CASP Checklist Analysis: Review of Healthcare Research Studies

This document presents a detailed analysis of several healthcare studies using the CASP (Critical Appraisal Skills Programme) checklist. The analysis covers three types of studies: a review study, an experimental (randomized control) study, and a cohort study. For each study, the analysis systematically evaluates the validity of the results, the nature and precision of the results, and the potential for applying the results locally. The CASP checklist is applied to assess various aspects, including the focus of the study, the methodology (e.g., randomization, cohort recruitment), the measurement of exposure and outcomes, consideration of confounding factors, and the completeness and duration of follow-up. The results of each study, including the treatment effects, precision of estimates, and implications for practice, are summarized. The analysis also considers the applicability of the results to the local population and whether the findings align with other available evidence, with a particular focus on interventions related to hand hygiene and its impact on healthcare practices.

CASP checklist for the included review study
CASP criteria for review study
Study Name
Gould et al., 2017 Luangasanatip et al.,
2015
Section A: Are the results of the review valid?
1. Did the review address a clearly
focussed question? Yes Yes
2. Did the author look at the right type
of paper? Yes Yes
3. Do you think all the important,
relevant studies were included? Yes yes
4. Did the review’s authors do enough
to assess quality of the included
studies?
Yes – Each studies
were hand assessed
using EPOC checklist
Yes – each considered
study had met quality
criteria set by authors
5. If the results of the review have
been combined, was it reasonable to
do so?
Yes Yes
Section B: What are the results?
6. What are the overall results of the
review?
Robust research is
needed in urgent
manner to increase the
hand hygiene
compliance
Promotion of hand
hygiene increases the
compliance among
health-workers.
7. How precise are the results? Not mentioned Very. CI is at 95 %
Section C: Will the results help locally?
8. Can the results be applied to the
local population? Yes Yes
9. Were all important outcomes
considered? Yes Yes
11. Are the benefits worth the harms
and costs? Yes Yes
CASP checklist for the included experimental study:
CASP criteria for randomized
control study
Study Name
Chassin, Mayer &
Nether, 2015
Allegranzi et al.,
2013
Section A: Are the results of the trial valid?

1. Did the trial address a clearly
focussed issue? Yes Yes
2. Was the assignment of patients to
treatments randomised? Yes Yes
3. Were all of the patients who
entered the trial properly accounted
for at its conclusion?
Yes Yes
4. Were patients, health workers and
study personal ‘blind’ to treatment? No No
5. Were the groups similar at the
start of the trial? Yes Yes
6. Aside from the experimental
intervention, were the groups treated
equally?
Yes Yes
Section B: What are the results?
7. How large was the treatment
effect?
Eight hospitals from
USA volunteered to
participate in this
investigation.
43 hospitals were
studied in 5 different
countries
8. How precise was the estimate of
the treatment effect?
Very. P value was less
than 0.001
Estimates were very
precise as the CI was
at 95 % and p value
<0.0001
Section C: Will the results help locally?
9. Can the results be applied to the
local population, or in your context? Yes Yes
10. Were all clinically important
outcomes considered? Yes Yes
11. Are the benefits worth the harms
and costs?
Yes, both the benefits
and risk factors are
considered by the
authors
Yes, both the benefits
and risk factors are
considered by the
authors
CASP checklist for the included cohort study:
CASP criteria for cohort study Study Name
Srigley et al., 2014
Section A: Are the results of the study valid?
1. Did the study address a clearly focused
issue? Yes
2. Was the cohort recruited in an
acceptable way? Yes

3. Was the exposure accurately measured
to minimise bias? Yes
4. Was the outcome accurately measured
to minimise bias? Yes
5. (a) Have the authors identified all
important confounding factors? Yes
5. (b) Have they taken account of the
confounding factors in the design and/or
analysis?
Yes
6. (a) Was the follow up of subjects
complete enough? Yes
6. (b) Was the follow up of subjects long
enough?
Yes – 8 month long follow up was
performed
Section B: What are the results?
7. What are the results of this study? Presence of auditors increased the rate of
hand hygiene approximately by three fold
8. How precise are the results? Results were significant with p value
equal to or less than 0.001
9. Do you believe the results? Yes. The results are credible.
Section C: Will the results help locally?
10. Can the results be applied to the local
population? Yes, it can be applied to local population.
11. Do the results of this study fit with
other available evidence?
Yes, this is in compliance with other
available evidence.
12. What are the implications of this study
for practice?
Hawthorne effect increase the rate of
sanitizer use in the health workers.

Bibliography
Allegranzi, B., Gayet-Ageron, A., Damani, N., Bengaly, L., McLaws, M. L., Moro, M. L., ...
& Donaldson, L. (2013). Global implementation of WHO's multimodal strategy for
improvement of hand hygiene: a quasi-experimental study. The Lancet infectious
diseases, 13(10), 843-851.
Chassin, M. R., Mayer, C., & Nether, K. (2015). Improving hand hygiene at eight hospitals in
the United States by targeting specific causes of noncompliance. The Joint
Commission Journal on Quality and Patient Safety, 41(1), 4-12.
Gould, D. J., Moralejo, D., Drey, N., Chudleigh, J. H., & Taljaard, M. (2017). Interventions
to improve hand hygiene compliance in patient care. Cochrane database of systematic
reviews, (9).
Luangasanatip, N., Hongsuwan, M., Limmathurotsakul, D., Lubell, Y., Lee, A. S., Harbarth,
S., ... & Cooper, B. S. (2015). Comparative efficacy of interventions to promote hand
hygiene in hospital: systematic review and network meta-analysis. bmj, 351, h3728.
Srigley, J. A., Furness, C. D., Baker, G. R., & Gardam, M. (2014). Quantification of the
Hawthorne effect in hand hygiene compliance monitoring using an electronic
monitoring system: a retrospective cohort study. BMJ Qual Saf, 23(12), 974-980.