CASP Checklist -10 questions to help you make sense of a Systematic Review

(A) Are the results of the review valid?

Screening Questions

1. Did the review address a clearly focused question?
HINT: An issue can be ‘focused’ In terms of

• The population studied
• The intervention given
• The outcome considered

Yes Can’t tell No

2. Did the authors look for the right type of papers?
HINT: ‘The best sort of studies’ would

• Address the review’s question
• Have an appropriate study design (usually RCTs for papers evaluating interventions)

Yes Can’t tell No

Is It worth continuing?

Detailed Questions

3. Do you think all the important, relevant studies were included?
HINT: Look for

• Which bibliographic databases were used
• Follow up from reference lists
• Personal contact with experts
• Search for unpublished as well as published studies
• Search for non-English language studies

Yes Can’t tell No

4. Did the review’s authors do enough to assess the quality of the included studies?
HINT: The authors need to consider the rigour of the studies they have identified. Lack of rigour may affect the studies’ results. (“All that glisters is not gold” Merchant of Venice – Act II Scene 7)

Yes Can’t tell No

5. If the results of the review have been combined, was it reasonable to do so?
HINT: Consider whether

• The results were similar from study to study
• The results of all the included studies are clearly displayed
• The results of the different studies are similar
• The reasons for any variations in results are discussed

Yes Can’t tell No

(B) What are the results?

6. What are the overall results of the review?
HINT: Consider

• If you are clear about the review’s ‘bottom line’ results
• What these are (numerically if appropriate)
• How were the results expressed (NNT, odds ratio etc)

Yes Can’t tell No

7. How precise are the results?
HINT: Look at the confidence intervals, if given

Yes Can’t tell No

(C) Will the results help locally?

8. Can the results be applied to the local population?
HINT: Consider whether

• The patients covered by the review could be sufficiently different to your population to cause concern
• Your local setting is likely to differ much from that of the review

Yes Can’t tell No

9. Were all important outcomes considered?
HINT: Consider whether

• Is there other information you would like to have seen

Yes Can’t tell No

10. Are the benefits worth the harms and costs?
HINT: Consider

• Even if this is not addressed by the review, what do you think?

Yes Can’t tell No