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Critical Appraisal Skills Programme (CASP) -12 questions to help you make sense of a diagnostic test study Checklist

(A) Are the results of the study valid?

Screening Questions

1. Was there a clear question for the study to address?
HINT: A question should include information about

  • The population
  • The test
  • The setting
  • The outcomes

Yes Can’t tell No

2. Was there a comparison with an appropriate reference standard?
HINT: Is this reference test(s) the best available indicator in the circumstances?

Yes Can’t tell No

Is it worth continuing?

Detailed questions

3. Did all patients get the diagnostic test and reference standard?
HINT: Consider

  • Were both received regardless of the results of the test of interest
  • Check the 2X2 table (verification bias)

Yes Can’t tell  No

4. Could the results of the test have been influenced by the results of the reference
standard?
HINT: Consider

  • Was there blinding?
  • Were the tests performed independently
  • (Review bias)

Yes Can’t tell  No

5. Is the disease status of the tested population clearly described?
HINT: Consider

  • Presenting symptoms
  • Disease stage or severity
  • Co-morbidity
  • Differential diagnoses (Spectrum Bias)

Yes Can’t tell  No

6. Were the methods for performing the test Described in sufficient detail?
HINT: Consider

  • Was a protocol followed?

Yes Can’t tell  No

(B) If so, what are the results?

7. What are the results?
HINT: Consider

  • Are the sensitivity and specificity and/or likelihood
    ratios presented?
  • Are the results presented in such a way that
    We can work them out?

Yes Can’t tell No

8. How sure are we about the results? consequences and cost of alternatives performed?
HINT: Consider

  • Could they have occurred by chance?
  • Are there confidence limits?
  • What are they?

Yes Can’t tell No

(C) Will the results help me and my patients/population?

(Consider whether you are primarily interested in the impact on a population or individual level)

9. Can the results be applied to your patients/the population of interest?
HINT: Do you think your patients/population are so different from those in the study that the results cannot be applied?
Such as age, sex, ethnicity and spectrum bias.

Yes Can’t tell No

10. Can the test be applied to your patient or population of interest?
HINT: Consider

  • Resources and opportunity costs
  • Level and availability of expertise required to Interpret the tests
  • Current practice and availability of services

Yes Can’t tell No

11. Were all outcomes important to the individual or population considered?
HINT: Consider

  • Will the knowledge of the test result improve patient wellbeing?
  • Will the knowledge of the test result lead to a change in patient management?

Yes Can’t tell No

12. What would be the impact of using this test on your patients/population?

Yes Can’t tell No

Critical Appraisal Skills Programme (CASP) -12 questions to help you make sense of a diagnostic test study Checklist
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