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    CAT Onko - Adhitya Wisnu Mahadewa

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    ahmad iffa maududy
    This document provides a summary of tools for critically appraising medical literature. It includes a screening tool to initially assess the validity and relevance of articles. It then provides descriptions of preferred study designs for evaluating therapy, diagnosis, and causation. The document also includes a table ranking levels of evidence from 1 to 5 for therapy/prevention studies, prognosis studies, and diagnosis studies. It concludes with grades of recommendation from A to D based on the levels of evidence.

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    CAT Onko - Adhitya Wisnu Mahadewa

    Uploaded by

    ahmad iffa maududy
    36 views9 pages
    This document provides a summary of tools for critically appraising medical literature. It includes a screening tool to initially assess the validity and relevance of articles. It then provides descriptions of preferred study designs for evaluating therapy, diagnosis, and causation. The document also includes a table ranking levels of evidence from 1 to 5 for therapy/prevention studies, prognosis studies, and diagnosis studies. It concludes with grades of recommendation from A to D based on the levels of evidence.

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    This document provides a summary of tools for critically appraising medical literature. It includes a screening tool to initially assess the validity and relevance of articles. It then provides descriptions of preferred study designs for evaluating therapy, diagnosis, and causation. The document also includes a table ranking levels of evidence from 1 to 5 for therapy/prevention studies, prognosis studies, and diagnosis studies. It concludes with grades of recommendation from A to D based on the levels of evidence.

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    © All Rights Reserved
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    Download as pptx, pdf, or txt
    36 views9 pages

    CAT Onko - Adhitya Wisnu Mahadewa

    Uploaded by

    ahmad iffa maududy
    This document provides a summary of tools for critically appraising medical literature. It includes a screening tool to initially assess the validity and relevance of articles. It then provides descriptions of preferred study designs for evaluating therapy, diagnosis, and causation. The document also includes a table ranking levels of evidence from 1 to 5 for therapy/prevention studies, prognosis studies, and diagnosis studies. It concludes with grades of recommendation from A to D based on the levels of evidence.

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    You are on page 1of 9

    CAT

    (Critical Appraisal of the Topics)

    Partial thyroidectomy for papillary


    thyroid microcarcinoma: Is
    completion total thyroidectomy
    indicated?
    Screen for Initial Validity and
    Relevance
    1. Is the article from a peer-reviewed
    journal ? Yes
    2. Is the location of the study similar to
    mine so that the results, if valid, would
    apply to my practice ? No
    3. Is the study sponsored by an organization
    that might influence the study design or
    results ? No
    4. Will this information, if true, have a direct
    impact on the health of my patients, and is
    it something they will care about ? Yes
    5. Is the problem addressed one that is
    common to my practice, and is the
    intervention or test feasible and available
    to me ? Yes
    6. Will this information, if true, require me
    to change my current practice ? No
    Clinical category Description Prefered Study Design

    Therapy Tests the effectiveness of a treatment, Randomized, double-


    such as a drug, surgical procedure, or blinded, placebo- controlled
    other intervention trial

    Diagnosis Measures the validity and reliability of a Case control study


    diagnostic test, or evaluates the
    effectiveness of a test in detecting disease at
    a presymptomatic stage when applied to a
    large population

    Causation Assesses whether a substance is related to


    Cohort or case-control
    the development of an illness or condition

    Prognosis
    Determines the outcome of a disease Longitudinal cohort study
    Level of Evidence
    Level Therapy/Prevention, Prognosis Diagnosis
    Aetiology/Harm

    1a SR (with homogeneity*) SR (with homogeneity*) SR (with homogeneity*) of


    of RCTs of inception cohort Level 1 diagnostic
    studies; CDR† studies; CDR† with 1b
    validated in studies from different
    different clinical centres
    populations

    1b Individual RCT (with Individual inception Validating case control


    narrow Confidence cohort study with > study with good
    Interval‡) 80% follow-up; reference standards; or
    CDR† validated in a Clinical Data
    single population Repository tested
    within one clinical
    centre
    1c All or none§ All or none case-series Absolute SpPins and
    SnNouts††
    Level of Evidence
    Level Therapy/Prevention, Prognosis Diagnosis
    Aetiology/Harm
    2a SR (with homogeneity* ) of SR (with homogeneity*) of SR (with homogeneity*) of
    cohort studies either retrospective cohort Level >2 diagnostic studies
    studies or untreated
    control groups in RCTs
    2b Individual cohort study Retrospective cohort Exploratory** cohort study with
    (including low quality RCT; study or follow-up of good†††reference standards;
    e.g., <80% follow-up) untreated control patients CDR† after derivation, or
    in an RCT; Derivation of validated only on split-sample
    CDR† or validated on or databases
    split-sample only
    2c "Outcomes" Research; "Outcomes" Research
    Ecological studies
    Level of Evidence
    Level Therapy/Prevention, Prognosis Diagnosis
    Aetiology/Harm
    3a SR (with homogeneity*) of SR (with homogeneity*) of 3b
    case-control studies and better studies
    3b Individual Case-Control Non-consecutive study; or
    Study without consistently applied
    reference standards

    4 Case-series (and poor quality Case-series (and poor Case-control study, poor or
    cohort and case-control quality prognostic cohort non-independent reference
    studies§§ ) studies***) standard
    5 Expert opinion without Expert opinion without Expert opinion without explicit
    explicit critical appraisal, or explicit critical appraisal, critical appraisal, or based on
    based on physiology, bench or based on physiology, physiology, bench research or
    research or "first principles" bench research or "first "first principles"
    principles"
    Grades of Recommendation
    A consistent level 1 studies

    B consistent level 2 or 3 studies or


    extrapolations from level 1 studies
    C level 4 studies or extrapolations from
    level 2 or 3 studies
    D level 5 evidence or troublingly
    inconsistent or inconclusive studies of
    any level

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