
HINT: Consider
• other factors that might
affect the outcome, such as;
age, sex, social class
There were some basic similarities at the advent of the group formation. However
there where intrinsic and extrinsic factors that segregated the group members from
one another. The project was conducted by students who came from various
demography and ethnic origin. That is why they were bound to be different from one
another. All of them were almost of similar age group other than 3 senior members
and the project lead. The gender differences were not counted as a factor of

differentiation for this project. Other factors that could affect outcome of the project
where experience level of the group members and their interactive capacity. In the
project stations that we had at the initial part of the project, the project manager
help us to develop our inherent attitude so that we could conduct any and every
action that was needed for the conduction of the project. This involved coordinating
which people freely, approaching people of all levels easily for project work and so
on.
6. Aside from the
experimental Yes
intervention, were the
groups yes
treated equally? Can’t Tell
No
Comments:
There was equal level of treatment
among the group members respective of
the class, please, 6 or social origin and
social class. Other than the experimental
interventions they all receive the same
kind of treatment, food, accommodation
as well as the other facilities that they
required. The rate of impact of
supplement was need to be observed
carefully and this is equal to count of all
the members was more essential so that
in any way the impact of the
implementation of the medication or
supplements did not turn out to be
different for the different groups owing to
difference in treatment towards them.
Section B: What are the results?
The result of strategic implementation was that the outcome of the experimental
intervention came in the way that was expected by the researchers. This internet
prove that the groups were treated equally and absolutely clinically as was expected
while they were chosen as the groups for the requisite study.
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7. How large was the treatment effect?
•
HINT:
Consider what
outcomes were
measured
• Is the primary outcome clearly
specified
• what results were found for
each outcome
The treatment effect was different from the group that were utilised for the research studies. In the first observation group,
conflicting results were obtained from the studies which revealed absolutely no impact from implementation of supplements among
the dementia patients. However, among the people with Alzheimer's disease, the supplements having Omega 3 fatty acid DHA
obtained from the fatty oils in marine fishes had a great impact in the prevention of memory decline.
Other studies involving people who are of a higher age group and complained to have memory issues, revealed in a report that they
were having prostaglandins leukotrienes as well as essential fatty acids in very less proportion. Appreciate of 24 weeks was the
observatory period during which time major supplements where provided to the selected Focus Group and by the end of the period
comma the Marine oil supplements leads to significant improvement in the memory test scores well compared to those having
dummy tablets.
8. How precise was the estimate of the
treatment
HINT:
Consider
effect?
• what are the confidence
limits
Comments:
Shipment effect was highly precise because implementation was
done carefully and people of selective age groups as well as other
demographic factors have been observed in order to selecting for
the focus study. Besides, the focus study was taken place for 24
weeks and any conclusion that is drawn after long an extensive
study period of 24 months is bound to be precise in its Returns.
Section C: Will the results help locally?
Again among the group of the Brightons, it was observed that they were having only 19 grams of the oily fishes weekly compared to the land that
is 140 grams that the government it remains as the standard for receiving the adequate level of fish oil.
9. Can the results be applied
to Yes yes HINT: Consider whether
the local population, or in
• the patients covered by the trial
are
your context? Can’t Tell
similar enough to the patients to
whom
you will apply this
No • how they differ

The results showed how the public health nutritionist who were in charge of the evidence collection for supplements containing fish oil would be
able to understand the level of dosage of the supplements and hence new medication dosage could be discovered in the future. The studies
returned that fish oil help in better performance in the officers as well as insured ASAP available memory which indicated the potential of delaying
the onset of the cognitive decline and established the fact that supplements containing DHA could help in the improvement of learning and
memory function. The lake in the nutritive value of the diet of some segment of Australian dollars evident through this research study. Indian
communities the country did not have any level of Omega 3 in their balanced diet and for such people found out that supplements where the best
alternative. This is one way in which the local people can be helped with this research study.
10. Were all clinically
important Yes HINT: Consider whether
outcomes considered? Yes
• there is other information you
would
Can’t Tell like to have seen
• if not, does this affect the decision
No
Comments:
The factor that was most needed to
be started is the impact of the
Omega 3 fatty acid that is contained
in the fish oil in the context of
feeling mentally illnesses of various
kinds. The quality of the fatty acid
that is present in the fishes that
were named in the article was also
needed to be assessed. Again it was
also assessed in the article how
extraction of essential fatty acid
from the fish should be done and
what proportion of essential
supplement was present in the
fishes and consequently what
proportion of fish consumption was
essential for consumption of the
right amount of supplement. I
suppose all these elements like you
me and clinical is studied in the
research study and hence the most
important not comes where actually
considered here in this research
study.
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11. Are the benefits worth
the Yes HINT: Consider
harms and costs? Yes • even if this is not addressed by the
Can’t Tell trial, what do you think?
No
Comments:
There was hardly any harm done to any
of the respondents are the participants
or even the experts or group members
participating in the research studies.
again it was the crucial outcome to
reach by means of conduct in this
research study as the outcome that
could be reached would be of global
importance here in. as an outcome it
can we will stated that the harm and
cost that was entered during the
research study was justified in the
context of the benefit that were
reaped.

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