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CASP Checklist: 11 Questions for Case Control Study Appraisal

   

Added on  2023-06-06

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Critical Appraisal Skills Programme (CASP) part of Better Value Healthcare Ltd www.casp-uk.net
CASP Checklist: 11 questions to help you make sense of a Case Control Study
How to use this appraisal tool: Three broad issues need to be considered when appraising a
case control study:
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. Case Control Study) 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

2
Section A: Are the results of the trial valid?
1. Did the study address a
clearly focused issue?
Yes HINT: An issue can be ‘focused’ In terms of
• the population studied
• Whether the study tried to detect a
beneficial or harmful effect
• the risk factors studied
Can’t Tell
No
Comments:
2. Did the authors use an
appropriate method to
answer their question?
Yes HINT: Consider
• Is a case control study an appropriate
way of answering the question under
the circumstances
• Did it address the study question
Can’t Tell
No
Comments:

3
Is it worth continuing?
3. Were the cases recruited in
an acceptable way?
Yes HINT: We are looking for selection bias
which might compromise validity of the
findings
• are the cases defined precisely
• were the cases representative of a
defined population (geographically
and/or temporally)
• was there an established reliable
system for selecting all the cases
• are they incident or prevalent
• is there something special about the
cases
• is the time frame of the study
relevant to disease/exposure
• was there a sufficient number of
cases selected
• was there a power calculation
Can’t Tell
No
Comments:
4. Were the controls selected in
an acceptable way?
Yes HINT: We are looking for selection bias
which might compromise the
generalisability of the findings
• were the controls representative of the
defined population (geographically
and/or temporally)
• was there something special about
the controls
• was the non-response high, could
non-respondents be different in
any way
• are they matched, population
based or randomly selected
• was there a sufficient number of
controls selected
Can’t Tell
No
Comments:

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